Balance Integrated Health

Childhood behavioural, developmental and learning disorders

Our Central Nervous System is our Control Centre for Living. It is essential for perceiving the world around us, for moving around and doing things in it; for thinking, feeling, learning, communicating, working, playing, loving and surviving.

Anatomically, the central nervous system is composed of the brain and the spinal cord, the brain may be further divided into a hierarchy of centres:

  • The cerebral cortex, the most evolved, thinking and integrating part at the top
  • The midbrain, the older brain of instinct and house keeping in the middle
  • The brainstem, the oldest part of the brain, just above the spinal cord

Of course these brain regions are not isolated, they are quite complexly interlinked, but separating them helps to understand brain processes.

'Primitive' means 'the earliest of its kind' and the nerve centres controlling primitive reflexes are located in the oldest and therefore most primitive part of the brain, the brainstem. After birth these reflexes are known as 'Neonatal Reflexes'. They help us with everything from the birthing process, to feeding, gripping things and reacting to stress.

In the womb and in the early months of life, before the higher brain, decision making processes are developed, we are protected and assisted by several reflexes controlled by the lower centres of our brain.

A reflex does not involve thinking, it is an involuntary response. That is; given a sensory stimulus such as touch, noise, heat or hunger for example there is an automatic, involuntary reaction if the relevant reflex is active. Reflex response varies from simple muscular movement like moving a body part away from pain to quite complex reflexes involving body movements, breathing, perceptual and hormonal changes.

Primitive reflexes are needed for the survival and development in the womb and in early months of life. As higher centres begin to mature enough for conscious control of activity, the involuntary, uncontrollable reflex responses are stored away for use in special circumstances, like the need to quickly move a body part away from excessive heat or something sharp. The reflexes stay with us for the remainder of our life, but if all is well they are integrated into higher centre control.

Primitive reflexes ideally begin to function in a particular order and are integrated in a specific sequence. If they are retained out of sequence, they disturb the development and integration of subsequent reflexes. If they are retained beyond their normal age of integration they can disturb some or all of the functions of the higher centres, which includes behaviour, learning, the integration of gross or fine movements and more. Basically, the perception of our entire world and our response to living in it may be disturbed.

What causes reflexes to be inappropriately retained? Like all questions on the nature of life and health there are no absolute answers. From research and experience it appears that trauma of some kind is involved somewhere between conception and early months of life. The trauma can be physical, chemical, emotional, hormonal or other forms not yet researched.

In utero many chemicals and hormones can pass through the umbilical cord and all manner of traumatic events can occur in the delicate earlier months of life. The biggest causative factor appears to be birth trauma. Birth trauma includes any intervention at birth including chemical induction, instrumental delivery, caesarian section and anaesthetic. Statistics and clinical observation show that there may also be genetic factors involved.

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Fear Paralysis Reflex (FPR)

The Fear Paralysis begins to function very early after conception and should normally be integrated before birth. It can be seen in utero as movement of the head, neck and body in response to threat. It sometimes classified as a withdrawal reflex rather than a Primitive reflex. This withdrawal may not be a quiet withdrawal however, it can often be a loud, screaming wild banshee withdrawal. If this reflex is retained after birth, it can be characterized by withdrawal, reticence at being involved in anything new, fear of different circumstances, the 'fraidy cat' child who bears the brunt of teasing by normally adventurous children.

The Fear Paralysis Reflex should be integrated by Birth, retention may present as any of the following symptoms;

  • Anxiety and low stress tolerance
  • Temper tantrums
  • Increased sensory sensitivity
  • Inability to cope with any change
  • Breath holding
  • Insecure and overly clingy
  • Obsessive traits
  • Stress paralysis, can't think and move simultaneously

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Moro Reflex (MR)

The Moro reflex begins to function between 9-12 weeks after conception and is normally fully developed at birth, it is the baby’s alarm reflex. The newborn’s higher centres have not yet developed enough to make a rational decision about whether a circumstance is threatening or not. The newborn is therefore protected by an involuntary reflex which is essentially a 'one reflex for all occasions' reflex that sets off a series of physical and hormonal events which cover most eventualities. The reflex is set off by excessive information to the baby's senses, a bright light, a loud sound, a sudden touch or change of balance or direction.

