OT Month: What Are Primitive Reflexes—And Why Integration Matters for Your Child's Development


By Kaysie Smith, MSOTR/L, CLC

From the moment your child is born, their brain is busy wiring up the skills they’ll need to thrive—starting with reflexes that help them navigate the world. Primitive reflexes are automatic, involuntary movements that babies are born with. They’re essential for survival and early development—but here’s the key: they’re supposed to disappear, or "integrate," as a child grows. When these reflexes stick around longer than they should, they can interfere with motor coordination, sensory processing, attention, and even emotional regulation.

A newborn baby in diapers on a white changing table with a ruler with a Moro reflex

What Are Primitive Reflexes?

Primitive reflexes are the brainstem-driven movements we all start life with. For example:

These reflexes help babies learn to move, interact with their environment, and develop postural control. But they should naturally integrate as the brain matures—usually within the first year of life.

What Happens If Reflexes Don’t Integrate?

If a child retains primitive reflexes beyond the typical age, they may experience:

For example, a retained ATNR can make it hard for a child to cross midline—an essential skill for reading and writing across a page. That child might tilt their head or move their whole body to track words, leading to fatigue and frustration in the classroom.

Why Reflex Integration Therapy Helps

Occupational therapists assess reflexes as part of a holistic developmental evaluation. If retained reflexes are present, we use neurodevelopmental movement-based exercises to help "repattern" the brain and support integration. These movements are purposeful and repetitive—essentially giving the nervous system a second chance to develop the way it was meant to. Over time, we see improvements in coordination, focus, emotional regulation, and overall confidence.

Signs Your Child Might Benefit from Reflex Integration Exercises

If your child:

…it may be worth scheduling a developmental occupational therapy evaluation.

Final Thoughts

Retained primitive reflexes are more common than you might think—but the good news is, with the right support, kids can catch up and thrive.

Early intervention can make a world of difference, and reflex integration is a powerful tool in helping children unlock their full potential—academically, socially, and emotionally. Specific movement patterns and play-based activities are used to support the nervous system and help integrate reflexes. 

If you are curious about reflex integration, don’t hesitate to reach out to our team at Gro!

OT Month: The Importance of Regulation for Occupation

By Lacey Lubenow MOTR/L, CLC

April is Occupational Therapy Month! We are continuing to highlight some important topics in the world of Occupational Therapy, this week is all about Self-Regulation!

Occupational therapy is often misunderstood due to the word ‘occupation’ being misleading to what the profession actually does. To better understand occupational therapy, it’s important to know that when the profession began, the word occupation was meant to be used to describe meaningful activities that ‘occupy’ your time. This concept was then used as a means of therapy, and still is today.

As a profession, we recognize the importance of doing meaningful daily activities as the key to better health and well-being. In pediatrics, self-regulation is an important skill that is often targeted to assist with increasing performance and participation in these meaningful activities.

What is Self-Regulation?

Self-regulation is the ability to manage emotions, behaviors, and reactions in different situations. It’s an important skill for children that helps them succeed in school, relationships, and everyday life. In pediatric occupational therapy, self-regulation is often a central focus and may include strategies to assist with managing impulses, staying calm when upset, focusing on tasks, and interacting appropriately with others. It’s critical for emotional well-being, academic success, and social interactions.

Children with strong self-regulation skills are better at:

How Occupational Therapy Can Help with Self-Regulation

https://zonesofregulation.com/what-are-the-four-zones-of-regulation/

Pediatric OTs support children by using strategies tailored to their unique needs. There are many approaches to promote improved regulation and they are used depending on the child’s specific needs:

  1. Sensory Processing: Many children struggle with sensory input that affects self-regulation. OTs use calming techniques, like deep breathing or weighted blankets, to help children manage sensory overload.
  2. Coping Strategies: OTs teach children ways to calm down, such as deep breathing exercises, body awareness, and mindfulness.
  3. Play-Based Learning: Play helps children practice self-regulation in a fun way. OTs use games and role-playing to teach turn-taking, patience, and managing frustration.
  4. Creating Routines: Consistent routines help children feel secure and understand what to expect, promoting better emotional regulation throughout the day.
  5. Improving Attention: OTs use activities that enhance focus and attention, helping children regulate their behavior and stay on task.

