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Primitive Reflexes

Effects on vision, behavior and learning

When children are born, they are equipped with primitive reflexes that provide them an immediate response to their environment for survival. These reflexes are automatic, and directed from the brain stem without cortical involvement. They pave the way for later voluntary control. It’s important that they are inhibited and controlled by higher centers of the brain at the appropriate time to allow for more sophisticated neural structures to develop properly.

 

If the primitive reflexes remain active beyond the first year of life, they are referred to as retained, and they are a structural weakness and immaturity in the central nervous system. This can result in immature patterns of behavior or may cause immature systems to remain prevalent despite the acquisition of later skills.

Depending on the degree of primitive reflex activity, this poor organization of nerve fibers can affect one or all areas of functioning such as: gross motor, fine motor, or oculomotor coordination, sensory perception, cognition, and expression. If the reflex activity is mild it’s not likely to have a significant impact on functioning and behavior. If, however, the reflex activity is moderate or severe, or there is a cluster of reflexes present, neuro-developmental delay will ensue. Unless the primitive reflexes are integrated and assimilated into higher level functioning, the child’s performance will continue to be impeded, despite a potentially normal level of intellect. Reflexes are integrated when the developing brain releases further movement patterns which contain the inhibitor to the initial primitive reflex, allowing more complex skills to be acquired.

By the application of stylized sequential movements practiced daily, it is possible to give the brain a chance to register the reflex inhibitory movement patterns which should have been made at the appropriate stage in development. As primitive reflex activity is corrected, many physical, academic and emotional problems disappear. 

 

Four of the primitive reflexes are directly involved in the development and functioning of the visual system. They are: the Moro reflex, Asymmetrical Tonic Neck Reflex (ATNR), Tonic Labyrinthine Reflex (TLR), and Symmetrical Tonic Neck Reflex (STNR). Other notable reflexes that have effects on behavior are: the Palmar Reflex, Rooting Reflex, and Spinal Galant. The purposes of these reflexes and what they can cause when they are not properly integrated are presented in the following tables.

 
 

Moro Reflex

This is a primitive whole body reaction when startled by any type of sensory stimuli causing movement of the arms and legs outward and extension of the head (withdrawal response) with intake of breath. It is the precursor to the adult startle reflex.

Reflex Effect

  • fight or flight reaction

  • adrenaline stress response

  • connects to all the senses

PrimitiveReflex_Moro.png

Possible results when not inhibited

  • exaggerated startle reaction; highly excitable

  • sensory hypersensitivity/over-stimulation

  • constantly on alert, on edge of fight or flight

  • fearful withdrawl or overactive aggressive behaviour

  • manipulative or controlling behavior in attempt to gain control over own emotional response

  • easily distracted; mood swings

  • poor balance and coordination; motion sickness

  • oculomotor and visual perception problems

  • pupil dilation and light sensitivity

  • can’t filter sensory information

  • auditory confusion; poor auditory discrimination

  • dislike change or surprise; anxiety/angst

  • insecurity, low ego and self esteem

 

Asymmetrical Tonic Neck Reflex

Arm, hand, and leg extend on the same side of the body when head is turned to that side.

Reflex Effect

  • involved in birthing process

  • develops extensor muscle tone

  • trains one side of body at a time

  • provides basis for later reaching movements

  • early hand-eye coordination; visually directed reaching

  • prevents baby from lying face down when on tummy

  • trains eyes to focus from 7 inches to arms length

Possible results when not inhibited

  • inability to do cross-lateral crawl

  • upset center of balance when walking

  • awkward; clumsy

  • difficulty crossing the vertical mid-line

  • failure to establish dominant side; mixed laterality

  • impaired bilateral movement

  • hesitancy in directing eye movement from one side to the other; prevents reading fluency

  • impairs visual tracking and ocular pursuits

  • visual perceptual problems

  • poor handwriting, immature pencil grip

PrimitiveReflex_AsymTonicNeckReflex.png
 

Tonic Labyrinthine Reflex

This is activated by stimulation of the labyrinths when head moves forward or backward. For the forward reflex, when head tips forward arms and legs go into fetal position; for the backward reflex, when head tips back arms and legs extend out.

Reflex Effect

  • assists birthing process

  • precursor for oculo and labyrinthine head righting reflexes for necessary head control

  • balance, muscle tone, and proprioception development

  • gravitational security development

PrimitiveReflex_TonicLabyrinthineReflex.

Possible results when not inhibited

  • unstable reference point in space

  • difficulty judging space, distance, speed and depth

  • lack of spatial and directional awareness

  • reverse numbers and letters

  • poor sequencing skills; poor sense of time

  • impedes head righting reflex and vestibulo-ocular reflex

  • creates mismatch between balance, vision, 
    and proprioception

  • may prevent crawling and creeping

  • impaired depth perception and figure-ground discrimination

  • poor posture; motion sickness

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Symmetrical Tonic Neck Reflex

For flexion, when the head bends forward the arms bend and the legs extend; for extension, when the head extends the arms straighten and the legs bend.

Reflex Effect

  • helps baby up off the floor onto hands and knees from the prone position

  • helps train eyes to fixate/focus change from far to close

  • integrates developing visual skills with other senses

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Possible results when not inhibited

  • interferes with crawling on hands and knees

  • baby will either: bear-crawl, scoot or skip crawling

  • interferes with eyes learning to cross the mid line

  • interferes with visual tracking for reading and writing

  • interferes with developing near point vision

  • impairs vertical visual tracking

  • stooped posture; severe slouching

  • clumsy; poor hand-eye coordination

  • “W” sitting position

  • problems with vision focus change from far to close

  • difficulty with copying tasks

  • can affect attention

 

Palmar Reflex

This involuntary grasp reflex can be elicited by the action of sucking due to a neurological loop connecting the hands with the mouth.

Reflex Effect

  • grip

Possible results when not inhibited

  • poor manual dexterity

  • lacking pincer grip

  • immature pencil grip

  • speech difficulties

  • palms hypersensitive

  • mouth movements when writing

PrimitiveReflex_PalmarReflex.png
 

Rooting and Sucking Reflex

Touching baby’s cheek elicits head to turn in that direction with open mouth and extended tongue for sucking. It is linked to the palmar reflex.

Reflex Effect

  • insures baby turns toward the source of food,
    and opens to latch

  • vital for early feeding

Possible results when not inhibited

  • hypersensitivity around mouth

  • dribbling

  • speech problems

  • poor manual dexterity

PrimitiveRelfex_RootingAndSucking.png
 

Spinal Galant Reflex

Stimulation of the back to one side of the spine will result in hip movement 45 degrees toward the side of the stimulus. This is present in equal strength on both sides.

  • may have an active role in birthing process

  • helps baby work its way down birth canal

  • functional relationship with hearing

Reflex Effect

Possible results when not inhibited

  • poor bladder control; bed wetting

  • difficulty sitting still; fidgeting

  • dislike clothing around waist

  • can affect attention and short-term memory

  • poor concentration

  • poor posture

  • gait anomalies; limping

  • uncoordinated in physical activity or sports

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