Primitive Reflexes

Rooting Reflex

Birth - 3 months

Stimulus/Response: When a light touch is made on the side of the infant’s face near its mouth. The Infant turns head and opens mouth toward touch near the cheek or mouth (searching for breast/bottle).

Function: Essential for feeding, helps the infant locate the nipple and initiate sucking.

Lack of integration: Interferes with exploration of objects and head control

Signs of Retention: Anterior tongue tie, Thumb-sucking, Oral hypersensitivity, Feeding difficulties, Speech delays

Impact on Occupational Performance: Difficulty with feeding, swallowing, speech production, and oral-motor coordination.

What is this reflex?

Rooting

Moro Reflex

(Startle Reflex)

Birth to 4–6 months

Stimulus/Response: Dropping of the head at midline and in supine. Illicits sudden extension/abduction of arms followed by flexion when startled by loud noise, movement, or loss of support.

Function: Survival reflex to alert caregiver to potential danger.

Lack of Integration/Onset: Interferes with head control, sitting equilibrium, and protective reactions

Signs of Retention: Sleep disturbances, Hypersensitivity to sensory input, Emotional lability (easily upset), Poor balance, motion sickness, Weak immune system

Impact on Occupational Performance: Difficulty focusing, regulating emotions, adapting to change, and coordinating movements.

What is this reflex?

Moro Reflex

Palmar Reflex

Birth to 4–6 months

Stimulus/Response: •Autonomic Flexion of the fingers to grab when the palm is stimulated

Function: Foundation for voluntary grasp and release.

Lack of Integration or Onset: Interferes with releasing objects

Signs of Retention: Poor manual dexterity, Immature pencil grip, Dysgraphia, Poor posture during handwriting

Impact on Occupational Performance: Difficulty with fine motor skills, handwriting, tool use, and hand-eye coordination.

What reflex is this?

What reflex is this?

Palmar Reflex

Plantar Grasp Reflex

Birth to 4-9 months

Stimulus/Response: Firm pressure on bottom of foot toes curl/flex when pressure applied to sole of foot.

Function: Prepares foot muscles for standing and walking.

Lack of Integration: Interferes with putting on shoes b/c of toe clawing, gait, standing, and walking problems

Signs of Retention: Toe-walking, Poor balance/coordination, Gravitational insecurity, Motor planning difficulties

Impact on Occupational Performance: Poor balance & coordination, gravitational insecurity (fearful when their feet touch the ground), motor planning difficulties, sensory processing challenges, postural issues (difficulty sitting still in a classroom.

What is this reflex?

Plantar grasp

Neonatal Positive Support

Primary Standing

Birth to 1-2 months

Stimulus/Response: The infant is upright and being bounced several times on the soles of the feet. LE tone increases and some plantar, hip, and knee flexion is present,

Lack of integration or onset: interferes with walking Patterns and leads to walking on toes.

Function: Prepares legs for weight-bearing and walking.

Signs of Retention: Toe walking, poor balance/coordination, delayed motor skills (crawling, walking, jumping), Hypertonicity in lower extremities, sensory processing/emotional regulation, and social/academic challenges, Delayed crawling/walking

Impact on Occupational Performance: Challenges with sitting positions, posture, and gross motor milestones.

What is this reflex?

Neonatal Positive Support

Asymmetrical Tonic Neck Reflex (ATNR)

Bow and Arrow

Birth to 4-6 months

Stimulus/Response: Supine, arms and legs extended and head in midpostion. Head turn causes extension of arm/leg on face side and flexion on skull side.

Function: Hand-eye coordination, assists birth process.

lack of Integration or onset: interferes with reaching, grasping, bilateral hand use, and rolling

Impact on Occupational Performance: Inability to function well in school.

What is this reflex?

Asymmetrical Tonic Neck Reflex (ATNR)

Symmetrical Tonic Neck Reflex (STNR)

Crawling Reflex… think of cat/cow yoga pose

6 months to 9–11 months

Stimulus/Response: Quadruped position or over the tester’s knee. Head flexion causes arms to bend/legs extend; head extension causes arms to extend/legs bend

Function: Prepares infant for crawling, strengthens neck/back muscles.

Signs of Retention: Poor posture, Difficulty sitting still, Apelike crawling/walking, Poor coordination

Impact on Occupational Performance: Interferes with crawling, Difficulty with attention, seated work, reading/writing, and motor planning.

What is this reflex?

Symmetrical Tonic Neck Reflex (STNR)

Tonic Labyrinthine Reflex (TLR)

Birth to 4-6 months

Stimulus/Response: Arms and legs are moved into flexion or extension. The extensor tone of neck UE and LE increases and moves into flexion. Flexor tone of neck UE, and LE increases when moved into extension

Function: Develops postural control, balance, and muscle tone.

Lack of integration or onset: This interferes with and causes difficulties with turning on one side, rolling over, transitioning from lying to sitting, and crawling. In older children, it interferes with the ability to hold in supine flexion or assume a pivot prone position.

Signs of Retention: Poor balance, coordination, Toe-walking, Motion sickness, Difficulty with spatial awareness, abnormal tone, fear of heights. W leg position on floor when sitting

Impact on Occupational Performance: Trouble with posture, stairs, following movement directions, and gross motor tasks.

What reflex is this?

Tonic Labyrinthine Reflex (TLR)

Landau Reflex

“swimming” or Superman

3-4 mo to 12-24 mos

Definition/Response: When held horizontally, baby extends head, back, legs (like “superman”).

Function: Strengthens back muscles, promotes posture.

Lack of Integration/onset: slows down the development of prone extension, sitting, and standing. Early onset can indicate excessive tone ot spasticity.

Signs of Retention: Postural and motor coordination issues.

Impact on Occupational Performance: Poor posture, motor, and memory issues

WHat is this reflex?

Landau Reflex

Spinal Galant Reflex

Birth to 3

Definition/Response: Stroking one side of spine causes hip to flex and rotate toward stimulus.

Function: Assists with birth process, helps with crawling, helps baby urinate after birth and with cordination for belly-crawling and creeping

Signs of Retention: Bedwetting, Poor posture, Scoliosis, Restlessness/fidgeting, scoliosis, IBS

Impact on Occupational Performance: Difficulty sitting still, attention issues, fatigue, poor short-term memory.

What is this reflex?

Spinal Galant Reflex