Bodymap wetenschappelijke onderbouw

Onderzoek reflexintegratie / groene flesjes

Primitive reflex retention and attention among preschool children

Pages 1-13 | Received 15 Jul 2020, Accepted 25 Mar 2021, Published online: 04 Apr 2021
Department of Occupational Therapy, Creighton University, Omaha, Nebraska, United States
Primitive reflexes are a critical part of early development but eventually integrate to give rise to volitional and cortically directed movements and higher-level cognitive skills. Failure to integrate these reflexes in a developmentally appropriate stage has shown correlation with developmental delays which affect occupational participation. Retention of reflexes may be linked to academic difficulties, including attention deficits in the classroom. The purpose of this study was to explore prevalence of primitive reflex activity among 4- to 6-year-old children and to understand the relationship between primitive reflex activity and attention. A total of 27 preschool students were screened for 7 primitive reflexes as well as attention utilizing the SNAP-IV. Overall, 100% of the students had at least 1 retained reflex, with STNR being the most common (81.4%). Males demonstrated more reflex activity than females for 6 of the 7 tested reflexes. A significant difference was found between males and females for scores within the inattention subtest of the SNAP-IV, with males scoring higher for inattention. Correlational analyses indicated a statistically significant relationship among males between ATNR activity and opposition/defiance as well as retention of Moro and inattention. Though ongoing research is indicated, the findings of this study support prior research which indicates a need for early screening of primitive reflexes as client factors which could impact occupational performance.

GRASP 2015

The Effects of Persistent Asymmetrical Tonic Neck Reflex (ATNR) on Reading Scores in First and Second Grade Children

Rebecca Montgomery,* Candise Nichols, Chelsey Ornburn, Amanda Rudd, Lindsey Williams
Faculty: Barbara Smith
Department of Physical Therapy, College of Health Professions

This study examined the relationship between a presence of a retained Asymmetrical Tonic Neck Reflex (ATNR) and its effect on reading scores of local first and second grade children. The ATNR, a primitive reflex seen in infants and normally integrated by 6 months, may be present in children up to age eight. ATNR’s retention is associated with certain learning disabilities, behavioral dysfunctions and motor maturation delay. These developmental deficits can also affect reading and motor skills including hand-eye coordination, left-right integration, visual tracking, and the ability to control the hand when writing.

A collection of standardized reading test scores was obtained from 66 first and second grade students. The student sample was additionally tested for ATNR retention level by a licensed school physical therapist. The school from which the participants were selected utilizes the AIMsWeb standardized test to assess student reading levels. This standardized test, at a basic level, measures the number of words a student can correctly read per minute. The AIMsWeb test efficiently and accurately measures a student’s progress because it is time efficient to administer and produces results that intuitively reflect increase in ability. A modified testing procedure was performed by the school physical therapist to obtain a score related with a gradation of ATNR retention level.

The findings showed that there was a significant relationship between total ATNR scores and reading in first grade participants. Those who demonstrated a more integrated reflex, or a higher ATNR score, showed fewer errors and a higher accuracy on the AIMsWeb reading test than those with a more persistent ATNR, or lower ATNR score.

The literature is equivocal as to the association between presence of the ATNR in first and second grades and their reading scores. The results support the findings of previous research demonstrating a link between ATNR retention and a lower reading score. These findings suggest that further research is needed in order to establish an effective integration program.

Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children 

by Anna Pecuch 1, Ewa Gieysztor 1,*, Ewelina Wolańska 2, Marlena Telenga 1 and Małgorzata Paprocka-Borowicz 1


Physiotherapy Department, Faculty of Health Sciences, Wrocław Medical University, Grunwaldzka 2, 50-355 Wrocław, Poland


Department of Pediatrics, Division of Pediatrics and Rare Disorders, Wrocław Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland


Author to whom correspondence should be addressed. 

Academic Editors: Christian Collet and Geneviève Albouy

Brain Sci. 2021, 11(8), 967;


Psychomotor development in the first year of life is possible due to activity and then integration of primitive (neonatal) reflexes. The presence of active primitive reflexes (APRs) in preschool and school-aged children indicates neuromotor immaturity. Studies show dependencies between the preserved activity of primary reflexes and developmental problems such as learning difficulties (problems with reading, writing, reduced mathematics skills, and dyslexia), difficulties with coordination, and attention deficit. The primary purpose of this study is to present the activity of three tonic reflexes in a sample of 112 Polish children aged 4–6 in relation to their motor skills. The children were examined for the presence of the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR). Motor performance was examined with the MOT 4–6. Statistical analysis shows an inverse correlation between the score in the test of reflexes and motor efficiency (MOT 4–6) at p < 0.05 (−0.33). Children with increased reflex activity presented a lower level of motor efficiency. The multiple regression model showed that with the older age of the child and the decrease in the level of reflex activity, the motor skills of children improve. Thus, there is a need for early screening of primitive reflexes in children. Properly selected exercises and therapeutic activities aimed at integrating APRs in children with developmental difficulties can improve their motor skills, perceptual abilities, and emotional behavior.

