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:

Moro reflex: Also called the startle reflex, where a baby flings their arms out and then curls in.
ATNR (Asymmetrical Tonic Neck Reflex): When a baby turns their head to one side, the arm on that side extends.
STNR (Symmetrical Tonic Neck Reflex): Helps babies get up on hands and knees for crawling.
Palmar grasp, rooting, spinal galant—the list goes on.

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:

Poor coordination or balance
Difficulty sitting still or maintaining posture
Trouble with handwriting or fine motor skills
Delayed speech or language development
Sensory sensitivities or emotional outbursts
Challenges with reading, focus, or attention

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:

Tires easily when writing or doing homework
Avoids climbing, riding a bike, or balancing
Has strong emotional reactions or meltdowns
Struggles with coordination or handwriting
Appears clumsy or bumps into things frequently

…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:

Managing emotions: Reducing stress and anxiety.
Focusing on tasks: Succeeding in school and activities.
Navigating social interactions: Building friendships and understanding social cues.
Becoming more independent: Managing daily routines like eating, dressing, and organizing.

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:

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.
Coping Strategies: OTs teach children ways to calm down, such as deep breathing exercises, body awareness, and mindfulness.
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.
Creating Routines: Consistent routines help children feel secure and understand what to expect, promoting better emotional regulation throughout the day.
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.