“Evidence-based practice (EBP) is based on integrating critically appraised research results with the practitioner’s clinical expertise, and the client’s preferences, beliefs, and values “(AOTA). 

Primitive reflexes are often a hot topic in OT forums. 

  1. Many OTs believe that retained primitive reflexes can interfere with a child’s learning.

  2. Others feel that the minimal research that’s been done isn’t substantial enough.

Personally, I took the Integrated Learning Strategies Retained Primitive Reflex Course, and when I tested some of my students that exhibited the symptoms, I saw exactly when the course said I would.  You can see examples of retained reflexes here.

The Retained Primitive Reflex course includes: 

  • More than 40 videos of personal instruction, testing for the reflexes and exercises to integrate the reflexes
  • 85-page digital handbook with signs and symptoms of primitive reflexes, myths about primitive reflexes, testing and exercises
  • 7 charts and graphs that include parent observation sheets, exercise schedule, progress tracking sheets, learning and motor development checklists and much more
  • Private Facebook group where you can ask questions about testing or exercises, visit with other parents or OTs that have had similar experiences and receive additional instruction or training as needed.
  •   Don’t wait to join because the e-course is only available three times a year.

Research that supports the idea of working to integrate retained Primitive ReFlexes:

Retained Primitive Reflexes in ADHD and ASD among Children in an Inpatient Psychiatric Setting

Written by Occupational Therapists, this article studies 96 children with ASD and ADHD in an inpatient psychiatric setting.  The purpose of the study was to find out which primitive reflex is most common, and to what degree are the reflexes associated with ASD and ADHD symptoms and executive function deficits. They used a cross-sectional study design. 90.3% of the sample had at least one retained reflex. The most common reflex observed was the ATNR (82.4%).  ATNR was the most common reflex among children diagnosed with ADHD and ASD. ATNR. was significantly positively associated with inattention and executive function deficits.  Conclusion: ATNR and STNR are the most common retained reflexes among children diagnosed with ASD and ADHD. This article offers an evidenced-based rational in order to assess and integrate primitive reflex interventions within pediatric occupational therapy practices, especially with children diagnosed with ASD and ADHD.

Retained Primitive Reflexes and ADHD in Children

This research article studies children ADHD (ages 8-11) and primitive reflexes; specifically pertaining to the Moro and Galant reflexes.  Their study confirmed that children with ADHD have a high occurrence of primitive reflexes. Also, as a consequence, these reflexes may play a role in ADHD.  This article explains how they tested for the Moro and Galant reflex that you could potentially try with your students.  The article summarizes by stating, “these persisting primitive reflexes may play a role in ADHD.”

Retained Primitive Reflexes 

Reflexes play a vital role in survival during certain age periods but should then naturally disappear.  If the reflexes don’t integrate, developmental delays can occur.  Symptoms may be concentration, impulse control, weak balance, and poor posture.

An abstract of the book Reflexes Learning and Behavior, written by Sally Goddarth-Blythe,  is provided. Her book explains how learning can be affected if reflexes are not integrated beyond the age of 3.  Her book explains the reflexes and provides interventions.

The Correlation between Primitive Reflexes and Saccadic Eye Movements in 5th Grade Children with Teacher-Reported Reading Problems.

Abstract: This research article focused on the Moro reflex, ATNR, TLR, and the STNR. The study found that children with retained primitive reflexes had reduced saccadic accuracy and decreased reading ability. The main reflexes associated with reading problems were the TLR and STNR. The information provided in this study may further determine if vision therapy should be implemented to inhibit primitive reflexes and to improve saccadic eye movements and reading skills.

Effect of Reflex Neuromodulation on an Infant with Severe Amniotic Band Syndrome: A Case Report on the use of MNRI Techniques for Physical Therapy

Side note: MNRI stands for Masgutova neurosensorimotor reflex integration. Dr. Masgutova created the Masgutova Method, which is a set of programs that focus on motor reflex and sensory integration. She has studied how communication, cognitive, behavioral, and emotional regulation can be affected by motor reflex and sensory integration. Her website offers MNRI training.

This link is specifically to the page where you can learn about the importance of reflexes. From there you can click on other links of reflex examples, the importance of reflex integration and clinical observations.