Curriculums like the Zones of Regulation, How Does Your Engine Run, and Superflex, are frequently used as a framework to assist in boosting children’s emotional awareness and control by using specific language, visuals, and concepts that are easy to understand and apply.

Self-regulation is vital for children’s success in everyday life. Pediatric occupational therapy provides the tools and strategies to help children manage their emotions and behaviors, setting them up for long-term success. Through sensory integration, coping skills, and structured routines, OT can support children in becoming more resilient, independent, and capable in their daily occupations.

APRIL IS OCCUPATIONAL THERAPY MONTH!

By Kaysie Smith, MSOTR/L, CLC

April is Occupational Therapy (OT) Month, and it’s the perfect time to celebrate the incredible impact of OT on children’s growth, independence, and confidence. Whether your child is struggling with fine motor skills, sensory processing, or self-care, pediatric occupational therapy provides the tools and support they need to succeed.

At Gro, we specialize in play-based, child-centered therapy designed to help kids overcome challenges and reach their full potential.

What is Pediatric Occupational Therapy?

Pediatric OT focuses on helping children develop the skills they need for everyday life—whether that’s holding a pencil, making friends, tying their shoes, or trying new foods. Every child is unique, and our therapists create fun, customized activities that build on their strengths while addressing any difficulties.

Key Areas We Support:

🖍 Fine motor skills – Strengthening hands for writing, cutting, buttoning, and zipping.
🤸 Gross motor skills – Improving coordination, balance, and movement for play and sports.
🌟 Sensory processing – Helping kids who feel overwhelmed by lights, sounds, textures, or movement.
👕 Self-care skills – Encouraging independence in dressing, grooming, and using utensils.
💬 Social and emotional skills – Supporting kids in managing feelings, making friends, and communicating.
🍎 Feeding & oral motor skills – Helping picky eaters and kids with sensory aversions or chewing difficulties.

How Families Can Celebrate OT Month at Home

This April, try these fun OT-inspired activities that encourage development through play!

🎨 Sensory Art – Let your child explore textures with finger painting, playdough, or sensory bins.
🧩 Fine Motor Fun – Practice cutting, beading, or sticker peeling to strengthen little hands.
🏃‍♂️ Obstacle Course – Set up balance beams, tunnels, or jumping stations to build coordination.
🥄 Kitchen Helper – Let kids mix, pour, and stir—great for hand strength and sensory engagement!
🧺 Laundry Sorting – Have kids match socks, fold towels, or sort clothes for fine motor practice.

Could Your Child Benefit from OT?

If your child struggles with every day tasks, occupational therapy (OT) can help them build confidence and gain the skills they need to thrive at home, in school, and in daily life.

Early support can make a world of difference! Contact us today to schedule an evaluation or learn more about how OT can support your child’s growth and success.

10 Holiday Gift Guide Ideas (Speech and OT Therapist Approved!) 2024 Edition

The holiday season is a great time to find gifts that are not only fun but also help our little ones learn and grow. Toys and activities that encourage communication, language development, and motor skills, along with allowing young children to explore the sensory system can make a big impact. At this stage, kids are learning to express themselves and understand the world around them, so gifts that build on those skills are a perfect choice. Whether it’s an interactive storybook or a simple musical instrument, these kinds of simple gifts make learning feel like play. Plus, they’re a great way for parents and kids to connect while introducing important skills like communication and vocabulary. It can be difficult to decide which gifts to buy out of the many available.  We compiled a short list of our favorite toys and games that we like to use in speech and occupational therapy and at home with our children!

1. Interactive Storybooks (Ages 0+)

Never Touch a …

These books have something to touch and feel on every page encouraging early interaction with books, and there is a book for every season or a book to fit every season.

Language goals/core vocabulary to incorporate: “animal, monster, or dinosaur noises (moo, baa, roar), touch + X, more, turn the page” 

Poke-a-Dot Books

Encourage interaction on every page engaging early readers while targeting fine motor skills.

Language goals/core vocabulary to incorporate: “animal noises, push, more/all done”

2. Laugh and Learn Smart Stages Piggy Bank (Ages 1+)

Language goals/core vocabulary to incorporate: “open/close, nose, in/out”

Target fine motor skills and hand/eye coordination.

