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Primitive Reflexes and Integration: What are they and why is this important?

The topic of primitive reflexes is not always a simple one to understand. There is a tremendous amount of data and information that we will not be able to cover in this short blog; however, we will provide a basis of understanding, with resources for further evaluation. Primitive reflexes surface in the womb and during infancy and are designed to become interactive after the toddler stage. These reflexes are extremely important as they are the basis of our nervous system and our ability to move. After a certain age, these reflexes merge into more sophisticated movements, and that is when we refer to the reflex as being “integrated.” Once this primitive reflex is integrated it is no longer active in the child.  Most primitive reflexes are integrated by the age of 2 years at the latest. 

Possible causes of retained primitive reflexes:

  • Lack of sufficient movement in early childhood. Plastic carriers, propping devices, playpens, walkers, swings, jumpers and car seats all restrict movements required for brain development. TV and computer use also hamper opportunities for movement. 
  • Stress of the mother during pregnancy, breech birth, birth trauma, Caesarean or exposure to sonograms. 
  • Illness, trauma, injury, chronic stress. 
  • Environmental toxins and plastics; complications with vaccinations; exposure to electronic pollution. 

The 8 basic primitive reflexes:

  • Rooting Reflex:
    • What it looks like: When an infant’s cheek is stroked, the baby turns their head toward the touch and opens their mouth for food. 
    • Why it happens: Helps to ensure successful first feedings from the breast or bottle. 
  • Moro Reflex:
    • What it looks like: When a baby’s head suddenly falls back into extension when it is not being supported, the baby first extends their arms, arches their back, and then extends thier legs. Next, s/he will flex their entire body, almost like they are curling up into a ball. 
    • Why it happens: This is a primitive fight or flight reaction and is often called a “startle reflex.” 
  • Grasping Reflex:
    • What it looks like: When you stroke an infant’s palm, the reflexive response is a fisted, tight grip – so strong that it can allow a baby to carry its own weight! 
    • Why it happens: May prepare a baby’s hand muscles for being able to voluntarily hold onto an object and may be related to the evolutionary ability of an infant to hold onto his/her mother. 
  • Asymmetrical Tonic Neck Reflex:
    • What it looks like: When a baby’s head is turned to one side, the arm and leg extend on the side their face is turned toward while the opposite arm and leg flex. 
    • Why it happens: Supports early development of hand-eye coordination, provides vestibular input. 
  • Symmetrical Tonic Reflex:
    • What it looks like: When a baby’s neck flexes, their arms flex and legs extend. As the neck is extended, the arms extend and the legs flex. 
    • Why it happens: Helps baby get into a quadruped position and prepares them for crawling. 
  • Babinski Reflex:
    • What it looks like: When the bottom of a baby’s foot is stroked, their foot twists inward and the toes fan outward in response. 
    • Why it happens: A sign of a healthy central nervous system.
  • Landau Reflex:
    • What it looks like: When a baby is held horizontally in the air (face and tummy down), their head will stay raised and legs will be slightly flexed. 
    • Why it happens: Assists with postural development. 
  • Primitive Walking: 
    • What it looks like: This is a series of stepping motions of the infant’s legs when you hold them under the arms and their feet contact the floor. 
    • Why it happens: Unknown, but many say that it integrates early as nature’s way of saying the baby is not quite ready to walk. 

Why is this important to know?

Automatic reflex movements are essential for the development of balance, mobility, vision, hearing, speaking, learning and communicating. Sometimes a child who fidgets in his or her chair and cannot focus is more than likely suffering from active reflexes. Once reflexes are integrated, head and limb muscle groups can move independently, and the ability to sit attentively without fidgeting comes easily. Active reflexes cause aches and muscle tension, weak muscle tone, fatigue and the need for great amounts of effort to complete tasks. This can have a direct impact on a child’s ability to complete writing and reading tasks.

What is my next step?

If you observe challenges in your child and suspect it may be secondary to an unintegrated primitive reflex, it is best to consult with your child’s medical doctor, and request an evaluation by a licensed therapist such as an occupational therapist, physical therapist or a therapist who specialized in the integration of primitive reflexes.

-JJ Schweikert, MOT, OTR/L


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