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Overview of primary reflexes

Primary reflexes have a significant impact on a child's psychomotor development. Movements triggered by primary reflexes help form a dense neural network, enabling connections between various areas of the brain. These connections are crucial for future learning processes, communication skills, emotional and interpersonal relationships, and motivation. They contribute to stimulating the cerebral cortex, which can then subsequently "take control" and suppress primary reflexes. 

However, if these reflexes are not inhibited (suppressed) in a timely manner, they can be counterproductive to neurological development. This is when we refer to persistent primary reflexes. If a single reflex persists to a small extent, it might naturally diminish with age. But if multiple reflexes persist or persist to a greater extent, they can no longer self-inhibit, and this is where Neuro-Developmental Stimulation "NDS Learning through Movement©" comes into play.

Below is an overview of the most important primary reflexes. If these reflexes do not disappear, they hinder the development of more advanced (postural) reflexes and movement patterns.


Moro reflex


The Moro reflex, also known as the startle reflex, is a primarye reflex that is present in newborn babies. It is an involuntary response to a sudden change in the environment or a loud noise, where the baby will spread their arms and legs out and then bring them back in towards their body. Even during pregnancy, the Moro reflex contributes to the development of the respiratory system. After birth, it plays a critical role in helping the newborn take its first breath by opening the airways in cases of suffocation, thereby ensuring the baby's survival. The Moro reflex is triggered by a startle response, as the infant's brainstem cannot differentiate between dangerous and non-dangerous stimuli. This reaction results in the infant throwing its arms out to the sides, releasing adrenaline and cortisol, which deepens the breathing in the upper parts of the lungs, increases heart rate, raises blood pressure, and causes skin flushing. The infant then cries, attracting the attention of an adult. 


The Moro reflex is important for newborn babies as it helps them to respond to and protect themselves from potentially dangerous situations. It also helps to stimulate the baby's nervous system, which is important for their overall development.The reflex also plays a crucial role in the development of eye movement control and balance.

Although the Moro reflex is crucial during the early stages of life, it must gradually be inhibited. There are varying opinions on the normal duration of the reflex's activity. Some experts suggest that the reflex is active up to the third month of life, while others believe it is normal for it to be active up to the sixth month of the child's life.

The most common symptoms of persistence of the Moro reflex:

  • attention deficit hyperactivity disorder (ADHD) or hypoactivity disorder (ADD)

  • symptoms of autism (avoids other children, does not look in the eyes, sensitivity to tactile, visual or auditory sensations) 

  • sensitivity to light, problems with black letters on white paper (visual stress)

  • allergy

  • burn out syndrome

  • problems with immunity, frequent ear infections

  • "stimulus bound"- inability to filter out stimuli, problems   with concentration

  • aggression

  • emotional lability

  • doesn't like surprises

  • problems controlling eye movements

  • delayed speech development

  • worse balance


Asymmetrical tonic neck reflex (ATNR)

Asymmetrical tonic neck reflex (ATNR) is activated when we turn the head to one side or the other. Wherever we turn the head, the arm and leg on that side extend, while the other arm and leg flexes.

During pregnancy, ATNR is supposed to improve muscle tone and help stimulate the balance system. ATNR has an important role during childbirth. During the second stage of labor, the baby has to find its way down with a specific twisting movement in the rhythm of labor contractions. The child's active participation during childbirth depends precisely on a properly developed ATNR. At the same time, the entire process of childbirth strengthens the activity of not only ATNR, but also other primary reflexes, which are important for the first months of life. Children who are born by caesarean section, therefore, have a disadvantage. In the first months of life, this reflex prevents the baby from lying face down on its stomach (danger of suffocation). It also supports the development of the first eye-hand coordination and influences the development of laterality.