3. Musical Instruments (Ages 1+ supervised)

Simple instruments like tambourines, maracas, or xylophones encourage exploration of sounds and rhythms, aiding in listening skills. 

Language goals/core vocabulary to incorporate: “bang, shake, more, nursery rhymes.”

Target fine motor skills.

4. Rainbow Spinning/Stacking toy  (Ages 6 months+)

Language goals/core vocabulary to incorporate: “on/off, ready, set, GO!, more, down, colors.”

Target spatial concepts and motor skills.

5. Critter Clinic (Ages 2+)

Language goals/core vocabulary to incorporate: “open/close, Ouch, uh-oh, help + animal, animal sounds (meow, woof,) animal names.”

Target spatial concepts and imaginative play.

6. Vehicle sound puzzle (Ages 1+)

Language goals/core vocabulary to incorporate: “on/off, vroom, Whee-oo, chugga-chugga-choo-choo, ship, train, more.”

Targets fine motor skills: pincer grasp.

7. Hahahaland 2-in-1 Car and Ball Toy (Ages 1+)

Language goals/core vocabulary to incorporate: “colors, my turn/your turn, down, bang, hit + color, vroom”

8. Little Tikes First Slip and Slide (Ages 1+)

Sometimes it takes a little movement to get children vocalizing! 

Language goals/core vocabulary to incorporate: “Ready, set, GO!, up/down, slide, more, whee,”

Target gross motor skills, balance and coordination, spatial awareness, and vestibular stimulation.

9. Melissa and Doug Food Cutting Play Set (Ages 2+)

Language goals/core vocabulary to incorporate: “cut + food, yum, yuck, eat, counting, I want + food.” 

Target fine motor skills.

10. Tongues Out! (Ages 4+)

Language goals to increase core vocabulary: “Find + color, not + color.”

Target motor skills, social communication (taking turns), and negation (not blue).

Sensory Processing: Tactile System

Lacey Lubenow, MOTR/L, CLC

Purpose: The tactile system is responsible for receiving information from the environment through touch. It’s important in keeping us safe through the detection of potentially dangerous stimuli such as hot, cold, or sharp objects.

Function: The tactile system is composed of receptors that detect pressure, temperature, vibration, and texture in our external environment. The tactile system works alongside the proprioceptive system to communicate with the brain through sensory receptors throughout the body.

Why it’s important: As mentioned previously, the tactile system serves a lot of purposes, but none more important than safety. Without the tactile system, the body would be at risk of harm through things like heat exposure when cooking or bathing or cold exposure when outside in the elements. It also serves the purpose of emotional attachment (think skin to skin after birth), body position, and feeding and nutrition.

System Breakdown: Because the tactile sensory system is so vast, children who have difficulty with tactile processing may present with a combination of over or under responsive tendencies. Children who are over-responsive to tactile input may be resistant to self care tasks like hair brushing/cutting, nail trimming, tooth brushing, or face washing. They may have a hard time feeding, which can lead to picky eating habits. Children also may avoid or dislike messy play such as finger painting, sand play, or playing with food. Resistance to certain textures of clothing, socks, difficulty with tags or seams, or tight clothing can also be a sign of tactile over-responsiveness. Children who are under-responsive to tactile input may seek out various textures and use parts of their body that have more touch receptors including lips, tongue, and face to feel them. They may not recognize tactile input as easily and thus have a lack of awareness of when their face or hands may be dirty. They also may appear to have a high pain tolerance and seek out messy play opportunities rather than avoid them. Similarly to other sensory systems (proprioceptive and vestibular) children may also engage in active or rough play like running, jumping, or crashing into things.

OT Intervention: Every person is unique to their sensory processing needs. It only warrants intervention if it prevents participation in meaningful activities and impacts their quality of life. Regardless, tactile input is beneficial for children with and without sensory impairments. A sedentary lifestyle restricts the opportunity for engaging the tactile system and can lead to sensory processing difficulty purely due to a lack of exposure. Our sensory systems require frequent input to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ that is unique to each child’s needs to help them better process sensory information and promote improved regulation. Examples of activities that OT’s may use to promote exposure to tactile input include:

Water Play: Water is a great way to engage the sensory system without the feeling of being too messy.

