Primitive reflexes are automatic, brainstem-mediated movement responses that are present at birth. They help a newborn manage the first tasks of life, then gradually give way to voluntary control as the nervous system matures. Knowing the usual pattern can make your baby’s movements less mysterious and help you recognize when a question for a pediatrician is more useful than an online checklist.
Why primitive reflexes matter in the first months
A reflex is not a learned skill. It is an involuntary response: a particular position, touch, or sudden change prompts a movement without the baby deciding to make it. Primitive reflexes support neonatal survival and early development while higher parts of the brain are still maturing. Rooting helps a baby turn toward a source of food; grasping produces a powerful hold; a startle response is part of a young nervous system’s reaction to sudden change.
As the cortex matures, the central nervous system gradually inhibits these early patterns and voluntary motor control develops. For many reflexes, that transition happens between 4 and 6 months of age. There are more than 20 primitive reflex types in infancy, and they do not all follow one timetable. That is why a single date or a single movement never tells the whole story.
It also helps to separate two questions. In a baby, clinicians look at whether a reflex is present, symmetrical, and appropriate for age. In an older child, they may consider whether a pattern appears to persist and whether it affects real-life function, such as feeding, balance, handwriting, or participation in play. Neither observation is a diagnosis on its own.
A primitive reflexes chart makes the early patterns easier to see
Parents often ask for a fixed list of five or eight primitive reflexes. There is no single universal “official” five or eight: more than 20 types occur during infancy. The chart below gives five frequently discussed reflexes, then three additional ones that broaden the picture. It is a guide to language and timing, not a home test.
| Reflex | What it looks like | Typical timing |
|---|---|---|
| Moro reflex | A startle response. Ernst Moro described it in 1918 and called it the “embracing reflex.” | Observable as early as 25 weeks post-conceptional age; present in full-term infants; begins to disappear by 12 weeks and is gone by 6 months. |
| ATNR reflex | The asymmetrical tonic neck reflex is often called the fencing reflex. | Emerges at 18 weeks’ gestation; present at birth and typically integrates by 3–4 months. Some sources give about 6 months as the upper limit. |
| Tonic labyrinthine reflex | With the child lying on the back, tilting the head back can stiffen and arch the back, straighten the legs, and close the hands into fists. | Present at birth. |
| Galant reflex | Also called the truncal incurvation reflex and named after Johann Susmann Galant. | Present at birth and fades between 4 and 6 months. |
| Palmar grasp | The hand closes around an object placed in the palm. | Appears by 28 weeks’ gestation and typically disappears by 4–6 months, alongside voluntary reaching and grasping. |
| Plantar grasp | A grasping response of the foot. | Appears by 28 weeks’ gestation and typically disappears between 9 and 12 months. |
| Rooting reflex | An early feeding-related response. | Emerges at approximately 28 weeks’ gestation and persists until 4–6 months after birth. |
| Babinski reflex | The extensor plantar reflex is normal in infants. | Usually absent after 12 months; persistence beyond 2 years indicates a central nervous system disorder. |
A simple example: the ATNR reflex is not “bad posture.” In an infant, it is an early automatic pattern. Its nickname, fencing reflex, gives a useful picture of why turning the head may be paired with a change in arm position. The important question is whether movements are developing appropriately over time, not whether a parent can spot every pattern on a given day.
When do primitive reflexes disappear? Why timing is a range
The word integrate is commonly used when a primitive response becomes inhibited as voluntary control develops. “Disappear” can be misleading, because clinicians are watching a developmental transition rather than flipping a switch. The ranges below show why it is better to discuss age, the whole child, and function with a professional than to treat one observation as a verdict.
| Reflex or response | Typical change |
|---|---|
| Moro | Begins to disappear by 12 weeks; complete disappearance by 6 months. At 12 weeks, about 20% of babies still exhibit it. |
| ATNR | Typically integrates by 3–4 months. |
| Stepping | Appears at birth and typically disappears by 2–3 months. |
| Galant, rooting, palmar grasp | Galant and rooting fade or persist until about 4–6 months; palmar grasp typically disappears by 4–6 months. |
| Plantar grasp | Typically disappears between 9 and 12 months. |
| Babinski | Usually absent after 12 months. |
| Landau | Emerges around 3 months, is present in most infants in the second six months, and becomes difficult to evoke after 12 months. |
| Parachute | Appears at approximately 6–9 months and persists throughout life. |
The parachute response is a helpful reminder that not every early response is expected to fade. It appears later than many primitive reflexes and persists. A clinician considers the specific response, its timing, and the child’s broader motor development.
