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  • Writer's pictureNatasha Mileusnic

"Retained primitive reflexes" can have a big impact on learning and development

When my son Luke was doing occupational therapy for visual-motor coordination (a weakness we’d uncovered in testing for learning differences), one phrase kept coming up over and over: retained primitive reflexes. I didn’t know what it meant or why it was relevant.

Now I have an appreciation for these reflexes, and I wish I’d learned about them years ago.

Newborn babies have a collection of primitive reflexes (e.g., sucking, grasping an object) that usually get integrated within 6–7 months. If the reflexes don’t get properly integrated — if they’re “retained” — this can lead to various difficulties as children grow.

With Luke, our occupational therapist noted a “definitely irregular ATNR reflex,” and gave us a detailed handout. Here’s an excerpt:

“Asymmetrical Tonic Next Reflex (ATNR) — When the head of a baby is turned to one side, the arm and leg on the side to which the head is turned with straighten, while the opposite arm and leg pull in.



Present at birth and typically integrates around 6 months.

Helps develop muscle tone, provides vestibular stimulation, develops balance, decreases chances of breech birth, initiates eye hand activities, helps initiate rolling.

If the ATNR reflex is retained, some of these characteristics may result:

  • Delay in motor milestones

  • Delayed eye-hand skills

  • Poor midline development; difficulty in crossing the midline

  • Difficulty with sharing information between right and left hemispheres

  • Visual perceptual difficulties

  • Difficulty with auditory processing

  • Poor organization

  • Poor handwriting

  • Awkward pencil grip with increased pressure

  • Difficulty copying from the board

  • Missing parts of the line when reading

  • Difficulty catching balls

  • Discrepancy between oral and written performance

  • Decreased balance

  • Poor at sports”

It turns out that Luke did have some of these traits — like difficulty “crossing the midline,” or raising your right knee up to meet your left elbow, for example — but I’d noticed only one. “Missing parts of the line when reading” is what had sent me searching for answers in the first place.

We’d ended up at OT after a long journey that started with an early ADHD diagnosis and continued into third grade, when Luke hated school. It seems likely that the vision difficulties we discovered were at least partly related to Luke’s retained ATNR reflex. (The reflex is now integrated and he’s done with OT.)

When Luke was an infant we had dutifully brought him in for regular pediatric checkups, and his development was right on track. I wish I’d known to ask about these primitive reflexes. If we’d caught it sooner we might have lessened Luke’s later struggles, especially with reading.

Here’s some information about all the primitive reflexes; and these are ones that particularly have to do with the visual system. Finally, please note that I’m not an expert in any of these areas — just a parent who continues to learn.

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