Brushing Protocol: The Wilbarger brushing protocol is often used by OT’s to assist with desensitization of the tactile system using a specific brush on the skin. It can decrease over-responsiveness to clothing, food, and self care like hair or tooth brushing.

Deep pressure: A powerful tool that not only helps with regulation of the proprioceptive system, but the tactile system as well.

Exposing children to various textures through play over time will assist in desensitization of an over-responsive tactile system. If a child is under-responsive, providing and educating them with safe sensory opportunities that allow them to feed their sensory system through rough or messy play is equally as important.

Sensory Processing: Vestibular System

Purpose: The vestibular system is responsible for sensing the direction of our body in space; up, down, backward, forward, spinning, and speed. It plays a critical role in our balance and coordination and can act as a powerful tool in regulation.

Function: The vestibular system is made up of structures within the ear which include three semicircular canals and two otolith organs. Hair cells, crystals, and fluid provide the brain with information about head movement and position. Children can be over-responsive to vestibular input, making them sensitive to excessive or specific types of movement. They can also be under-responsive, requiring increased movement to remain engaged.

Why it’s important: The vestibular system provides us with important information pertaining to balance, orientation, coordination, eye control, and security in movement. It can be thought of as an internal GPS and without it, movement would be very difficult, if not impossible.

System Breakdown: Children with vestibular processing difficulties may present with resistance to change in position. This can look like fear or avoidance of swinging motions or refusal to partake in activities that involve climbing, jumping, or going upside-down. This would be considered over-responsive to vestibular input and result in sensory avoidant behavior. Children with these tendencies are often perceived as overly cautious. If the child is under-responsive to vestibular input, we would see just the opposite and they would be seeking out that sensory input for regulation; running, jumping, climbing, rocking, and fidgeting, which is often summarized as difficulty remaining still.

OT Intervention: Each person is unique to their sensory processing habits. It only warrants intervention if it prevents participation in meaningful activities and impacting their quality of life. Regardless, vestibular input is beneficial for children with and without sensory impairments. A sedentary lifestyle restricts the opportunity for engaging the vestibular system and can lead to sensory processing difficulty purely do to a lack of exposure. Our sensory systems require frequent input to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ that is unique to each child’s needs to help them better process sensory information and promote improved regulation. Examples of activities that OT’s may use to promote exposure to vestibular input include:

Swings: There are many different types of swings available and therapy gyms often have more than one to assist with various needs. However, regardless of the type of swing, they all target the vestibular system.

Climbing equipment: Rock walls, jungle gyms, and slides are all great pieces of equipment that can frequently found in a therapy gym to promote engagement of the vestibular system.

Bouncing: Trampolines and exercise balls are useful tools that make bouncing easier and fun.
Inverted exercises: Yoga, bars, and exercise balls are great tools to move the body upside-down, which is a great way to target the vestibular system.

10 HOLIDAY GIFT GUIDE IDEAS (SPEECH AND OT THERAPIST APPROVED!)

Toys and games that promote language, social communication, sensory regulation and fine motor skills

Looking for holiday gifts for little ones can be HARD, there are so many options that may make it difficult for parents or loved ones to find a gift that will keep a child engaged while also targeting some skills they are working on in therapy. We compiled a (short) list of some of our favorite toys and games that we use in speech and occupational therapy to help encourage expressive and receptive language, build core vocabulary, develop fine motor skills and explore our sensory system to help you navigate gift giving this season. Something these toys have in common are that they are simple and promote interactions, which from a social communication level--we love! These are for the most part very low-tech and allow room for the caregiver to model and encourage language while playing!

