The Connection between Primitive Reflexes, Vision and Motor Development

This blog was inspired by the patients I worked with throughout the day as we focused on retained primitive reflexes This might be the first time you have read about or even heard of Primitive Reflexes.

Primitive reflexes are the foundation of our early neurological development, present at birth to help us survive and establish critical motor and sensory pathways. While these reflexes are designed to integrate naturally within the first 24 - 36 months of life, factors such as environmental shifts, emotional discomfort or traumatic events can cause them to remain active or even reappear later in life. When this happens, the impact can ripple across motor, vision and sensory development and emotional regulation, often manifesting in ways that challenge daily functioning.

As a vision therapist, I often explore the intricate connections between our neurological development, visual skills and motor function. One area that frequently comes up in my practice is the role of primitive reflexes—automatic movements that develop in infancy and are essential for survival. While these reflexes are crucial during early development, if these reflexes are retained they can significantly impact visual development, learning, behaviour and emotional intelligence. 

Einstein once said, "Foundations are the building blocks of life." 

I passionately believe that reflexes form the foundation for higher-level learning.

In this post, I will “geek out” a little as I delve into how retained primitive reflexes, along with postural and equilibrium reflexes, can impact the development of our visual, motor and sensory systems. Additionally, I share some effective vision therapy techniques for integrating these reflexes and the importance of adapting therapy to meet the individual needs of each child (and adults as required).

Retained primitive reflexes can profoundly affect a motor development, emotional control and overall nervous system regulation. For example, the Moro reflex, if unintegrated, can lead to heightened anxiety, difficulty focusing and overreactions to stimuli. Similarly, a retained Tonic Labyrinthine Reflex (TLR) may result in poor posture, balance issues or challenges with spatial awareness. Retained Primitive reflexes can disrupt the brains ability to process sensory information effectively, which in turn impacts coordination, fine motor skills, and emotional responses. Over time, this can lead to frustration, diminished self-esteem and difficulties in academic, social or work environments.

Primitive reflexes are instinctual movements that infants are born with, serving essential purposes for survival and development.

There are a multitude of primitive reflexes. Throughout testing in office I focus on testing to see if the following reflexes are retained:

Grasp Reflex: Allows infants to hold onto objects placed in their palms, ensuring they can grasp their caregiver for security.

Asymmetrical Tonic Neck Reflex (ATNR): Triggered when the head is turned to one side, causing the arm on that side to extend while the opposite arm bends. This reflex facilitates hand-eye coordination but can become problematic if retained, leading to difficulties in visual tracking and spatial awareness.

Symmetrical Tonic Neck Reflex (STNR): This reflex emerges when the child is in a crawling position and helps develop coordination between the arms and legs. It is critical for the development of crawling and transitioning to upright posture. If retained, it can impact balance and coordination in activities like running or jumping.

Moro Reflex (Startle Reflex): A response to sudden stimuli like loud noises or unexpected movement, causing infants to flail their arms and legs before bringing them back in, which helps them cling to their caregiver during stressful situations. If retained, the Moro reflex can lead to anxiety and difficulties in sensory processing.

Spinal Galant Reflex: This reflex occurs when the side of an infants spine is stroked gently, causing the hip to flex on that side. It is essential for developing hip movement and coordination. Retention can result in issues with attention, emotional regulation and discomfort in seated positions.

Tonic Labyrinthine Reflex (TLR): This reflex helps maintain posture and balance in response to changes in head position. It facilitates the ability to stay upright and orient the body in space. When TLR is integrated, children can confidently engage in physical activities without excessive wobbling.

These reflexes are essential for initial development and typically integrate into more complex motor patterns by the time a child reaches one year of age. However, some children retain these reflexes, which can lead to various developmental challenges.

Retained primitive reflexes can disrupt visual processing and motor development in several ways:

Disruption of Eye Movements: Reflexes such as the Moro reflex can lead to difficulties with eye tracking and coordination. Children may struggle to focus on objects or follow moving items, impacting their reading and learning abilities. This disruption can lead to frustration in academic settings, where visual attention is crucial.

Difficulty with Visual-Motor Integration: Reflexes like the Grasp Reflex can hinder the development of fine motor skills and hand-eye coordination, affecting tasks like writing or drawing. Children may find it challenging to participate in art projects or sports that require precision, leading to decreased self-esteem.

Challenges in Spatial Awareness: Retained reflexes, such as the ATNR and STNR, can hinder the ability of a child to understand spatial relationships and depth perception, making activities like sports or navigating environments difficult. Children might also struggle to gauge distances accurately, affecting their ability to play games like tag or catch.

In addition to primitive reflexes, postural and equilibrium reflexes also play a vital role in motor and visual development. These reflexes help maintain balance and posture, ensuring that our bodies can respond appropriately to external stimuli. Key reflexes in this category include:

Equilibrium Reflexes: These reflexes, such as the Righting Reflex, help the body maintain its position and orientation when tilted or displaced. They are crucial for activities that require balance, such as walking or riding a bike. If these reflexes are not properly integrated, children may appear clumsy or have difficulty participating in sports and playground activities.

