Primitive Reflex Integration in Occupational Therapy: Helping Kids Feel More at Ease
Ever wondered why your child insists on wearing the same socks every day, melts down over small changes, or struggles to sit still for handwriting?
These everyday challenges may be linked to something deeper in the nervous system called primitive reflexes.
In this post, we’ll explore what primitive reflexes are, why they sometimes stick around longer than expected, and how occupational therapy uses playful, movement-based activities to help.
You’ll also see what research says and how reflex integration can make daily routines like dressing, toileting, transitions, and learning feel a whole lot easier.
What Are Primitive Reflexes?
When babies are born, they come with built-in movement patterns called primitive reflexes. These automatic responses — like the Moro (startle) reflex or the grasp reflex — help infants survive and grow in their earliest months.
As the brain matures, these reflexes are supposed to fade away. But sometimes, they linger longer than expected. When that happens, kids may experience:
Big feelings and trouble calming down
Tough transitions between activities or routines
Strong sensory preferences, like always wanting socks or long sleeves, or refusing to wear certain clothes
Challenges with motor skills such as handwriting, balance, or coordination
What Is Reflex Integration Therapy?
Primitive reflex integration is a therapy approach used in pediatric occupational therapy. Through fun, movement-based activities, therapists help the brain and body “finish the job” of integrating reflexes.
Think of it like updating old software on a computer — once the reflexes are integrated, the brain is free to focus on higher-level skills like reading, writing, emotional regulation, and flexible problem-solving.
Why Occupational Therapists use Reflex Integration
At B.well tots, reflex integration is never a stand-alone therapy. It’s just one tool in a bigger plan that also includes:
Sensory processing strategies
Emotional regulation supports
Practice with real-life routines (like dressing, toileting, and transitions)
The goal is always functional: helping kids feel more comfortable in their bodies, more flexible in daily life, and more confident in learning and play.
What the Research Says
The science around reflex integration is still growing, but results are promising:
A randomized controlled trial in The Lancet (2000) found that children practicing reflex-based movements improved their reading skills by nearly two years in just 12 months.
A 2024 systematic review concluded that OT interventions targeting retained reflexes may help children improve attention and self-regulation, while emphasizing the need for more large-scale studies.
Research published in the American Journal of Occupational Therapy has linked retained reflexes with handwriting difficulties in school-aged children.
A BMJ Case Report (2023) showed that reducing retained reflexes in children with autism was associated with improvements in both cognitive function and brain activity patterns.
Signs Your Child Might Benefit from Reflex Integration
🚶 Motor & Postural Signs
Poor balance and coordination – frequent tripping, clumsiness, or difficulty riding a bike.
Slumped or “w-sitting” posture – struggles to sit upright without support.
Unusual gait patterns – walking on toes or with stiff legs.
Difficulty with bilateral integration – struggles to use both sides of the body together smoothly (e.g., catching a ball, crossing midline).
✍️ Fine Motor & Learning Signs
Messy handwriting or difficulty with spacing on paper.
Trouble with hand dominance (switching hands often).
Poor sequencing skills (trouble with steps in tasks, math, or reading fluency).
Difficulty with copying from the board or visual tracking when reading.
🧠 Cognitive & Behavioral Signs
Poor focus and attention – easily distracted or restless.
Impulsivity or difficulty with self-regulation.
Low frustration tolerance – emotional outbursts over small challenges.
Struggles with executive function skills (planning, organization, time management).
👀 Sensory & Reflex-Specific Signs
Each primitive reflex leaves its own “footprint” when retained:
Moro reflex: exaggerated startle response, hypersensitivity, poor impulse control.
ATNR (Asymmetrical Tonic Neck Reflex): difficulty crossing midline, poor hand-eye coordination, struggles with reading/writing.
STNR (Symmetrical Tonic Neck Reflex): poor posture at desk, difficulty sitting still, “slumping” during tasks.
TLR (Tonic Labyrinthine Reflex): weak muscle tone, balance problems, motion sickness.
Spinal Galant: fidgeting in chairs, bedwetting beyond typical age, discomfort with clothing waistbands.
✅ Takeaway: Signs of retained reflexes often show up as a combination of motor, learning, and behavioral challenges rather than one isolated issue. Occupational therapists, reflex integration specialists, and developmental pediatricians can screen for them and provide strategies or integration programs.
How We Support Kids at B Well Tots
Every child is different, which is why our occupational therapy plans are personalized to your child’s strengths and needs. Reflex integration is just one of the ways we help kids:
Develop stronger emotional regulation
Reduce sensory sensitivities
Navigate transitions with more ease
Gain confidence in school and play
The Bottom Line
Primitive reflexes are a normal part of development, but when they stick around longer than expected, they can make everyday life harder. Reflex integration therapy, backed by emerging research, gives children another path to thrive — helping them feel calmer, more flexible, and ready to shine in daily routines.
👉 Want to learn more? Reach out today and discover whether reflex integration could be the right support for your child.