  1. “Learning Resources Spike the Fine Motor Hedgehog” (ages 18 months +): Language goals/core vocabulary to incorporate: “in/out, colors, my turn, pull, push.” Targets fine motor skills and hand/eye coordination.
  2. “Melissa and Doug Pizza Party Wooden Play Food Set” (ages 3+): Language goals/ core vocabulary to incorporate: “more + food, counting, eat, I want + food, yummy, yuck!, cut.”
  3. “B-Toys- Interactive Red Barn” (Ages 2+): Language goals/core vocabulary: “Ready, set, GO!, down, up, push, open, close, animal names + sounds, ball, roll, slide, spin, peek-a-boo!” Target spatial concepts, following 1-2 step directions and fine motor skills.
  4. "Melissa and Doug Slice and Bake Cookie Set” (ages 3+): Language goals/core vocabulary to incorporate: “more + flavor/color, on, off, help me, hot, cut, open.” Target spatial concepts (i.e. put it on top, take it off, cut.”
  5. “Magna-Tiles” (ages 3+): Core vocabulary to incorporate when requesting additional tiles: “More + color, colors, shapes, up, down, on, off.” Can incorporate special concepts and following directions.
  6. “Melissa and Doug Take Along Tool Kit Wooden Construction Toy” (ages 3+): Language goals/core vocabulary to incorporate: “bang bang, boom, turn, help, on, off, in, out and dump.” Targets fine motor skills with turning gears and tools.
  7. “Ocean and Sand Sensory Bin” (ages 3+): Language goals/ core vocabulary to incorporate: “uh-oh, hide, my turn, shake shake, dig + animal names.” Targets fine motor skills, imaginative and sensory play skills.
  8. “Melissa and Doug Examine and Treat Pet Vet Play Set” (ages 3+): Language goals/core vocabulary to incorporate: “Ouch! Boo-boo, help, open, shot, look!, dog, cat, meow, woof + body parts.”
  9. “Melissa and Doug Magnetic Matching Picture Game” (Ages 3-5): Language goals/ core vocabulary to incorporate: “on, off, up, down, go, stop, swing, vroom, drive, bus, + farm animals.” Target spatial concepts, matching and following 1-2 step directions.
  10. “Let’s Go Fishin” (ages 4+): Language goals to increase core vocabulary: Open/close + Colors. Fine motor skills: pincer grasp. Social communication: working on taking turns.

Sensory Processing: Proprioceptive System

Purpose: The proprioceptive system is responsible for obtaining information about the body's position in space.

Function: Proprioceptors are small sensory receptors that are located within muscles, tendons, and joints. Information is received from proprioceptors when these structures pull, press, bend and straighten. When these receptors are pulled, pushed, bent, or stretched, information is sent to the brain to provide us with a sense of body awareness, motor planning, and coordination. A breakdown with processing this information can be caused by damage or dysfunction to sensory receptors, nervous system pathways, or areas of the brain responsible for interpretation.

Why It’s Important: The proprioceptive system provides us with important information for participation and completion of everyday tasks such as washing our hair, brushing our teeth, getting dressed, or eating/drinking. Without these receptors providing information, these tasks would become much more challenging or even impossible.

System Breakdown: When children have difficulty processing proprioceptive input it can often present as clumsiness or being uncoordinated. Children may seek out more input if they have a low proprioceptive threshold, which can present as rough play (crashing), deep pressure (hugs), or big movements (running, jumping, pushing, pulling, heavy lifting, climbing). If they’re over responsive to proprioceptive input, then children tend to be more cautious in their movements and avoid physical activities.

OT Intervention: Everyone processes sensory information differently and it doesn’t necessarily warrant intervention unless it prevents a child from participating in meaningful activities that impact their quality of life. Proprioceptive input is beneficial for children both with and without processing difficulties. A sedentary lifestyle restricts children’s opportunity to engage in proprioceptive activity and can ultimately result in sensory processing difficulty solely due to lack of exposure. Our sensory systems require frequent input and exposure in order to be able to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ to improve children’s ability to process sensory information that is unique to their needs. Some examples of activities that OT’s may use to promote exposure to proprioceptive input include:

Fine Motor: pinching, pulling, or squeezing playdough or putty, opening/closing objects, or manipulating velcro strips.

Gross Motor (frequently referred to as ‘heavy work’): jumping jacks, pushing/pulling/carrying heavy objects, building a fort, climbing on a jungle gym.

Oral Motor: blowing bubbles, chewing gum, eating certain foods like jerky or licorice.

Weighted objects such as vests, blankets, or lap pads can be helpful as deep pressure stimulates the release of serotonin and encourages the parasympathetic response, which assists with regulation by providing feedback for body awareness, decreased anxiety levels, and improved attention.