What’s all this talk amongst OTs and Developmental Optometrists about “Primitive Reflex Therapy?”

What’s all this talk amongst OTs and Developmental Optometrists about “Primitive Reflex Therapy?”

Primitive reflexes are the first building blocks/foundations for one’s eventual ability to navigate space and conquer gravity, as well as to launch smooth/precise motor responses to visual, auditory, olfactory, and tactile stimulation.

When primitive reflexes do not extinguish as an individual moves more toward what is termed “postural reflexes,” this can interfere with many aspects of life such as the following: body schema (knowing where one’s body ends and the world starts), pairing motor movements with sensory stimuli, self-regulating attention and emotions, developing higher-level coordination (fine and gross motor skills), developing appropriate nonverbal mannerisms to be consistent with the situation (using hand and body gestures to supplement language), running or walking with smoothness and traditional posturing, all aspects of handwriting, processing speed, bilateral integration, oculomotor tracking and convergence, and other higher cortical functions.

When primitive reflexes become integrated, a strong foundation for more sophisticated, normal postural reflex development will be possible. As primitive reflexes slowly extinguish, what’s left will merge with postural reflexes as a child transitions in development. Postural reflexes are automatic movements that control the body position/awareness (schema), of an infant, toddler and preschooler, as they become upright, move, and learn to negotiate with gravity. These reflexes maintain posture, balance, fluidity for movement, and bilateral integration.

What are the primitive reflexes that should get out of the way of developing postural reflexes?

Moro Reflex

The Moro Reflex is often called the Startle Reflex. That is because it usually occurs when the baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out his or her arms and legs, cries, and then pulls the arms and legs back in. A baby’s own cry can startle him or her and trigger this reflex. This reflex lasts until the baby is about 2 months old.

Rooting Reflex

The Rooting Reflex begins when the corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and “root” in the direction of the stroking. This helps the baby find the breast or bottle to begin feeding. This reflex lasts about 4 months.

Sucking Reflex

Rooting helps the baby become ready to suck. When the roof of the baby’s mouth is touched, the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Therefore, premature babies may have a weak or immature sucking ability because of this. Because babies also have a hand to mouth reflex that goes with rooting or sucking, they may suck on their fingers and hands.

Tonic Neck Reflex

When the baby’s head is turned to one side, the arm on that side stretches out, and the opposite arm bends up at the elbow. This is often called the Fencing Position. This reflex lasts until the baby is about 5 to 7 months old.

Palmar Grasp Reflex

Stroking the palm of a baby’s hand causes the baby to close his or her hand in a grasp. The Palmar Grasp Reflex last until a baby is about 5 or 6 months old.  A similar reflex in the toes lasts until 9 to 12 months.

Stepping Reflex

This reflex is also called the Walking or Dance Reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface. This reflex last about 2 months.

In summary, as primitive reflexes transition toward postural reflexes, new sets of reflexes emerge. However, if one is not migrating through the primitive reflexes as would be expected, this can inhibit the development of postural reflexes and result in a host of under-integrated sensory motor systems.

When these reflexes have not extinguished as expected, higher-level sensorimotor, attentional difficulties, and learning challenges are inevitable. As parents, if you believe your child’s ability to manage gravity is challenged (gravity is winning) and you see difficulties in timing, coordination, self-regulation, body awareness, eye tracking, and/or an over responsiveness to stimuli, you may want to consult with an Occupational Therapist for formal assessment and treatment planning.


Please also see this article by Dr. Robert Melillo regarding 5 Exercises that Inhibit Primitive Reflexes (http://drrobertmelillo.com/2016/03/18/5-exercises-inhibit-primitive-reflexes/)


  1. stich onesie

    obviously like your website however you have to check the spelling on several of your posts. A number of them are rife with spelling problems and I find it very troublesome to inform the truth however I will surely come again again.

    • Hi Stich Onesie, Dr. Rizzo who writes these posts is dyslexic and uses voice to text. We diligently check these for spelling errors but a few do tend to slip through from time to time with so much to check through. Thank you for pointing this out and we will improve our spelling!

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