Primitive Reflexes
By Sibella van Wyk (B. Occ Ther UP)

Let’s start at the beginning. What is a reflex? A reflex is an immediate and automatic response to a specific stimulus. In other words, these responses are not voluntary. Primitive Reflexes are a group of motor reflexes found in infants. These reflexes start to develop during pregnancy in the foetus and can be elicited after the birth of a healthy baby. ¹ These primitive reflexes can originate at spinal level or brainstem level.

 

Why are primitive reflexes so important?
Primitive reflexes help the baby to survive when his/her nervous system is not yet fully developed. ¹ It also facilitates movement of the baby, which is important for the progressive development of the child, such as rolling, sitting, crawling and standing. As these primitive reflexes are integrated, higher patterns of righting and equilibrium reactions will be established. It is important to take note that a child may ‘skip’ one level of development, such as creeping, but continue to develop normally.

 

Why is it important to know about primitive reflexes?
Primitive reflexes can serve as an indicator for normal development. The various primitive reflexes are expected to present at a specific age and to also be integrated at a specific age. Thus, if a child either does not present with the appropriate primitive reflex when it is expected, or if they present with a primitive reflex after it is expected to be integrated, it can assist medical professionals in early diagnosis of abnormalities in the neurological functioning of the child. This further ensures that the child receives the necessary intervention early, which assist in more effective functioning.

 

Below are some of the primitive reflexes, their purpose, what it looks like and presentation/integration ages²:
Please note that you should not perform these primitive reflex testing on your child, or any other child. A neurological assessment can be done by a medical doctor, occupational therapist or physiotherapist.

Why is it important that these primitive reflexes are integrated at the right age?
Even though primitive reflexes initially assist the baby in developing normally and to progress to more voluntary movements, the opposite might be true if the reflex is not integrated at the right age. In Reflex Testing Methods for Evaluating C.N.S Development, they explain it as follows: “When the inhibitory control of higher centres is disrupted or delayed, primitive patterns dominate to the exclusion of higher, integrated sensorimotor activities.”³ In other words, these primitive reflexes take over and result in abnormal movements and muscle tone. This can then further interfere with effective movement and participation in desired activities. A good example of this is in children diagnosed with cerebral palsy. Children with cerebral palsy often present with various primitive reflexes that are still present after the expected integration age. This inhibits the child’s ability to perform voluntary movements effectively, and thus hinders their development and quality of life.

 

What can I do if I suspect my child has primitive reflexes or is not developing normally?
If you suspect that your child is delayed in their development or is presenting with abnormal reflexes, you can take them to a medical doctor or occupational therapist for a neurological assessment. In the case that abnormalities regarding neurological functioning are detected, referral to a neurologist will be done. If required, you will also be referred to other medical professionals such as speech therapists or physiotherapists. The necessary intervention will then also be given to facilitate the integration of primitive reflexes and to promote the child’s development with regards to gross-motor, fine-motor, visual perceptual, cognitive and sensory functioning.

 

References
1. Ptive Reflexes [Internet] 2018 (cited 2018 Jan 16). Available from: http://www.neurostart.co.uk/primitive-reflexes/
2. Sprocket therapy solutions. Primitive Reflexes [Image on the internet]. (updated 2016 Sept; Cited 2018 Jan 16]. Available from: http://www.sprockettherapy.com/primitive-reflexes.html
3. Fiorentino MR. Reflex Testing Methods for Evaluating C.N.S Development. Second Edition. Illinois, USA: Charles C Thomas Publisher; 1981.

 

Disclaimer: The information in this article should not be used as medical advice. Information on this site is intended for educational purposes only. D.O.T and Sibella van Wyk Occupational Therapist does not claim responsibly for any injuries that result from the educational information.

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