The newborn arches its head back, lifts its arms up and back, spreads its hands and takes gasps of air as if falling. It then curls forwards and pulls its legs up, folds its arms across its chest and breathes out in a cry for help seemingly to grasp or cling to mother or to protect the most vulnerable front of the body.

The Moro Reflex should be integrated between 4 - 5 months, retention may present as any of the following symptoms;

  • Hyperactivity
  • Extreme sensitivity to sudden movement, noise or light
  • Difficulty getting to or staying asleep
  • Impulsive or distractive behaviour
  • Inappropriate response to a situation
  • Food sensitivities
  • Emotional and social immaturity

If the Moro reflex persists beyond three to six months of age it becomes an automatic therefore uncontrollable overreaction, overriding the newly acquired higher centre decision making.

Because the reflex stimulates fight or flight responses, these responses may happen inappropriately from anything in the person’s environment. Fight or flight responses prepare or stimulate the body ready for fighting or for running so the child may be an aggressive, over reactive or highly excitable person, unable to turn off and relax. These responses are for pure survival, for being very focused on fighting or running, not for being perceptive, sensitive or noting the subtleties of circumstances. Thus the person with a retained Moro reflex may have difficulty functioning socially in the schoolroom, playground, workplace etc. The child or adult with a retained Moro reflex may be loving, perceptive and imaginative but at the same time immature, overactive, aggressive and difficult to understand.

As the 'fight or flight' adrenaline response may be inappropriately turned on many times a day and is on 'standby' most of the time, there is a constant demand on the adrenal glands which may become fatigued. These glands are very important for immune system and stress management. If they become fatigued, excessive tiredness, allergy and chronic illness may be experienced.

When an inappropriately retained Moro reflex begins to integrate after therapy, there may be changes in emotional state or behaviour. This is common and is a good sign that the Moro is integrating. Emotional ups and downs are common, as the nervous system and hormonal system readjust. With a retained Moro, the child may never have fully experienced the discovery phase of development the 'terrible twos'. As the Moro integrates, the child, teenager or adult has the opportunity to pass through this important developmental stage. 'Terrible twos' may not appear appropriate in later years, but it is important that this phase of development runs its course.

One unusual but not uncommon occurrence is that the child’s mother may also experience a period of emotional sensitivity when the child’s Moro is integrating.

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Rooting Reflex (RR)

Light touch of the cheek or stimulation of the edge of the mouth will cause a baby to turn its head toward the stimulus, and open its mouth with extended tongue in preparation for for suckling. The combination of rooting and suck reflexes ensure that a babies head turns toward a source of food and the mouth opens wide enough to accommodate a nipple.

The Rooting Reflex should be integrated between 3 - 4 months, retention may present as any of the following symptoms;

  • Increased sensitivity around the lips and mouth
  • Speech and articulation problems
  • Dribbling, difficulty swallowing and chewing.
  • They may be fussy eaters, particularly with texture and are often thumb suckers.
  • Poor manual dexterity

Associated with this reflex is a response known as the Babkin response, which is a neurological link between the hand and the mouth. This can be seen as kneading movements of the hand associated with suckling. This is a two way response, hand movements can affect speech and speech my affect hand movement and dexterity.

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Juvenile Suck Reflex (JSR)

The neonate projects the tongue forwards to suck a nipple. In the adult swallow reflex, the tongue moves backwards to push a bolus of food down the throat. If a Juvenile Suck Reflex is not adequately integrated, the tongue projects forwards before moving backward in the normal swallow. This tongue thrust continually pushes the front teeth forwards, altering the shape of the maxillary arch pushing the front teeth forward into an overbite. This is a huge problem for dentists, orthodontists, speech therapists and of course their patients and parents.

The Juvenile Suck Reflex should be integrated between 3 - 4 months, retention may present as any of the following symptoms;

  • Speech delay
  • Articulation and pronunciation difficulties
  • Swallowing and chewing problems
  • Overbite of the upper jaw
  • Involuntary tongue movements when writing or drawing
  • A lisp with the tongue often visible during speech

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Asymmetrical Tonic Neck Reflex (ATNR)

The ATNR begins about eighteen weeks after conception. It should be fully present at birth and appears to assist the baby’s active participation in the birthing process. If a newborn’s head is turned to one side, the arm and leg on the side to which the head is turned, straighten outward while the opposite arm and leg pull in. The reflex continues after birth and plays an important part in the development of hand eye coordination, object and distance perception.

