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The Reflexes


Each one of us is born with a set of primitive reflexes (sometimes known as survival reflexes). As the infant brain develops during the first year of life connections to higher centres in the brain become stronger and increasingly take over the functions of primitive reflexes. As this occurs, early survival patterns are inhibited or controlled to allow more mature patterns of response (postural reflexes) to develop in their place. The postural reflexes support control of balance, posture and movement in a gravity based environment. Postural reflex development is mirrored in the infant's increasing ability to control its body, posture and movements.

If these primitive reflexes are not fully integrated during infancy, control of voluntary, skilled and complex movements can be affected. This is known as Neuro Developmental Delay (NDD) or Neuro-Motor Immaturity (NMI).


Some children fail to gain this control fully in the first year of life and continue to grow up in a reflexive ‘no man’s land’, where traces of the primitive reflexes remain present and the postural reflexes do not develop fully. These children continue to experience difficulty with control of movement affecting coordination, balance, fine motor skills, motor development and associated aspects of learning such as reading, writing and physical education.  These uninhibited reflexes can interfere with subsequent motor development, visual functioning, hand-eye coordination and perceptual skills. If the physical nature of these difficulties is not identified, it can lead to frustration, hyperactivity, stress, hypersensitivity, and emotional problems later on. It can also interfere with concentration and short term memory. Retained primitive reflexes can also affect a child’s sensory perceptions, causing hypersensitivity in some areas and hyposensitivity in others.

The Primitive Reflexes

The Symmetrical Tonic Neck (STNR) Reflex


The STNR is present in normal development from circa 8 to 11 months of post-natal life and is a precursor to crawling on the hands and knees.

STNR in extension and in flexion









If it remains present in an older child, it can affect:

  • Integration of upper and lower portions of the body

  • Sitting posture (tendency to slump when sitting at a desk or a table). A conventional learning position is very uncomfortable for this child

  • Poorly developed muscle tone This child is more likely to slump when sitting at a desk or a table, sit on their legs or generally twist and turn resulting in inattention and possibly hyperactivity.

  • Poor hand-eye co-ordination. Will be quite slow at copying tasks

STNR Flexion
STNR Extension
The Tonic Labyrinthine (TLR) Reflex


Inhibition of the TLR is a gradual process involving the maturation of other systems. It should be completed by three and a half years of age.

TLR in extension and in flexion









​If it persists beyond this time, it is often associated with:

  • A greater tendency to reverse letters or mix them up with similar letters (bd / pq)

  • Sequencing difficulties which can affect the ability to learn off the days of the week, months of the year, maths tables, or remember a sequence of instructions

  • Postural problems resulting in the child with floppy or tight muscles who may have a tendency to walk on their toes

  • History of motion sickness

  • Orientation and spatial difficulties with a direct impact on our concept of time, understanding and giving directions, or maths ability

  • Dislike of Physical Education (PE)

  • Poor balance

TLR Flexion
TLR Extension
The Moro Reflex


The Moro reflex acts as a baby's primitive fight/flight reaction. It should be inhibited by circa 4 months of post-natal life to be replaced by an adult "startle" reflex.



If it persists in the older child, it can be associated with:

  • Hypersensitivity

  • Stimulus bound effect (cannot ignore peripheral stimuli to focus attention on one thing - has to pay attention to everything, very distractible)

  • Sensory overload which could result in child switching off or daydreaming

  • Anxiety

  • Emotional and social immaturity

  • Need to control and manipulate events

  • Physical timidity

  • Allergies and lowered immunity

  • Dislike of change or surprise - poor adaptability

Moro Reflex
Asymmetrical Tonic Neck Reflex (ATNR)


The ATNR is activated as a result of turning the head to one side. As the head is turned, the arm and leg on the same side will extend while the opposite limbs bend. The reflex should be inhibited by 6 months of age in the waking state.

If the ATNR remains active in a child at a later age, it can affect:

  • Hand-eye co-ordination - difficulties such as ability to control the arm and hand when writing resulting in an awkward pencil grip or turning of the page

  • What the child writes will generally be of a lesser standard than that which they can produce orally

  • Ability to cross the vertical midline. For example, a right-handed child may find it difficult to write on the left side of the page. Writing may slope one way then the other

  • Visual tracking will be more difficult i.e. the ability of the eyes to move over and back smoothly along a line of print when reading and writing. The child may have to use their finger when reading, or continually lose their place on the page

  • Bilateral integration (differentiated and integrated use of the two sides of the body) will be more difficult

  • Mixed-handedness above 8 years of age

References: Sarah Marshall (

Sally Goddard Blythe (Director, INPP): Reflexes, Learning and Behaviour

Spinal Galant Reflex


This reflex is present at birth and should be inhibited between 3 and 9 months of post-natal life.

If it persists it can affect:

  • Ability to sit still

  • Attention

  • Co-ordination

  • Posture

  • Sometimes associated with bedwetting

Spinal Galant

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Palmer Grasp Reflex Info Sheet
Pincer Grasp Info Sheet
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