#412 - Why We're Screening More COVID-Era Kids for Primitive Reflexes

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Why We're Screening More COVID-Era Kids for Primitive Reflexes

If your child was born between 2018 and 2022, should they have their primitive reflexes screened?

In this episode, Rachel and Amanda explore how the COVID-19 pandemic may have impacted child development and why Rachel believes primitive reflex screenings should become a routine part of early childhood care. From pregnancy stress and delayed services to increased screen time, fewer social opportunities, and less movement, they discuss how these experiences may have affected (and continue to affect) kids today.

They also explain what primitive reflexes are, how retained reflexes can impact learning, behavior, coordination, and emotional regulation, and what signs parents, therapists, and educators may want to watch for.

This conversation isn't meant to cause fear or point blame. We want people to get curious, focus on early identification, and give kids the support they need to thrive.

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We'd love to hear your thoughts. Do you have a pandemic-era child, and have you noticed any of the challenges we discussed?

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Links

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Why We're Screening More COVID-Era Kids For Primitive Reflexes

If your child was born between 2018 and 2022, should they have their primitive reflexes assessed? 

That was the question discussed in a recent episode of the All Things Sensory by Harkla podcast, where occupational therapy practitioners Rachel Harrington and Amanda Hall shared their observations from working with children before, during, and after the COVID-19 pandemic.

While this idea may sound bold at first, the conversation isn't about fear or labeling children. Instead, it's about curiosity, early identification, and making sure children have the support they need to thrive.

What Are Primitive Reflexes?

Primitive reflexes are automatic movement patterns that develop before birth and help babies survive, connect with caregivers, and reach developmental milestones.

Some common primitive reflexes include:

• Moro Reflex

• Fear Paralysis Reflex

• Asymmetrical Tonic Neck Reflex (ATNR)

• Symmetrical Tonic Neck Reflex (STNR)

• Tonic Labyrinthine Reflex (TLR)

• Spinal Galant Reflex

As a child develops, these reflexes should naturally integrate, allowing higher-level motor, sensory, emotional, and cognitive skills to emerge. When reflexes remain active beyond their expected timeline, they are often referred to as retained primitive reflexes. 

According to Rachel and Amanda, retained reflexes can affect:

• Coordination

• Balance

• Emotional regulation

• Anxiety levels

• Attention and focus

• Reading and writing skills

• Social-emotional development

• Sensory processing abilities

Why Focus on Children Born Between 2018 and 2022?

Children born during this time experienced something no previous generation has encountered: a global pandemic during critical developmental years. The therapists discussed several factors that may have influenced development:

1. Increased Stress During Pregnancy

Research has consistently shown that maternal stress can influence fetal development.

Many parents who were pregnant during 2020 experienced:

• Significant uncertainty

• Social isolation

• Financial concerns

• Changes in healthcare access

• Increased anxiety

The podcast highlights the possibility that these stressors may have affected early neurological development for some children.

2. Reduced Social Interaction

Many toddlers and preschoolers experienced:

• Fewer playdates

• Limited access to parks and playgrounds

• Reduced exposure to preschool settings

• Less interaction with peers

These experiences are important because movement, social play, and exploration all contribute to healthy neurological development.

3. Masking and Communication Challenges

During key language-development years, many children primarily interacted with adults wearing masks.

This may have limited opportunities to:

• Observe facial expressions

• Read emotional cues

• Watch mouth movements during speech development

While masks served an important public health purpose, therapists are still exploring how these experiences may have influenced development for some children.

4. Increased Screen Time and Container Use

Like many families, parents often relied on screens and baby equipment simply to get through a difficult season.

Examples include:

• Extended screen time

• Swings and bouncers

• Jumpers

• Seats and other positioning devices

The concern is not that these tools are inherently harmful. Rather, excessive use may reduce opportunities for:

• Tummy time

• Crawling

• Rolling

• Climbing

• Free movement

These activities play an important role in integrating primitive reflexes.

What Occupational Therapists Are Seeing Today

Amanda shared observations from working in elementary schools, noting a significant increase in children struggling with foundational skills needed for:

• Reading

• Writing

• Attention

• Motor coordination

• Classroom participation

The therapists discussed how many of these students are now reaching school age, making it easier to recognize developmental patterns that may have started years earlier. It's important to remember that these observations are clinical experiences, not proof of causation. 

However, they do raise important questions about how early developmental disruptions may influence later learning and participation.

Signs That May Warrant A Primitive Reflex Screening

Every child is unique, and having one of these challenges does not automatically mean retained reflexes are present. However, Rachel shared several common signs she often sees in children with retained reflexes:

Emotional and Behavioral Signs

• Anxiety

• Frequent mood swings

• Difficulty with emotional regulation

• Fearfulness or heightened stress responses

Motor Development Challenges

• Poor balance

• Coordination difficulties

• Trouble riding a bike

• Difficulty learning to swim

• Challenges with sports participation

• Problems skipping, jumping, or cross-body movements

Academic Difficulties

• Reading struggles

• Handwriting challenges

• Vision tracking difficulties

• Ocular motor concerns

Daily Living Skills

• Delays in self-care skills

• Difficulty completing age-appropriate tasks independently

Why Screening Matters

One of the key messages from the podcast is simple:

"When in doubt, rule it out."

A primitive reflex screening is generally quick and non-invasive. It can help identify whether retained reflexes may be contributing to a child's challenges before other interventions are pursued.

Early identification may allow families and professionals to:

• Better understand the root cause of difficulties

• Create targeted intervention plans

• Support developmental progress sooner

• Prevent challenges from becoming more impactful over time

What Parents Can Do Next

If you're wondering whether your child might benefit from a reflex screening, consider these steps:

1. Observe Without Panic

Notice patterns:

• Does your child seem unusually anxious?

• Are motor skills significantly delayed?

• Are teachers reporting concerns?

Curiosity is more helpful than worry.

2. Talk With Your Pediatrician

Share your observations and ask questions.

You can request referrals to:

• Occupational therapy

• Developmental pediatricians

• Vision specialists

• Other appropriate professionals

3. Seek an Occupational Therapy Evaluation

Many pediatric occupational therapists are trained to screen for primitive reflexes and can help determine whether further assessment is needed.

4. Focus on Movement

Regardless of screening results, children benefit from activities that support healthy development:

• Crawling games

• Obstacle courses

• Playground play

• Climbing

• Swinging

• Cross-body movements

These experiences help strengthen the neurological foundations for learning and participation.

A Note For Occupational Therapists

Rachel and Amanda emphasized that reflex screening should be considered an important part of pediatric practice. Even if a therapist is not extensively trained in primitive reflex integration, basic screening can help identify children who may benefit from further assessment or referral.

For professionals seeking to build confidence in this area, continuing education and evidence-based training can provide valuable tools for supporting clients more effectively.

Final Thoughts

The conversation around children born between 2018 and 2022 is not about labeling an entire generation. It's about recognizing that many children experienced developmental circumstances unlike any seen before.

The good news is that the brain remains adaptable throughout life. Early identification, supportive interventions, and meaningful movement experiences can all help children build stronger foundations for learning, regulation, and participation.

If you have concerns about your child's development, trust your instincts and seek guidance. A simple screening may provide valuable information and peace of mind.

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.

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