I’ve specifically written this article with parents in mind and aim to provide an introductory, plain language approach. My intention is to describe the effects of retained or under-developed primitive and postural reflexes and how this profoundly manifests as learning, language, behaviour and physical difficulties. As a parent I recall experiencing an ‘aha’ moment when I first learned about the symptoms and characteristics of retained or under-developed reflexes, and amazement at how specific, neuro-developmental movements could restore natural early childhood development and facilitate learning success.
Primitive reflexes are essential for the baby’s survival in the first few weeks of life and are intended to have a limited life-span and, having helped the baby to survive the first hazardous months of life, they should become inhibited or controlled by higher centres of the brain. This allows more sophisticated neural structures to develop. A primitive reflex doesn’t involve thinking. It is an involuntary, automatic response given to a stimulus for example touch, noise. Postural reflexes are lifelong, automatic reactions for the maintenance of balance, stability and flexibility throughout the body and emerge from some of the primitive reflexes as they are inhibited.
Reflexes are intended to begin functioning in a particular order and are integrated in a specific sequence. If they are retained out of sequence, they disturb the development and integration of subsequent reflexes. The degree of abnormal reflex activity influences how poorly nerve fibers are organized, and this can affect gross muscle and fine muscle co-ordination, sensory perception, cognition and means of expression. Skills developed by a child later on are bound to an earlier stage of development and instead of becoming automatic, can only be mastered through continuous conscious effort, which is stressful. Neural development, not chronological age, determines at what time each reflex emerges and at what time it becomes inhibited. Although the child will have adequate intellectual ability, the fundamental equipment essential for learning will be faulty or inefficient.
Detection of retained primitive reflexes can help to isolate the causes of a child’s challenge so that a reflex stimulation and inhibition program using movements and activities can be targeted effectively. Movement lies at the heart of learning. Specific neuro-developmental movements facilitate the growth of material surrounding nerves, enabling enhanced transmission of nerve impulses and improved brain circuitry. As abnormal reflex activity is adjusted, more desirable neural networks are created and many of the physical, academic and emotional challenges of the child will disappear.
Fear Paralysis Reflex (FPR)
The fear paralysis reflex (FPR), also known as the withdrawal reflex, is the key to all other reflexes. It is the first reflex to emerge. It develops very early in utero and is intended to be integrated by week nine to twelve in the first trimester. If the FPR does not follow the intended route of development, the child’s (or adult’s) system is left locked in a fear state that permeates all waking and sleep activity. If FPR is active, then it may manifest as: low tolerance to stress; anxiety seemingly unrelated to reality; hypersensitivity to touch, sound, changes in visual field; dislike of change or surprise; poor adaptability; fatigue; elective mutism; holding breath; fear of social embarrassment; insecurity; lack of trust in oneself; overly clingy or may be unable to accept or demonstrate affection easily; compulsive traits; negativism; defeatist attitude; won’t try new activities; temper tantrums; controlling or oppositional behaviour especially at home; motor paralysis under stress; reduced muscle tone; craves attention; avoids eye contact; and shyness. A non-integrated FPR affects the tonic labyrinth reflex and moro reflex.
Develops in the eighth week in utero and is intended to be integrated by about four months after delivery and is replaced by an adult startle reflex. If the moro reflex is retained then the child may live in a constant state of inner stress, oversensitive to external sensory impressions – sound, touch, light, visual stimuli, and vestibular stimulation (the latter results in motion sickness, poor balance and coordination). Children with a non-integrated moro reflex and oversensitive senses can withdraw into themselves and shut off external sensory impressions that they cannot handle. A child may show a paradox of being acutely sensitive, perceptive and imaginative on the one hand and immature and over-reactive on the other. The child may cope in one of two ways: 1) being the fearful child; withdrawing from situations; difficulty socializing; and can neither accept, or demonstrate affection easily; 2) become over-active; aggressive; highly excitable; cannot read body language and need to dominate situations. Either child will seek strategies to give some measure of control in situations. They may lack the inner security they need to be spontaneous and flexible and often react with anxiety and outbursts when there is a change of routine and things no longer remain the way they are used to.