Abstract: This research article focuses on using the MNRI method for physical therapy interventions with children born with amniotic band syndrome. Amniotic band syndrome is a rare congenital disorder that can lead to physical abnormalities, especially pertaining to an upper extremity. This article discusses how using the MNRI method can lead to new potential interventions and another tool to use in your therapy tool kit.

Reflex Based Interventions For Children with Autism and Developmental Disabilities: An Evidence-Based Practice Project

(This is a rather large document, consisting of 255 pages of information!)

Abstract: Their evidence-based PICO Question was: Are reflex-based interventions effective for improving occupational performance when treating children with autism and developmental disabilities? They focused on the MNRI method, reflex integration, and rhythmic movement training. Page 119 summarizes 5 research articles pertaining to reflex integration. Each category they focused on explains in depth a variety of articles all a part of their evidence-based practice project.

Integrated Learning Corner is a great website to learn about Primitive Reflexes.

Their reflex E-course contains 40 video lessons, a handbook, tracking sheets, reflex exercise schedule, observation materials, and the ability to join a private Facebook support group. If you aren’t sure you are ready to purchase the course, you can read some of the articles they have posted. They have three articles for you to briefly learn about Primitive Reflexes. The articles are called:

  1. Primitive Reflexes: How Retained Primitive Reflexes are Holding My Child Back in Learning and Motor Development.
  2. RED FLAGS: Are These Warning Signs and Red Flags Telling Me My Child May Have a Retained Primitive Reflex Delaying their Learning Devel
  3. MYTHS: The Myths about Retained Primitive Reflexes that could be Holding Your Child Back in their Learning and Motor Development.

Don’t forget to get your FREE handout on the signs of Retained Primitive Reflexes!primitive reflexes, retained reflexes, ATNR, Moro Reflex, Galant Reflex, STNR

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What do Retained Primitive Reflexes Look Like?

What are ReTAINED Primitive Reflexes? 

Primitive reflexes start to develop in utero and they actually help the baby get down the birth canal during labor. (Who knew!?) A reflex is an automatic motor response that is triggered by a stimulus.

These primitive reflexes assist the baby in their developmental milestones, helping them with things like breastfeeding, rolling and crawling. But if the reflexes don’t integrate (go away), they can hinder a child’s development. Retained reflexes can cause:

  • Sensitive to touch, sound, smell and taste
  • Balance issues, is clumsy, struggles with sports, runs into furniture
  • Freezes or is in constant fight or flight mode
  • Poor impulse control, easily distracted, severe mood swings
  • Can’t cross the midline, trouble with hand-eye coordination, struggles with fine motor
  • Has difficulty tracking when reading and writing
  • Poor posture, attention issues, wraps legs around chair, wets the bed after age 5
  • W-sitting, poor muscle control, toe walking

how Do YOU tell if your child has a retained reflex?

Get your Free Signs of Retained Reflexes:

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Get your Free Printable “Signs of Retention” Handout

The primitive reflex course from Integrated Learning Strategies teaches you how to test for each of the reflexes, as well as the exercises to do to help integrate them.

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Click here to sign up for the E-Course

TESTING The Moro Reflex

The Moro Reflex is usually present in infants 3 to 4 months. The child responds to a sudden loss of support by spreading their arms, then bringing them in, and crying. This reflex should be integrated by the age of 6 months. If the reflex does NOT integrate, the child may exhibit signs of distractibility, poor balance and coordination, emotional outbursts, food sensitivities, withdrawn behavior, or frequent car sickness.


A child attempting to pigeon walk, as part of the testing for a retained Moro Reflex. The child’s awkward arm position indicates that the reflex IS NOT yet integrated. Other signs of a retained Moro Reflex may be distractibility, balance and coordination difficulties, emotional outbursts, food sensitivities, frequent car sickness.  

An Integrated Moro Reflex:


Integrated Moro Reflex- the Cross Over Test

Are you intrigued?  You can sign up for the Retained Primitive Reflex Course here. These videos are showing two ways to test for the Moro Reflex, which should be integrated (gone) by 6 months of age. Looking at these videos, it’s easy to see which child has a retained Moro reflex. The other child has a simple time performing the exercises.

The Retained Primitive Reflex Course is available for early bird discount ($99.00) until March 19th.   After that, the course goes up to $127, and is available until April 1st.