The most common symptoms of persisting ATNR:

  • hand-eye coordination problems

  • problems with writing because it is difficult to control the hand

  • worse cooperation of the cerebral hemispheres

  • problems putting the hand across the mid-line of the body - for example, a child who writes with the right hand has problems writing on the left side of the paper

  • inconsistency between spoken and written expression

  • a problem with developing lateral eye movements, such as following lines with the eyes, which is a necessity for both reading and writing

  • impaired automatic balance control

  • worse bilateral integration-using both halves of the body separately

  • persistence of crossed or unclear laterality (e.g. child does not favor one hand when writing) even after 8 years of age


Tonic Labyrinth Reflex (TLR)

Tonic labyrinthine reflex (TLR), also known as the Tonic Labyrinth Reflex (TLR), is a primitive reflex that is present in newborns and infants. It is elicited by changes in the position of the head in relation to gravity, causing a change in muscle tone throughout the body. When the head is tilted backwards, the TLR causes an extension of the arms and legs, while when the head is tilted forward, the TLR causes flexion of the arms and legs, so the baby bends its limbs and takes a position similar to that typical of the position in the womb.. The TLR plays an important role in the development of balance and postural control in infants.

The TLR helps the baby to resist gravity at a time when the ability to lift and hold the head and neck upright is not yet developed, until the head is supported. However, the baby learns quickly, so after the first six weeks, they learn to hold their head in the plane of the spine when laying on the belly. This is the first step to complete control of the neck muscles. Then, they gradually learn to control muscle tone also in the cephalo-caudal direction, i.e. gradually from the head, through the upper half of the body, the lower half of the body to the heels. This ability is essential for maintaining balance, upright posture, and coordination later on. The development of gross motor skills is significantly influenced by the TLR. A child with persistent TLR will find it extremely difficult to crawl on all fours because extension (tilting) of the head causes simultaneous extension (stretching) of the legs. However, climbing and crawling are very important for developing proper hand-eye coordination and for integrating information from other sensory organs.

The persistence of TLR is associated with a range of symptoms, including:

  • Poor gross motor skills

  • Coordination difficulties

  • Difficulty holding the head up while writing or laying the head face down on a bench

  • Difficulty sitting on a chair with the feet flat on the ground instead of sitting on the heels

  • Changes in muscle tone, including decreased or increased tension

  • Walking on tiptoes or waving arms when happy or upset

  • Difficulty focusing vision quickly at different distances, which is necessary for tasks such as copying text from a board.


Spinal Galant reflex

The Spinal Galant reflex, along with the Asymmetric Tonic Neck Reflex (ATNR), aids in childbirth by responding to the pressure of the uterine wall on the trunk area during contractions. This reflex provides the baby's hips with flexibility, allowing the baby to slowly turn through the birth canal. However, if the reflex persists, it can cause excessive sensitivity in the lumbar region of the back, hindering the development of postural reflexes.


The most common symptoms of the persistent Galant reflex include:

  • sensitivity in the lumbar region of the back

  • discomfort with clothing tags, belts, and jeans, just wants to wear loose-fitting trousers

  • difficulties with urinating

  • scoliosis

  • poor concentration.


Palmar reflex

The Palmar Reflex is a primary reflex that affects fine motor skills in infants. This reflex causes children to automatically wrap their fingers around anything that fits in their palm with a firm grip. Initially, newborns can even hold themselves up on their toes due to the strength of the Palmar Reflex. However, as infants develop an active grip, the Palmar Reflex should disappear. During the first few months of life, there is a strong connection between the Palmar Reflex and sucking. The reflex is also evident during breastfeeding, as infants reflexively clench and open their palms during sucking, resembling the movement of kneading dough. This connection is known as the Babkin reflex. Interestingly, the opposite is also true, as children often move their mouths and tongues while concentrating on tasks that require fine motor skills, such as writing.

The persistence of the Palmar Reflex can lead to various symptoms, including:

  • worse fine motor skills

  • worse graphomotor skills

  • difficulties in speech and articulation

  • Increased sensitivity in their palms and dislike different materials, such as sand, modeling clay, or finger paints, or conversely, may seek out these materials excessively.




