Reflex Integration

If you’ve ever felt like something about your child’s development just isn’t clicking, trust that instinct. Many parents discover reflex integration only after years of searching for answers — and suddenly everything makes sense. This blog is here to make that journey easier. We’ll talk about what reflexes are, why they sometimes don’t fully integrate, and how that can affect everything from behavior to learning.

Reflexes are controlled by the brainstem. They begin in utero and have the very important purpose of aiding the baby through the birth canal and helps with development, muscle tone, postural stability and support survival behaviors (feeding, alertness). Typically by the age of 3.5 years, these reflexes should be integrated, which means that as the brain matures, the cortex is able to override the automatic response, and sends inhibitory signals to suppress the reflexes. This is where voluntary and more precise/refined movement begins to take over!

Types of reflexes I see most commonly:
• STNR
• ATNR
• MORO
• SPG
• Babkin (palmar-oral) reflex/Babkin response.

STNR – This reflex helps babies prepare for pre-crawling stages.
Integration: 9-11 months
Signs: W sitting, poor posture, difficulty sitting still. I typically see kiddos with this reflex constantly wrapping their legs around the chair leg as they sit at a desk.
Affects: Core stability, difficulty with posture especially sitting in a chair, poor hand-eye coordination.

ATNR – This reflex looks like the “sword fighter” position. When the baby’s head turns, the arm and leg on the face side extend, and the opposite side flex.
Integration: 4-6 months
Signs: Difficulty crossing midline, poor bilateral coordination, arm extends as head turns (like a child copying something off the board in class), mixed hand-dominance, poor visual tracking.
Affects: Messy handwriting, poor spacing, challenges with dressing.

MORO – “Startle reflex”: sudden extension of arms/legs, inhale, then flexion and cry. Triggered by sudden movement, sound, or head drop.
Integration: 2-4 months
Signs: Startles easily, sensitive to sound/light/touch, emotionally reactive, anxiety and fight-or-flight tendencies
Affects: Difficulty with self-regulation, feeling overwhelmed in busy environments and vestibular sensitivity, ie; motion sickness.

SPG – This reflex assists with hip flexion/rotation in the birth canal during birth.
Integration: 3-9 months
Signs: Fidgeting, sensitive to clothing around the waist, bedwetting, poor trunk stability.
Affects: Poor core strength, difficulty with attention, restlessness

BABKIN – This reflex is part of the early survival system that links the hands and mouth for feeding and exploration. This reflex helps with feeding, rooting, grasping the caregiver and coordinate hand to mouth movements.
Integration: 3-4 months
Signs: Oral overflow during tasks like- crumbling a piece of paper in each hand, cutting or coloring, chewing motions during drawing/other fine motor tasks.
Affects: Jaw tension may be associated during writing tasks, drooling/open mouth posture, endurance for fine motor tasks.

This being said, I see many children over the age of 3 who have continued to demonstrate retained reflexes. The reason behind this can vary, but in OT we are able to use specific reflex integration exercises that go through the movement patterns of the reflex, however it is slow and controlled, and this is what helps inhibit the automatic response.
Why is this important, you might ask? Kiddos that have retained reflexes, primarily the “learning reflexes” – atnr/stnr, can make day to day life more difficult. But luckily, we can help! In OT, we complete various exercises and movement patterns in slow, controlled form to help integrate these reflexes and strengthen our cortex!