Primitive Reflexes e-Course and Handbook includes the following:

  • More than 40 videos of personal instruction, testing for the reflexes and exercises to integrate the reflexes
  • 85-page digital handbook with signs and symptoms of primitive reflexes, myths about primitive reflexes, testing, and exercises
  • 7 charts and graphs that include parent observation sheets, exercise schedule, progress tracking sheets, learning and motor development checklists and much more
  • Private Facebook group where you can ask questions about testing or exercises, visit with other parents or OTs that have had similar experiences and receive additional instruction or training as needed.


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5 reasons to ditch the screens and PLAY!

This is a guest post about the benefits of play, written by Jenny Silverstone.

5 Extraordinary Benefits of Playtime

Sticky sap on hands from climbing trees.

Glitter going (and staying!) absolutely everywhere.

Always, the sound of laughter.

Playtime, in all of its various forms, is a hallmark of a happy childhood. However, in today’s fast-paced society children often lose the time they need to play. Some may wonder if playtime is truly a “big deal” and has any sort of positive effect on children as they grown.

The answer is a resounding yes! Playtime has many extraordinary benefits to help children in their physical, mental, and emotional development. Here are just five benefits of play.

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The real reason your students can’t sit still…Poor Core Strength!

Poor core strength is often the reason kids can’t sit still…

“Do you mind taking a look at one of my students?  He just can’t seem to stay in his chair…”

As a school based Occupational Therapist, I hear this question at least twice a week.

For the most part, kids are expected to sit at their desks in the classroom. There are times when the class breaks up into groups and move around to sit on the floor, etc., but for the rest of the day, they are supposed to sit in their seat.

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5 Creative Core Strength Activities


Need ideas to help your child get strong? Here are five creative core strength activities using the Core Strength Handbook!

Core Strength Actvities

Does Your Child Have Weak Core Strength?

Does your child slump and slouch all the time?

Do they have difficulty with balance?

Is their “helping hand” holding their body up, rather than hold their paper steady?

Do they always lean on a chair, the couch, or other furniture when sitting on the floor?

Are they struggling to participate in exercise due to poor endurance?

If you answered yes to any of these questions, your child may have weak core strength.

*This post contains affiliate links

I’ve been on a CORE STRENGTHENING kick lately.  Poor Core Strength is often an underlying cause of many other deficits a child may be demonstrating. Plus, it counts as “heavy work”, because it provides proprioceptive input – so it’s great for my sensory kiddos too!

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Your Child With Special Needs: How to Conquer Independent Bathing

child with special needs

Teach your child with special needs to shower independently with these 20+ tips from a pediatric OT. It will improve their quality of life as well as yours.


Your child with a Special Needs: How to conquer independent Bathing

20 plus Occupational Therapy tips and strategies to facilitate independent showering and bathing for your child with special needs

“I have no time to myself.  Ever.  My other kids were at least taking a bath by themselves by the time they were 7, but I can’t leave him alone….”

The young mom had bags under her eyes and a stain on her T-shirt.  The corners of her mouth turned down in a helpless, sad expression as she looked at her sweet ten-year-old child with Down’s Syndrome who was playing quietly with the toys in the waiting room.

She was exhausted.

Raising a child with special needs can do that to you.

I spent 5 years working as an Occupational Therapist in a residential home for adults with Developmental Disabilities.  Plus, working with dozens of families who have a child with special needs has taught me a few AMAZING tricks.

And I’m happy to share every one of them.

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positioning in the classroom

The Crucial Importance of Positioning in the Classroom

School Day Functions – Positioning in the classroom

Positioning in the classroom is a HUGE part of student success.  In fact, “properly fitted furniture is essential if children are to learn handwriting efficiently” (Henderson &  Pehoski, 1995).

One of my biggest pet peeves about working in the school system is the gosh darn furniture.   Children are often seated in furniture that is just not the right size for them, and it totally stinks.

On top of that, many teachers have never been trained to check if a child’s desk or chair is the right size.   For the ones who do check, what are the chances that the school has other furniture available?   Sigh.  Rant Over.

The point is – what adult would tolerate working all day at a desk that was way too high? Companies spend a fortune supplying their workers with wrist supports to avoid carpal tunnel injuries and screen guards to protect employees vision.  Shouldn’t we make sure our students are in the proper position, too? Continue reading

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