Rooting and sucking reflex

The rooting and sucking reflexes are critical for a baby's survival as they allow the baby to receive food. The rooting reflex causes the baby to turn towards the source of touch on its face, open its mouth, and look for something to suck. It is important not to touch a baby's face too much during breastfeeding as it can disrupt the rooting reflex.

When a child has a persistent sucking reflex, their tongue may remain too far forward in the mouth, causing it to rest on the floor of the mouth. This can make it difficult for the child to close their mouth and breathe through their nose. The persistent sucking reflex can affect the child's entire head position and posture, with the head often being tilted forward.

If the tongue is placed too far forward in the mouth, it becomes difficult to control, leading to problems with speech, swallowing, and drooling. The child may also have difficulty coordinating breathing and speaking and may be unable to eat with their mouth closed. Even if the sucking reflex later inhibits and the tongue moves to the correct position, the tongue needs to be strengthened, as it is likely to be weakened.


The most common symptoms of a persistent rooting and sucking reflex include:

  • the tongue staying too far forward in the mouth, making it difficult to chew and swallow, and causing drooling

  • Speech and articulation problems

  • Poor fine motor skills

  • Excessive sensitivity around the mouth

  • A need for oral stimulation- always need to chew or suck something - they suck their thumbs, hair, pencils, collars, etc.

  • May be picky about food textures



Landau reflex

The Landau reflex is a critical milestone in a child's development, as it helps to improve muscle tone and head lifting in the prone position. The reflex typically emerges between the ages of 3 to 10 months and is inhibited around the age of 3. When a caregiver lifts and holds the child with their hands under the child's chest and facing the ground, the child should stretch or slightly bend. An exaggerated extension may occur in cases of hypertonia, while hypotonia may cause the child to "fold" around the caregiver's hands.

The Landau reflex is important as it helps to inhibit the tonic labyrinthine reflex and enables the child to lift not only their head but also their chest. This skill is a prerequisite for more complex movements of the arms and legs simultaneously, such as running, hopping on one leg, hopping, and cycling.

The most common symptoms of persistence of the Landau reflex:

  • problems with rapidly alternating and more complex movements: running, hopping on one leg, hopping, cycling


Symmetrical Tonic Neck Reflex (STNR)


The Symmetrical Tonic Neck Reflex (STNR) is a reflex that occurs before a child begins to crawl on all fours. It helps to break the Tonic Labyrinthine Reflex (TLR) at the level of the pelvis, which allows the child to use both halves of the body separately. STNR causes the lower half of the body to automatically do the opposite of what the upper half does. The task of this reflex is to lift the baby from a prone position to a sitting position on the heels in preparation for crawling. Once the baby is in the heel position, it begins to rock to all fours and back to the heel position, experimenting with movement and examining its own abilities. Once the child learns to reach these positions of their own volition, they suppress the reflex response and begin to improve movements by climbing and later walking.

Children with persistent STNR tend to have poor coordination of the upper and lower halves of the body. They often sit "collapsed" on a chair during classes and almost lie with their heads on the table at the end of the school hour. These children also often sit on one or both legs or "hang" on a chair. Another popular position is sitting on the ground with the bottom between the heels (the so-called W-position). Children with STNR persistence have a harder time learning to swim.

The most common symptoms of STNR persistence:

  • Skipped the crawling phase as walking is easier for them

  • Poor movement coordination

  • Tendency to "collapse" and almost lie with their head on the table at the end of the school lesson

  • Problems focusing the eyes far and quickly back, problems copying text from the blackboard

  • Sitting on one or both legs

  • "hanging" on a chair, lying on a table

  • An inability to concentrate when they have to sit in one position all the time

  • Having a harder time learning to swim (preferring to swim under water)

Articles on the subject of primary reflexes

Image by Rachel Forrez

Want to learn even more about primary reflexes?


Order my book Persistent Primary Reflexes. In the Czech environment, it is a unique publication about persistent primary reflexes and is intended for a wide range of readers and especially for those who are trying to solve the cause of the exponentially increasing problems with learning and behavior of today's children.

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PhDr. Marja Volemanová, PhD.

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