Your Cart is Empty
In this episode, we explore how totrack progress beyond reflex testing by looking atfunctional, everyday signs of improvement. Reflex tests are important, but they don’t always tell the whole story. Sometimes a child may have several retained reflexes, but those reflexes don’t significantly interfere with their day-to-day life!
If you’ve ever wondered whether your reflex integration work istruly helping, this episode will help you connect the dots betweenreflexes,functional outcomes, andreal-life independence.
This episode will help you shift your focus fromtesting and exercises alone to looking atreal-life skills—because progress isn’t just about what happens in therapy, it’s about creating lasting change in daily life.
We’d love to answer your questions on the podcast! Fill out this form -https://harkla.typeform.com/to/ItWxQNP3
All Things Sensory Podcast Instagram
Primitive Reflex Digital Course
Primitive Reflex Screening Checklist Freebie
When working with children who have sensory processing challenges, autism, ADHD, or developmental delays, retained primitive reflexes often come into the conversation. But one question comes up again and again:
“If a reflex tests as retained, but the child isn’t showing functional struggles… do we still need to intervene?”
Let’s break this down.
Primitive reflexes are automatic movement patterns that emerge in utero and early infancy to support survival and development. Over time, as a child matures, these reflexes are supposed to integrate—meaning the brain takes over control, allowing more refined movement and sensory-motor skills.
When these reflexes remain retained, they can interfere with daily functioning—impacting everything from attention and posture to emotional regulation and fine motor skills. But the keyword here is "interfere."
Just because a primitive reflex tests as retained (a “positive” result) doesn’t automatically mean it’s impacting a child’s life. Likewise, a child may pass the physical test for a reflex but still show functional signs of challenges commonly associated with that reflex.
Here’s the takeaway:
If a retained reflex is functionally impacting a child’s daily life—intervention is warranted. If it’s not affecting function? You may not need to intervene right away.
Occupational therapy always comes back to one thing: functional outcomes. According to AOTA’s Practice Smart Guidelines, interventions must be linked to real-life occupations—like dressing, playing, learning, and socializing.
So when evaluating whether to target a retained reflex, consider:
Does the child struggle with daily tasks related to this reflex?
Are symptoms of the reflex showing up in your functional checklist?
Is the child experiencing frustration, anxiety, or motor delays connected to this reflex?
If the answer is yes, it's time to intervene.
Let’s walk through common primitive reflexes and how they can affect day-to-day life when retained:
Often called the “startle reflex,” a retained Moro can lead to:
Heightened anxiety or sensory over-reactivity
Startle responses to sounds or touch
Difficulty with transitions or unexpected changes
Functionally impacts: Focus in school, emotional regulation, sleep, transitions.
This reflex affects the ability to cross midline and coordinate both sides of the body.
Challenges with handwriting, dressing, catching a ball
Switching hands mid-task or struggling to establish hand dominance
Functionally impacts:Bilateral coordination, school tasks, dressing.
This reflex divides the body top to bottom and impacts posture.
Slouching during table tasks
Trouble copying from the board
Difficulties in sports, swimming, or toilet training
Functionally impacts:Postural control, academic performance, independence.
Affects muscle tone and balance.
Poor core strength
Clumsiness, frequent falls
Difficulty tolerating head movements (e.g., looking up or down)
Functionally impacts:Safety, dressing, meal time, attention span.
Highly correlated with:
Excess fidgeting and attention challenges
Bedwetting or delayed toilet training
Sensitivity to clothing and tags
Functionally impacts: Toileting, sitting still, clothing tolerance.
If retained, this can impact:
Pencil grip and writing
Using utensils
Tactile defensiveness in hands
Functionally impacts: Feeding, play, schoolwork.
These oral reflexes affect:
Feeding and eating (especially textures)
Speech and articulation
Oral sensitivity (aversion or seeking)
Functionally impacts: Mealtimes, speech, social participation.
A best practice is to use a functional symptoms checklist before beginning reflex integration activities. After 1–2 months of consistent intervention, retest the reflex and redo the checklist.
Improvement in function = success (even if the reflex is still present on the test).
No change? It may be time to adjust your strategy or consider another cause.
Retained reflex work shouldn’t be repetitive or rote. We want children engaged, motivated, and playing; That’s how the brain learns best!
Incorporate reflex integration strategies into:
Obstacle courses.
Yoga poses.
Movement-based games.
Balance and core exercises.
Sensory play.
Pro Tip: If you’re a parent and your child has different sensory needs than you, establish regulation routines for both of you. Think: noise-canceling headphones for you + a sensory gym setup for them.
Don’t get stuck in “checklist paralysis” or rely solely on test results. Look at the child holistically:
What are they doing well?
Where are they struggling?
What does their environment look like?
How is their family dynamic?
At the end of the day, function guides intervention. Retained reflexes are just one part of a child’s beautiful, complex story.
BORING, BUT NECESSARY LEGAL DISCLAIMERS
While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science & art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views & opinions on how to address common sensory challenges, health related difficulties & what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.
Keep in mind that we may receive commissions when you click our links & make purchases. However, this does not impact our reviews & comparisons. We try our best to keep things fair & balanced, in order to help you make the best choice for you.
This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
Comments will be approved before showing up.