Retained primitive reflexes are clues, not labels
“Retained primitive reflexes” means that a primitive response is still observed after the period when it would usually be inhibited. The phrase can sound alarming, but residual responses are not rare in preschool children. In one study of healthy 4- to 6-year-olds, 65% showed primitive reflexes at a residual level and only 11% had none at all; 89% had at least one retained reflex. In that group, left ATNR was the most frequent, occurring in 66% of children.
Those findings are a reason to avoid a common shortcut: seeing one awkward movement and assuming it explains a child’s learning, attention, or sensory differences. A reflex observation needs context. Clinicians consider the intensity of the response, age, symmetry, motor skills, medical history, and whether a pattern gets in the way of everyday activities.
Patterns that may be worth discussing
A retained Moro reflex has been associated with hypervigilance, anxiety, sensory processing difficulties, and poor impulse control. At home or school, you might notice a child who reacts strongly to sound, light, or movement and takes longer to settle. That does not establish a cause. It does give you a concrete observation to bring to a pediatrician or occupational therapist: “Unexpected noise seems to derail the next ten minutes,” rather than “My child has a retained Moro reflex.”
A retained ATNR reflex has been associated with poor eye tracking, difficulty crossing the visual midline, left-right confusion, and lower reading and spelling scores. A practical example is a child who tilts their head while writing, struggles to move the eyes across a page, or finds skipping and bike riding unusually hard. These are functional concerns a clinician can assess; they are not a do-it-yourself diagnosis.
A retained STNR has been associated with poor posture, poor eye-hand coordination, focusing difficulties, and trouble sitting still at a desk. A child may avoid ball games, find swimming difficult, or prop their body in ways that make desk work tiring. Start with what the child is experiencing and what would help them participate, not with a label.
When to see a doctor
Contact your child’s pediatrician when a reflex seems markedly asymmetric, when movement or feeding concerns interfere with daily life, or when you are worried about developmental progress. For a full-term newborn, weak rooting raises concern for conditions including hypoxic-ischemic injury, intraventricular hemorrhage, or congenital structural brain abnormalities, so it warrants medical attention. Seek prompt medical advice for a new loss of skills or new neurological symptoms as well. This article cannot determine what any individual reflex pattern means.
What the research says about school, ADHD, and autism
Research has found associations that deserve careful wording. Persistent ATNR in girls and STNR in boys were strongly and specifically associated with ADHD symptoms and balance deficits in a study of 80 medication-naive children aged 8–11. Children with ADHD also demonstrated a greater occurrence of Moro and Galant reflexes than control groups. Persistent primitive reflexes have been discussed as possible early indicators of autism, and retained rooting, sucking, and ATNR occur more often in children later diagnosed with autism spectrum disorder.
Association is not proof of cause, and a reflex does not diagnose ADHD or autism. A child with attention differences, sensory sensitivities, handwriting struggles, or coordination challenges deserves support for those needs whether or not reflexes are part of an evaluation. For example, an occupational therapist can focus on handwriting, coordination, play, dressing, and classroom participation. These are goals a family and school can actually observe.
There are also measurable academic associations in older children. Persistent ATNR has been associated with lower reading, spelling, and math scores in children ages 7–11. That finding is not a prediction for one child and does not show that ATNR caused the scores. It does support taking persistent functional difficulties seriously and looking at the full developmental picture.
Retained primitive reflexes debunked: what claims miss
The existence of primitive reflexes is not the point of the debate. The open questions are how much a persisting reflex matters clinically and which interventions work reliably. A systematic review found emerging evidence that movement programs targeting persisting reflexes could help, but the findings were inconsistent. That is a useful middle position: neither dismiss every concern nor promise a guaranteed cure.
