Coordination challenges in children and adults often go beyond clumsiness - they may reflect underlying retained primitive reflexes. These reflexes are automatic movement patterns present at birth that support survival and early development. Normally, they integrate as the brain matures, allowing higher-level motor control and cognitive skills to emerge. When reflexes are retained, coordination, balance, and even learning can be affected.

What Are Primitive Reflexes?

Primitive reflexes are involuntary movements controlled by the brainstem and spinal cord. 

Key reflexes include:

🧠  Moro reflex: Startle response to sudden movement or noise

🧠  Asymmetrical Tonic Neck Reflex (ATNR): “Fencing position” when the head turns

🧠  Tonic Labyrinthine Reflex (TLR): Movement of the head affecting body posture

🧠  Palmar and Plantar grasp: Automatic gripping with hands or feet

Integration of these reflexes is crucial for postural control, bilateral coordination, and smooth motor planning.

How Retained Reflexes Affect Coordination

When primitive reflexes remain active beyond infancy, we may see:

♦️ Balance and gait issues: Children may appear clumsy or unstable

♦️ Hand-eye coordination difficulties: Affecting writing, sports, or daily tasks

♦️ Cross-lateral movement challenges: Impacting reading, math, and other cognitive tasks

♦️ Sensory processing difficulties: Over- or under-reactivity to touch, movement, or visual stimuli

From a brain perspective, retained reflexes indicate delayed or incomplete cortical maturation. The prefrontal cortex and cerebellum, which support planning, sequencing, and motor coordination, rely on integrated reflexes to function efficiently.

Assessing and Supporting Reflex Integration

⚙️ Observation and Screening

Look for persistent reflexes, asymmetry in movement, or coordination struggles in everyday tasks.

⚙️  Targeted Motor Exercises

Activities that encourage crossing midline, balance, and core strength can help integrate retained reflexes.

⚙️  Sensory Enrichment

Movement-based sensory experiences stimulate the brain and support reflex integration.

⚙️  Sequential Skill Building

Start with foundational gross motor activities, then progress to fine motor tasks to support motor planning and coordination.

⚙️  Cognitive and Executive Function Support

As reflexes integrate, higher-level skills like focus, working memory, and problem-solving improve, highlighting the interconnectedness of motor and cognitive development.

The Brain Behind Coordination

Coordination difficulties are not simply “clumsiness” - they may reflect incomplete integration of early brain pathways. By identifying and addressing retained primitive reflexes, therapists, educators, and parents can strengthen brain development, improve motor skills, and support learning and executive function.