Tonic Labyrinth Reflex (TLR)
Tonic labyrinth reflex (TLR) forward develops twelve weeks in utero and is intended to be integrated four months after birth. TLR backward develops at the time of delivery and is intended to be integrated by the age of three. If the TLR is not fully integrated before the child has learnt to walk the effect will be that every head movement forward or backward changes the muscle tone and confuses the balance centre. Children with an active TLR forward may: tire easily when standing for a length of time; have difficulties in holding the head up – it may lean forward or to the side; weak neck muscles; shrunken up posture; weak muscle tone and over-flexible joints; problems lifting the arms or climbing; problems with working the eye muscles; balance problems when looking downward; tendency for motion sickness; stooping posture; poor balance; fear of heights. Children with an active TLR backward may have: tense muscles; a tendency to toe walking; balance and coordination problems; stiff, jerk movements; tendency for motion sickness; poor organization skills; poor sequencing skills; and poor sense of time. The child cannot easily separate and categorize conflicting visual information, for example walking up an open staircase or crossing a slatted bridge, where the water can be seen through the slats.
Symmetrical Tonic Neck Reflex (STNR)
The STNR develops when baby is about six months old and is intended to be integrated by nine to eleven months of age. If STNR is not sufficiently integrated the child will move around by sliding on her bottom; or “bear walk” on hands and feet; or those that do crawl rotate her hands outward or lock elbows; or just sit until she rises and walks. Children who never crawled on all fours usually have an active STNR. The STNR influences body posture, strength in the upper arms, and focusing vision at short and long distances. A non-integrated STNR causes poor posture; tendency to slump when sitting at a table; messy eating; clumsiness; attention difficulties; sitting on feet or legs in ‘W’ position; challenges with swimming, doing somersaults and ball games; and poor hand eye co-ordination. The reflex develops near-distance and binocular vision in the child, and when retained is linked to difficulties in vertical tracking of the eyes.
Spinal Galant Reflex
The spinal gallant reflex develops at twenty weeks in utero and is intended to integrate three to nine months after birth. Children with a non-integrated spinal galant reflex often have problems sitting still, concentrating, and with short-term memory. Tight clothing, belts or just leaning against the back of the chair can trigger the reflex and cause the child to fidget. Most children who have not integrated this reflex prefer to wear loose clothes. Some children with an active spinal galant reflex are bed wetters. If the reflex is active only on one side there can be scoliosis of the spine at teenage years. Older children with an active spinal galant reflex learn to fixate (lock or stiffen) the lumbar spine, which may cause back problems when they become adults. Fixation and rigidity of the spine in the lumbar region impairs the co-operation between upper and lower body and may also cause problems in getting in touch with feelings. The reflex is believed to take an active role in the birth process and assists the baby to work its way down the birth canal. Consequently, the birthing experience may affect integration of the reflex.
The landau reflex emerges at three to ten weeks of age and is ideally integrated at the age of three and a half. The continued presence of landau reflex suggests the TLR is still retained. The person will have low muscle tone especially in the neck and back and will have difficulties raising his head and chest in a prone position. There may be difficulties doing the breaststroke. If the landau is developed but not integrated the child may be clumsy in the lower part of the body and may have tense legs which extend backward. The child may run with stiff awkward movements and find hopping, skipping and jumping difficult.
Amphibian reflex develops between four to six months after birth. Before a person learns to crawl the amphibian reflex must have developed. This reflex helps the child to bend his legs and get up on hands and knees. If this reflex fails to develop it signifies that the spinal gallant, TLR and possibly Asymmetrical Tonic Neck Reflex (ATNR) have not been integrated. Adults who have not developed their amphibian reflex often suffer from clumsiness in the lower part of their body and tension in their legs. An underdeveloped amphibian reflex will impede cross pattern crawling and creeping, and may interfere with activities requiring gross muscle coordination, such as physical education and sport.
Asymmetrical Tonic Neck Reflex (ATNR)
ATNR develops about eighteen weeks after conception and is intended to be integrated when the baby is about six months old. If this reflex is not integrated the child will have difficulties making cross movements and being able to cross the midline. The child may walk in a slow amble. The balance of the child is affected when the head is turned to the side making it difficult for her to ride a bicycle. When the child turns her head to the right the right arm and fingers are extended and the child easily drops things or turns them over. Writing for any length of time will require enormous effort. The child compensates for this by using an immature pencil grip or excessive pressing of the pen, which impairs handwriting. The physical skill of writing requires intense concentration at the expense of cognitive processing. Fluent expression of ideas in written form may show a marked difference from the child’s ability to express orally. Both the quality and quantity of handwriting is affected. In order not to have to cross the midline some of these children turn the paper 90 degree and write vertically. Many of them have challenges writing eights. The retention of the ATNR is the single most important reflex to cause reading challenges.