If the ATNR is retained, difficulty may be experienced with tasks which involve both left and right sides of the body including eyes, ears, limbs etc. Establishment of dominant hand, foot, ear or eye may be difficult. Turning the head may cause a visual image to momentarily disappear or parts of the visual field to be missed. Visual tracking and judgement of distance may be therefore be affected.

The Asymmetrical Tonic Neck Reflex should be integrated between 6 - 7 months, retention may present as any of the following symptoms;

  • Difficulty catching a ball if looking directly at the ball (easier if looking away)
  • Poor handwriting, difficulty obtaining a pen licence
  • Disproportionate drawing (particularly of people, small eyes and large hands)
  • Difficulty establishing right and left body dominance
  • Poor distance judgement
  • Chronic shoulder and neck problems

Wlist the ATNR is operating, the hand moves in conjunction with the head. This connection between touch and vision helps to establish distance perception and hand eye coordination.

By the middle of the first year of life this is normally accomplished and the ATNR, being no longer required, should be integrated. If the reflex persists, the hand eye connection makes cordinated crawling difficut. When walking, turning the head results in the straightening of the arm and leg on the same side, upsetting the balance and therefore normal walking pattern.

In early months, after hand-eye relationship is established, ATNR locks vision on to anything which catches the attention, further reinforcing object and background perception.

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Palmar and Plantar Reflexes (PR)

The Palmar Reflex emerges in utero and is fully present at birth, the Palmar Reflex is elicited by a grasping of the hand when the palm is touched or pressed, it is usually integrated between 4 - 6 months of age. The Plantar reflex is similar to the Palmar reflex in that stroking or pressing the ball of the foot causes the foot to flex and the toes to flex or curl and should integrate at about the same time, between 4 - 6 months. The Palmar and Plantar reflexes are part of a group of reflexes that develop in utero and whose common characteristic is to grasp.

The Palmar and Plantar reflexes should be integrated between 5 - 6 months, retention may present as any of the following symptoms;


  • Poor fine motor skills
  • Poor pen-grip and handwriting
  • Slumped posture when writing or working over desk
  • Trouble putting ideas on paper
  • Poor spelling
  • Balance and walking is affected
  • Delayed walking beyond 14 months
  • Awkward running style and poor balance
  • Toes curl under when putting on shoes
  • Adults and older children complain of lower back pain when walking or standing
  • History of ingrown toenails, shin soreness, recurrent ankle twisting
  • Difficulty walking in the dark due to a lack of feedback from the feet to the brain

Both the Palmar and Plantar reflexes are thought to be a continuation of an earlier stage of human evolution, when it was necessary for the baby to cling to its mother for safety. If retained beyond the first few months, these reflexes can impede independent finger and toe movement, affecting fine motor skills such as writing.

In most cases these reflexes spontaneously integrate when the Fear Paralysis Reflex, Moro reflex,  Tonic Labyrinthine reflex,  Asymmetric Tonic Neck reflex  and  Spinal Galant reflexes are integrated.

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Spinal Galant Reflex (SGR)

This reflex is found about 18 weeks after conception and is normally integrated before the end of the first year of life. There are as many questions as answers about this reflex, it used to be called the 'Salamander Reflex' as it's wriggling motion appears to take an active role in the birth process, with movements of the hip helping the baby to work it’s way down the birth canal.

The Spinal Galant Reflex should be integrated between 12 - 13 months, retention may present as any of the following symptoms;

  • Inability to sit still (Ants in their pants)
  • Attention and concentration problems
  • Bedwetting and poor bladder control
  • Clumsiness, often falling over
  • Possible development of spinal scoliosis

If the spinal galant reflex is retained beyond the normal time of integration, it may be elicited by light pressure in the lower back. In the classroom, just the act of leaning back against the chair may activate the reflex. The child who sits in their car seat and needs to go for a wee 5 minutes into every car journey.

In the newborn, stroking the lower back to one side of the spine will result in side flexion of the lower back away from that side whilst raising of the hip on the same side. Stimulation down both sides of the spine simultaneously will activate a related reflex, which causes urination.

