Retained Reflexes related to Learning Difficulties



Photo Compliments of Free Digital Photos


Did you know that there are 70 known primary reflexes? Here at Optometric Physicians, Nashville Vision Therapy Center, we concentrate on the primary reflexes that are known to affect educational progress. From previous posts we have learned what primitive reflexes are, and how the reflexes become retained. Today we will explain briefly what these reflexes do and how they cause interference when they are retained.

 First up: Asymmetrical Tonic Neck Reflex (ATNR)

The ATNR reflex is noticed before 6 months of age when a baby turns its head to one side and the limbs on that side straighten then the limbs on the other side bend or flex. ATNR should be switched off at six months of age. The retention of this reflex causes the most interference with a child’s learning process. It is responsible for problems with:

• Handwriting - Problems with handwriting is the most obvious casualty of the retained ATNR. Each time a child turns his head to look at the page, his arm will want to extend and the fingers will want to open. Holding and working a pen or pencil for any length of time will require enormous effort. This leads to very heavy pencil grip and tension in the body. All the energy is now going into the writing and distracts attention from the writing content. Some children learn to compensate with an immature pencil grip. Writing may slope in different directions from one side of the page to the other so the child may rotate the page as much as 90 degrees when writing in an attempt to “accommodate” the effect of ATNR.
• Reading - This deals with eye tracking difficulties. When reading some things you might notice is the eyes do not move smoothly from one side of the page to the other, and they often jump. This results in loosing your place, loss of accuracy, which  then leads to poor comprehension.
• Mixed Laterality – Child may use left foot, right hand, left ear or child may use left and right hands interchangeably for the same task. The effect of mixed laterality can be failure to send information to the most efficient centre of the brain for that skill. Competition between 2 centres may occur, which is very like two people trying to drive the same car.

Symmetrical Tonic Neck Reflex (STNR)

This reflex allows the baby to straighten its arms and bend its legs when it looks up. The STNR reflex is present in normal development for a relatively short time span and is normally lost at 8 months after birth. If it is not lost, it can affect a child’s ability to crawl on hands and knees. Crawling is a major developmental milestone, as a baby crawls, as well as looking ahead, babies also learn hand-eye coordination from the movement of the hands.  Later on this ability will be essential for being able to read without losing the words at the middle of the line and to visually follow the moving hand when writing. The focusing distance and hand-eye coordination skills used in the act of crawling are at the same distance that the child will eventually use when reading and writing.

Other symptoms of retained STNR include:

• Poor posture
• Poor hand-eye coordination
• Clumsiness
• Slow at copying from board 

Moro Reflex:
The Moro Reflex should disappear at 2-4 months and should be replaced by the adult “Startle” reflex. The Moro reflex is a response to unexpected changes within the infant’s environment and acts as the infants’ “fight of flight” response. The prolonged retention of this reflex can be highly disruptive to a child’s development.


Symptoms of a retained Moro Reflex include:

• Poor coordination (particularly during ball games) – which leads to poor sequencing and memory skills
• Balance problems
• Motion sickness
• Sensitivity to bright lights
• Difficulty reading black print on white paper
• Tires easily under fluorescent lights
• Dislike of loud noises
• Easily distracted
• Allergies and lower immunity
• Dislike of change- child may be clingy or shy

Tonic Labyrinthine Reflex (TLR)
The TLR is the opposite of STNR; when a baby looks up TLR causes the baby to straighten it’s legs and arms, likewise when the head goes down the limbs fold in. This reflex should be fully present from the time of birth to 4 months old. It is active during the birthing process. It is linked to balance and muscle tone. If this reflex persists it will disrupt balance and gross motor skills. 
        Symptoms of this retained reflex can include:

• Poor posture
• Tendency to walk forward on toes
• Weak at ball skills
• Poor articulation

Spinal Galant Reflex:
This reflex is present at birth, and should disappear by the time the baby is 9 months old. The Spinal Galant Reflex provides the opportunity to experience a change from whole body movements to same side (homolateral) movements.  The Spinal Galant Reflex emerges at 20 weeks in utero, is actively present at birth, and should be integrated by the time the baby is 3 to 9 months of age. The Spinal Galant Reflex is present when a baby is placed in a prone position (on their stomach) and stimulation is placed to one side of the spine, the hip on the side of the stimulus will flex (curl toward that side).  This reflex helps the baby to work its way down the birth canal during the birthing process, and also allows the fetus to hear and feel the sound vibrations in the womb.The Spinal Galant Reflex is important in the development of hearing and auditory processing, as well as helping to achieve balance when the child is creeping and crawling.  If persists, the child experiences :

• Restlessness
• Fidgeting
• Inability to sit still
• Bedwetting
• A tendency to dislike tight clothing
• Poor concentration and short term memory

It is great to be educated on all these reflexes. The great news is we can do several different exercises to improve all the above areas. We now know that with retained reflexes it can hinder your child's educational progress. Let's work together, build up these reflexes and improve your child life!

What Causes Reflexes to Be Retained?

I have been doing a lot of research on Primitive Reflexes. I have so many great articles that have helped me understand each reflex and how to implement them into our office.  From Visual Dynamix inc. , I found this great article on what causes reflexes to be retained. Take a look!

What Causes Reflexes to Be Retained?

There are a number of different reasons why primitive reflexes fail to integrate.  One of the biggest factors that cause reflexes to be retained is a traumatic birthing process.  This includes prolonged or premature birth, breach position, births involving forceps or suction, and emergency Caesareans.  The general increase in Caesarean section births may also be a contributing factor to the increased incidence of retained primitive reflexes since some of the reflexes are stimulated by the process of passing through the birth canal during natural childbirth.  The reflexes involved in aiding the birthing process are more likely to still be ‘present’ at a later age with children that were born via Caesarian section. 

Societal factors can also come into play such as not allowing babies to spend enough time lying on their stomachs (tummy time) due to the fear of Sudden Infant Death Syndrome (SIDS).  *It is important to follow the advice of your pediatrician regarding SIDS. 

Another societal factor that can cause reflexes to be retained is the lack of exploration of the infant’s space and world during the creeping and crawling stage.  If an infant spends a great deal of time in a car seat, stroller, crib, or other confining environment it is more likely that the primitive reflexes will be retained past the typical timeline.

Doing “too much, too fast” can also be detrimental to the developmental process.  As a child develops they gain more and more control over their physical body. 

Children progress from lying on their back, to rolling over onto their stomach, to creeping, to crawling, and eventually to walking.  Some parents will comment, “My child was very fast to develop!  He was walking very early!”  Unfortunately, the child who spends little time crawling can miss out on some valuable developmental experiences for visual-spatial development. 

It is very important that we first gain mastery of our environment from the ground as this stage of development strengthens our muscular system and sets in place the building blocks for higher-level coordination and spatial awareness.