Starts emerging at eleven weeks in utero and is fully present at birth, then integrates between two and three months after birth. For hands and fingers to release well and for the fingers to be mobile and flexible, proper development and integration of the palmar reflex is important. If the reflex is still active people may move their mouth, lick lips, or stick out their tongue when writing, drawing, sewing or undertaking some other fine motor activity. Handwriting is also affected, because it is difficult to develop a mature pencil grip. Other effects of a retained palmar reflex include stuttering and stammering, very sensitive palms, speech and articulation challenges and poor dexterity using the hand because the thumb and fingers find it difficult to move independently. People with this reflex unintegrated have a tendency for an active inner life, and can find it difficult to be fully engaged in the world around them.
Infant Plantar Reflex
Starts emerging at eleven weeks in utero and integrates between seven and nine months after birth. With the plantar, the toes curl under (to cling) when there is pressure on the ball of the foot. There is a link with language impairment. People with retained plantar can have difficulties performing tasks quickly, running, walking, motor planning, have a tendency to ‘toe walk’, need to have a routine for their day to orient and ground them.
It emerges about twelve weeks in utero, and ideally integrates by fourth month after birth. The rooting reflex is strongest in the first two hours after birth, and if for any reason a baby cannot be fed through the usual means (breast or bottle) after birth the reflex declines in strength over a few days. If the reflex is not able to fulfill its responsibilities after birth, it will hang around in a weakened form, and over time may affect taking in of food, speech and articulation, manual dexterity, and making good relationships. A retained rooting reflex also shows as hypersensitivity when touched on the face, people can be immature and find it difficult to grasp more complicated concepts on both emotional and intellectual levels.
The suck reflex emerges between nine and ten weeks in utero, and is ideally integrated by fourth month after birth. It works in conjunction with the rooting reflex to feed and get nourishment. A person with a retained suck reflex may have the following challenges: sucks thumb or fingers; speech and articulation delays and difficulties; difficulties with chewing (especially hard food); may bite cheek or tongue when eating; may have increased arching of the palate; often needs orthodontic work done; invades others personal space – likes being extra close; wants to lie down a lot; difficulties with developing fine motor skills and dexterity; inner temperature gauge not efficient; and difficulties swallowing.
The babkin response is where there is kneading of the hands as the baby is sucking. Apart from having a lot to do with speech development and articulation, it plays a role in bonding and attachment. It works in conjunction with palmar, infant plantar, rooting and suck reflexes, and the motor ocular response to establish strong, healthy attachment to the mother initially and then to the world around her. It is vital for these reflexes and responses to integrate well if trust is to be established. A retained babkin response may show with speech and articulation difficulties; mouth movements when writing or drawing; dribbling and drooling; difficulties reading body language; may appear to be ‘thick’ or ‘thin’ skinned.
The babinski reflex develops during the first month after birth and ideally is integrated by age two. It is important in preparing the feet for walking and influences the ability not only to move the feet but also the legs, hips and lumbar spine. It is important for muscle tone of the lower part of the body. An undeveloped babinski often shows as flat feet, slowness and dislike of walking; loose ankles that easily sprain; and a tendency to walk on the inside of feet – consequently shoes are worn off on the inside; or in other cases a tendency to walk on toes. If the reflex is developed but not integrated the child has a tendency to walk on the outside of feet – consequently shoes are worn off on the outside.
The grasp reflex emerges three months in utero, and is ideally integrated during the first year after birth. If the grasp reflex is not integrated the child may have challenges with the motor control of his hands, poor handwriting and poor fine motor skills. The pencil grip will be poor or unusual and there is a tendency to hold the pen too tightly.
Hands Pulling Reflex
This reflex normally emerges immediately after delivery. A retained hands pulling reflex may cause tension in the forearms, making it difficult to write. At two months after birth the grasp reflex and hand pulling reflex start to function as a unit to grasp objects and put them into her mouth, assisting the integration of the babkin response.
Reflexes and sensory processing cannot be separated. Balance, touch, hearing, vision and proprioception (brain cells in the muscles, tendons and joints) are all senses connected to movement and crucial to learning.This article is written by Paula Wilson, 2009, and aims to describe reflexes and their relationship to learning, language and behaviour, in plain language. It is based on the teachings of Sally Goddard, Moira Dempsey and Dr. Harald Blomberg, and the pioneering work of Peter Blythe.