Retained postural and equilibrium reflexes can exacerbate visual challenges in a variety of ways.

Impaired Balance and Coordination: Children with retained equilibrium reflexes may struggle with balance, making it difficult to engage in sports or activities requiring physical coordination. This can impact their ability to visually track moving objects and anticipate their trajectory, leading to accidents or injuries during play.

Visual-Motor Integration Issues: If a child struggles to maintain proper posture due to retained reflexes, their visual-motor integration will likely be impaired. Tasks requiring fine motor skills, like writing or cutting, can become challenging, which may hinder academic progress.

Reduced Spatial Awareness: Difficulties in maintaining balance can lead to challenges in spatial awareness and depth perception, hindering activities that require precise visual judgment, such as navigating stairs or balancing on a beam.

Every child is unique, and their experiences with retained reflexes can vary significantly. As a vision therapist, adapting therapy to meet the individual needs of each child is crucial.

A thorough comprehensive assessment of the reflexes, alongside visual skills and motor development of a child is the first step in understanding which reflexes are retained and how they impact the overall functioning of each child can guide therapy.

Setting specific, achievable and personalised goals tailored to the strengths and any challenges present for each child is essential. For example, if a child struggles with visual tracking due to retained reflexes, the therapy might focus on improving that skill through targeted exercises.

Incorporating flexible techniques—movement-based exercises, visual-motor activities, sensory integration techniques and practices to support the nervous system—can keep therapy engaging and effective. Adjusting the pace and complexity of activities based on the response of the child often optimises their learning experience.

Parental involvement (or involvement from a carer or guardian) in the therapeutic process is vital. Providing them with strategies and exercises to practice at home can reinforce progress and foster a supportive environment for the child.

Ongoing monitoring of the progress for each child (and adult) and adapting the therapy plan as needed is key. This ensures that the therapy remains effective and relevant as the patient grows and develops.

Integrating retained primitive, postural and equilibrium reflexes is crucial for supporting visual development and enhancing learning and behaviour.

Here are a few effective vision therapy techniques that I use on a routine basis, along with a plethora of other procedures and techniques.

Movement-Based Exercises: Incorporate activities that encourage full-body movement. Crawling, rolling and balancing exercises stimulate the integration of reflexes while promoting overall motor development. For example, obstacle courses that require various movements can be beneficial.

Eye Tracking Games: Use visual activities that require tracking and focusing on moving objects. Games like “I Spy,” playing catch or following a ball with the eyes can strengthen visual processing skills while integrating reflexes.

Rhythmic Movement Activities: Engage children in rhythmic activities, such as jumping, swinging or dancing. These activities can develop coordination and promote the integration of reflexes. Dance classes or rhythmic gymnastics can be particularly effective.

Balance and Coordination Drills: Exercises focusing on balance—like standing on one foot, walking along a line or using balance boards—can help integrate reflexes associated with stability and spatial awareness. These drills can also be fun group activities that foster social interaction.

Fine Motor Skill Development: Activities like threading beads, using scissors, or playing with playdough can promote fine motor skills and help integrate reflexes associated with grasping and manipulation. Incorporating crafts into play can make this practice enjoyable.

Sensory Integration Techniques: Incorporating sensory-rich activities—like swinging, spinning or playing with textured materials—can support the integration of reflexes while providing essential sensory input. Sensory bins filled with various materials can encourage exploration and engagement.

Recognising and addressing retained reflexes as early as possible can make a significant difference in a childs development. Early intervention can help prevent challenges associated with these retained reflexes, such as learning difficulties, behavioural challenges, ability to maintain concentration and reduced self-esteem.

The connection between primitive reflexes, postural & equilibrium reflexes, vision and motor development is profound and multifaceted.

As I work with both children and adults, I am continually reminded of the importance of these foundational reflexes in shaping their ability to learn, move and interact with the world around them.

Understanding how these retained reflexes impact visual skills and overall development allows us to take meaningful steps toward integration. By employing targeted vision therapy techniques and adapting therapy to meet the unique needs of each child, we can support children in overcoming challenges related to retained reflexes, ultimately enhancing their learning, behaviour and quality of life.

Through targeted therapies like vision therapy, occupational therapy, cranio-sacral adjustments, movement exercises and nervous system regulation, it is possible to work toward integrating these reflexes, paving the way for improved function and quality of life.

Recognising the connection between primitive reflexes, vision and motor development is about creating a strong foundation for lifelong learning and resilience.

If you suspect that retained reflexes might be affecting your childs visual development, motor development or behavioral control, consider seeking guidance from a qualified Behavioural Optometrist who offers in-office Vision Therapy.

Together, we can develop a tailored approach to help your child thrive!