Neuromotor readiness for school: the primitive reflex status of young children at the start and end of their first year at school in the United Kingdom

Pages 654-667 | Received 09 Nov 2020, Accepted 15 Feb 2021, Published online: 08 Mar 2021
d Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
The presence of primitive (infant) reflexes in school-aged children as indicators of immaturity in neuromotor functioning has been associated with under-achievement in terms of reading, writing and mathematics, and been linked to conditions such as dyslexia, developmental coordination disorder (DCD) and attention deficit and hyperactivity disorder (ADHD). The research presented here explores the extent to which three such reflexes, previously linked to learning and behavioural difficulties in the classroom, were present in a sample of 120 children in the September that they started formal schooling (aged 4–5) in the United Kingdom (UK). Approximately half of these children then participated in a movement programme and 108 were then tested again towards the end of their first year at school. The data demonstrate that a high percentage of young children are, indeed, starting school with one or more of these reflexes present to some extent. Those children who received no additional input throughout the school year showed no improvements in their reflex status when compared to children who had participated in a developmental movement programme. Thus, recommendations are made for further research; particularly in relation to neuromotor screening, appropriate physical development provision prior to and during school; and developmental movement interventions for older children.

Vestibular stimulation and primitive reflex integration may drive multisensory processing: putative principles for a Targeted sensorimotor therapy (TSMT)

Szilvia Harsanyi

Debreceni Egyetem

Karoly Dobos

Debreceni Egyetem

Brigitta Tele-Heri

Debreceni Egyetem

Judit Palinkas

Debreceni Egyetem

Fanni Fenyosi

BHRG Foundation

Csaba E More

Debreceni Egyetem

Judit Zsuga (  )
University of Debrecen

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University of Canterbury

Grigg, Tessa Maude


The birth of a human is facilitated by primitive reflexes which assist with the infant’s survival. Once the reflexes have been engaged, they then integrate and cognition takes over the functions needed to survive and thrive. Typically this process is completed within the first year of life. However, for some people, the primitive reflex integration process is interrupted, varying degrees of immaturity may persist and this may be associated with delays in skill acquisition. Movement-based interventions have been developed to assist the integration process. This thesis focuses on the phenomenon of primitive reflexes and the use of one reflex integration programme: Rhythmic Movement Training, with an aim of addressing the research question ‘What influences does the use of Rhythmic Movement Training (RMT) have in a classroom?’ The mixed methods methodology allowed the complexity of the issue to be explored hermeneutically and statistically. Ninety-eight New Zealand children, divided into two groups, intervention and control, used the RMT movements for between five and ten months. Seven teachers and 26 parents were interviewed and test results relating to the children’s reflex profiles, Draw-A-Person Test, Reading, Writing, Mathematics and the Strengths and Difficulties Questionnaire were analysed. The findings and results of this thesis are organised around three emergent themes: the classroom, student achievement and student behavioural outcomes. The intervention’s focus on the ‘whole child’ was seen as a strength and recommendations for further research are made to extend what is known about how and why primitive reflex integration enhances children’s development. The teachers found the generic RMT programme easy to use with their children and they noticed positive changes in focus, achievement and self-worth. Statistically significant differences were detected in student reflex profiles, reading scores, social and emotional challenge scores when RMT was used four or more times each week for five months. This research also found that there were gains noted by teachers and parents, and improved results for children when they were engaged in this reflex integration programme using generic movements for five minutes per day, four or more times a week for five months.

Journal of Research in Special Educational Needs•

Volume 5•

Number 3•

2005 101–111

doi: 10.1111/J.1471-3802.2005.00049.x

Blackwell Publishing, Ltd.

The effects of the Primary Movement programme

on the academic performance of children attending

ordinary primary school

Julie-Anne Jordan-Black

Queen’s University, Belfast, Northern Ireland


The present study investigated the prevalence of a

primary reflex (the Asymmetrical Tonic Neck Reflex)

in children attending ordinary primary school and

how this related to attainments in a number of

academic areas. The effectiveness of a specific

movement intervention programme in reducing

primary reflex persistence and improving academic

attainment was also evaluated.