One myth is that a checklist can diagnose a child. It cannot. A professional assessment may use structured observations, but a score does not replace a developmental evaluation. The INPP battery, for example, rates reflexes from 0 to 4: 0 means normal with no persistence, 1 mild, 2 moderate, 3 high, and 4 maximal persistence. In older children and adults, the Schilder test can be used to assess ATNR. These are clinical tools, not a reason to test or label a child at home.
Another myth is that reflex integration alone is the goal. The American Occupational Therapy Association suggests using exercises to improve coordination and performance in activities of daily living and instrumental activities of daily living, rather than treating reflex integration as a standalone therapy. This turns a vague promise into meaningful questions: Is the child more comfortable joining a game? Is handwriting less effortful? Is dressing or using utensils becoming easier?
A third myth is that every movement activity is either proven or pointless. Some children with higher primitive-reflex scores who were underachieving academically at baseline showed the most pronounced benefits from reflex integration programs. At the same time, inconsistent findings mean families should look for clear goals, qualified guidance, and changes they can observe rather than dramatic claims.
How to respond to ATNR concerns with practical movement support
If you are asking how to get rid of the ATNR reflex, start by replacing the idea of a quick fix with a functional plan. A pediatrician, occupational therapist, or another qualified clinician can decide whether ATNR is relevant and whether it is connected to a concern such as coordination, handwriting, balance, or midline crossing. A clinician may assess ATNR by asking a child to get on hands and knees, then slowly turn the head left and right over four seconds, repeating five times. Do not use that observation to diagnose or treat your child by yourself.
Movement programs in the available evidence are structured and repeated. One 12-week program, delivered four times weekly in 30- to 40-minute sessions with progressive intensity through three phases, significantly reduced ATNR retention. A different 12-week program using rhythmic, balance, and whole-body coordination exercises reduced ATNR retention and improved fine-motor coordination in children with autism and ADHD.
Activities a therapist may include in a bigger plan
- Cross-crawl patterns that coordinate opposite sides of the body.
- Rolling like a log to practice whole-body rotation.
- Crawling repetitions, which are associated with integration of ATNR and STNR.
- Rhythmic rocking, balance work, and whole-body coordination activities that stimulate vestibular and proprioceptive pathways.
- Slow head turning in an all-fours position, when appropriate and professionally guided.
Other typical INPP exercises include the starfish exercise, superman/banana poses, and cat/cow pose. For Moro, the starfish exercise uses a slow, controlled extension-flexion pattern intended to retrain the startle response. An activity is most useful when it fits the child’s abilities, is supervised as needed, and is tied to a practical goal. More repetition is not automatically better.
Frequently Asked Questions
What are the five primitive reflexes?
There is no single universal list of only five because more than 20 primitive reflex types occur in infancy. Five commonly discussed examples are Moro, ATNR, tonic labyrinthine, Galant, and palmar grasp reflexes.
What are the 8 primitive reflexes?
A useful eight-reflex list includes Moro, ATNR, tonic labyrinthine, Galant, palmar grasp, plantar grasp, rooting, and Babinski. Lists vary because clinicians describe more than 20 infant reflexes.
How do you know if your child has retained primitive reflexes?
Look for a pattern of functional concerns, not a label from one movement: persistent strong startle, difficulty crossing the midline, head tilt while writing, poor coordination, posture challenges, or sensory reactivity may be worth discussing. A pediatrician or qualified clinician can assess the whole developmental context.
How do you get rid of the ATNR reflex?
There is no reliable instant method. Evidence describes structured, progressive movement programs over weeks, including coordination, balance, crawling, rolling, and cross-crawl activities. Work with a qualified clinician to make the plan safe and focused on daily function.
When do primitive reflexes disappear?
Many are inhibited in the first 4–6 months, but timing varies. ATNR typically integrates by 3–4 months, stepping by 2–3 months, plantar grasp by 9–12 months, and Babinski is usually absent after 12 months. The parachute response appears later and persists throughout life.
