Moro Reflex in Toddlers and Children: How a Retained Startle Reflex Impacts Development

Understanding the Moro (Startle) Reflex Beyond Infancy

When parents hear the term Moro reflex, they often associate it with newborns - arms flinging outward in response to loud noises or sudden movement. While this reflex is completely typical in infancy, it is designed to integrate, or fade, by 4- 6 months of age.

However, when the Moro reflex remains active beyond infancy, it can continue to influence a child’s sensory processing, emotional regulation, attention, and motor development well into toddlerhood and childhood.

What Is the Moro Reflex? 

The Moro reflex, also known as the startle reflex, is a primitive reflex that develops in utero and is present at birth. It is an automatic survival response triggered by:

• Loud or unexpected sounds

• Sudden changes in position

• Bright lights

• Unexpected touch

In typical development:

• The Moro reflex is strongest in early infancy

• It integrates naturally by 4-6 months

• Higher brain centers take over stress regulation

When integration occurs, children are better able to respond calmly and flexibly to everyday sensory input. This process is closely tied to early movement and postural development, which is why ‘why movement is essential for your baby’s brain development’ plays such a critical role in nervous system maturation.

What Is a Retained Moro Reflex?

A retained Moro reflex occurs when the nervous system continues to react as if the child is under constant threat. This can keep the body in a chronic fight-or-flight state, making everyday experiences feel overwhelming.

Children with a retained Moro reflex are not being “dramatic” or “overreacting” - their nervous systems are simply working harder to feel safe.

Signs of a Retained Moro Reflex in Toddlers and Children

Symptoms can vary, but common signs of a retained Moro reflex include:

Emotional Regulation Challenges

• Big emotional reactions to small stressors

• Anxiety or excessive worry

• Frequent meltdowns

• Difficulty calming once upset

• Avoidance of new or unfamiliar situations

  These patterns are closely tied to how the nervous system processes stress, as explored in social-emotional regulation across early years.

Sensory Processing Difficulties

• Sensitivity to loud noises or busy environments

• Discomfort with unexpected touch

• Easily startled or “jumpy”

• Difficulty tolerating transitions or changes in routine

  These signs often overlap with sensory processing differences. Parents may find clarity by learning more about helping kids with sensory-based feeding differences, which explains how sensory regulation impacts daily participation beyond mealtimes.

Attention and Arousal Differences

• Trouble focusing or sustaining attention

• Appearing constantly alert or on edge

• Fatigue from prolonged nervous system activation

Motor and Postural Signs

• Poor balance or coordination

• Fear of movement or playground equipment

• Motion sensitivity (swings, stairs, uneven surfaces)

Because these signs overlap with sensory processing disorder, anxiety, and ADHD, retained primitive reflexes are often missed without a comprehensive occupational therapy evaluation. 

How Occupational Therapy Helps with a Retained Moro Reflex

Pediatric occupational therapy focuses on how a child’s nervous system supports participation in daily activities - play, learning, self-care, and social interaction.

When a retained Moro reflex is identified, OT intervention supports nervous system regulation and reflex integration through purposeful, play-based activities.

Occupational Therapy Interventions May Include:

• Primitive reflex integration activities

• Proprioceptive (deep pressure) input to calm the nervous system

• Gradual vestibular input to improve balance and movement confidence

• Breathing strategies and body awareness exercises

• Sensory-environment modifications at home or school

• Emotional regulation tools to support coping and self-confidence

All interventions are individualized, developmentally appropriate, and designed to help children feel safe, regulated, and successful.

**If you’re wondering whether a retained reflex could be impacting your child’s behavior, learning, or emotions: Book a free 30-minute virtual consult with B.well tots to talk through your concerns and next steps in a supportive, no-pressure space.

Why Addressing a Retained Moro Reflex Early Matters

When a child’s nervous system remains in a heightened state of alert, it can affect:

• Learning and attention

• Emotional resilience

• Social participation

• Confidence and independence

With occupational therapy support, children can develop improved self-regulation, increased sensory tolerance, and stronger foundations for growth and learning.

When to Seek a Pediatric Occupational Therapy Evaluation

If your toddler or child demonstrates:

• Persistent startle responses

• Heightened anxiety

• Sensory sensitivities

• Ongoing regulation challenges

A pediatric occupational therapy evaluation can identify underlying neurological patterns and provide a clear, supportive path forward. Families unsure where to begin may benefit from reviewing holistic pediatric wellness: a guide to trusted providers.

**Not sure what kind of support would be the best fit? Explore the B.well tots provider pages to learn more about occupational therapy and other developmental specialists available to support your child.

The Moro reflex is a vital part of early development - but when it remains active beyond infancy, it can quietly impact a child’s daily life. Pediatric occupational therapy helps integrate these early reflex patterns and supports children in building calm, confident, and flexible responses to the world around them.