A comparative study of the progress of 683 children

over a two-year period from Years 3 and 5, who

completed an intervention programme known as

Primary Movement, was carried out using the

relative attainments of children at the same schools

and standardised scores as baseline and follow-up

measures. A second, quasi-experimental study

followed the progress of four parallel groups in each

of two large schools with the experimental side

completing the movement intervention programme

while the other side acted as the control.

It was found that ATNR persistence was significantly

associated with level of attainments in reading,

spelling and mathematics and that boys were more

at risk than girls for ATNR persistence. In both

studies, it was found that the movement intervention

programme had a very significant impact on

reducing the levels of ATNR persistence in children

and that this was associated with very significant

improvements in reading and mathematics, in


This research provides further evidence of a link

between the attainment of core educational skills

and the interference that may result from an

underlying developmental deficit. The effectiveness

of the intervention programme in reducing ATNR

persistence and in increasing academic attainments

suggests that this programme could be used to

complement other strategies that have been shown

to have a positive effect on children’s learning.

Are effects of the symmetric and asymmetric tonic neck reflexes still visible in healthy adults?


S.M. Bruijna,b,∗, F. Massaada, M.J. MacLellanc, L. Van Gestela, Y.P. Ivanenkoc, J. Duysensa,d

a Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Department of Kinesiology, K.U. Leuven, Belgiumb Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China

c Neuromotor Physiology Laboratory, Santa Lucia Foundation, Rome, Italy

d Department of Research, Development and Education, Sint Maartenskliniek, Nijmegen, The Netherlands

Trunk rotation due to persistence of primitive reflexes in early school-age children

Ewa Z. GieysztorA–D,F, Ludwika SadowskaA,E,F, Anna M. ChoińskaA,E,F, Małgorzata Paprocka-BorowiczE,F

Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland

The Moro reaction: More than a reflex, a ritualized behavior of nonverbal communication

Pierre V.RousseauabFlorenceMattonaRenaudLecuyeraWillyLahayea
Department of Family Sciences, Faculty of Psychology and Education, University of Mons, Belgium
Department of Obstetrics, Tivoli University Hospital, La Louviere, Belgium

Received 16 December 2015, Revised 26 January 2017, Accepted 26 January 2017, Available online 20 February 2017



To propose a phylogenetic significance to the Moro reflex which remains unexplained since its publication in 1918 because both hands are free at the end of the gesture. 


Among the 75 videos of healthy term newborns we have filmed in a research project on antenatal education to parenthood, we describe a sequence that clearly showed the successive movements of the Moro reflex and we report the occurrence of this reflex in the videos that were recorded from Time 0 of birth defined as the moment that lies between the birth of the thorax and the pelvis of the infant.



This paper proposes for the first time a phylogenetic significance to the Moro reflex: a ritualized behavior of nonverbal communication. Professionals should avoid stimulating the newborns’ fear system by unnecessarily triggering Moro reflexes. Antenatal education should teach parents to respond to the Moro reflexes of their newborn infant by picking her up in their arms with mother talk.

Persistence of primitive reflexes and associated motor
problems in healthy preschool children

Ewa Z. Gieysztor1, Anna M. Choińska2, Małgorzata Paprocka-Borow

Rehabilitation Developmental Laboratory, Department of Physiotherapy,

Faculty of Health Sciences, Medical University of Wroclaw, Wroclaw, Poland

2 Department of Physiotherapy, Faculty of Health Sciences, Medical University

of Wroclaw, Wroclaw, Poland

Submitted: 14 September 2015

Accepted: 24 December 2015

A b s t r a c t

Introduction: Retained primitive reflexes can disturb natural development

and involve difficulties in social and educational children’s life. They can

also impact on psychomotor development. Mature responses in a child’s

psychomotor progress can only occur if the central nervous system itself

has reached maturity. The process consist the transition made from brain

stem reflex response to cortically controlled response. This study define the

occurrence of primitive reflexes in healthy 4–6 years old children and analyze

the impact of survived primitive reflexes on psychomotor development.

Material and methods: The study involved 35 participants aged 4–6 years

healthy preschool children. The study tools were: primitive reflexes tests by

Sally Goddard for children and Motor Proficiency – Test (MOT 4–6 test) in

18 tasks.

Results: Over a half (65%) preschool children had survived the primitive

reflexes on the residual level. Eleven percent of them had no retained primitive

reflexes. According to the psychomotor ability, 9% of the children were

in the category of “altered development”, 29% in “delayed development”,

59% in “normal” and 3% in “very good development”. The greater the severity

of the reflex, the motor efficiency was lower (p < 0.05).

Conclusions: It seems reasonable to introduce reflexes integration therapy

in children’s with low psychomotor skills. Primitive reflexes routinely tested,

can contribute to improved early psychomotor development in children with

needs, thus preventing many difficulties which children can encounter within

their social and school life.

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