The neurological link with the bladder voiding reflex causes these children have poor bladder control, in bed wetters, it is the pressure of the sheets or the waistband of their pyjamas that stimulates the involuntary voiding reflex, so they continue to wet the bed in spite of all efforts.

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Tonic Labyrinthine Reflex (TLR)

The TLR begins about 12 weeks after conception. It is elicited by bending the neck forwards or tilting it backwards. It involves the vestibular system, your sense of balance and position in space and the vestibular interaction with other senses. When the neck is tilted backwards the limbs straighten, when the neck is bent forwards the limbs bend. The reflex should be fully developed in both positions from birth and has done its job by the end of the first year of life.

The Tonic Labyrinthine Reflex should integrate in two parts, flexion between 3 - 4 months, and extension between 17 - 18 months, retention may present as any of the following symptoms;

  • The 'floppy' child
  • Poor balance and co ordination
  • Motion sickness
  • Orientation difficulties, judging space, distance, depth etc.
  • Auditory processing difficulties

If the Tonic Labyrinthine reflex is not integrated it will constantly disturb the sense of balance and the integration with other sensory systems.

Head control and proper eye function will be affected. The balance system and hearing system are very closely related and this reflex needs to be integrated if success is to be obtained for children with auditory processing disorders undergoing sound therapy.

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Symmetrical Tonic Neck Reflex (STNR)

The STNR is an acquired reflex as with the Landau reflex. These reflexes are termed transitional reflexes as they are not present at birth, but begin in the first year of life to help initiate movement.

The STNR is at it's most obvious just prior to crawling as the baby rocks back and forward on all fours. When the baby is on its belly, it will straighten its arms, tilt the head back and focus on vision in the distance. This is an important phase of development for refining near-far accommodation of the eyes, this is required to be able to shift focus. For instance in a classroom, looking up from writing to a whiteboard, or whilst driving, being able to alternately look in the distance and read the speedometer.

The Symmetrical Tonic Neck Reflex should be be initiated between 6 - 7 months and integrated between 12 - 13 months, retention may present as any of the following symptoms;

  • Crawling later than 10 months
  • Poor hand - eye co-ordination
  • Walking on toes
  • Ataxic gait (ape like walking pattern)
  • Slumping at desk
  • Eye fatigue, complaining of 'tired eyes'
  • Poor organisation skills

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Retained Neonatal Reflex Correction (RNR)

The Central Nervous System is so important as a Control Centre that it is housed within a membrane which isolates it from the rest of the body. Outside that membrane, blood supplies nutrition and lymph carries wastage. Inside the membrane, a special clear fluid called cerebrospinal fluid provides nutrition and protection.

The membrane surrounding the Central Nervous System is called the Dura Mater. It attaches at its uppermost end to the inside of our skull; it surrounds our brain, brainstem and spinal cord, and attaches at its lowermost end to our tailbone. Cerebrospinal fluid is circulated mainly by the rhythmic movement of our cranial (skull) bones at the top and the movement of our sacrum, (in the middle rear of our pelvis) at the bottom, joined by the dura mater between.

If this cranio- sacral system is not functioning correctly, many symptoms can occur. Basically, as the central nervous system is involved, almost any part of this system cannot function at its best. Headaches, muscular imbalance, hormonal dysfunction, developmental delay including retained neonatal reflexes, low tone and learning disability are common problems as a result of dural tension/torsion.

Cranial or sacral correction is applied via very gentle pressure at a particular point or points on the skull or pelvis in a specific direction, often on a specific phase of breathing. This helps to restore the normal membrane-bone relationship and normalize cranio-sacral movement. As it is the cranio-sacral movement which circulates cerebrospinal fluid, its correction helps to normalize central nervous system function.

Recently it was discovered that some cranio-sacral faults may only be found in certain body postures related to the neonatal reflexes. It also appears that these cranio-sacral problems may inhibit normal integration, or ore correctly, cortical inhibition of these reflexes. Correction of these cranio-sacral faults whilst in these postures assists in improving cortical (upper brain) inhibition and therefore integration of normal reflex activity.

Clinical experience has demonstarted that in any procedure related to Retained Neonatal Reflex protocols, that the order of treatment best follows the natural hierarchial sequence of integration and that a minimum of one week between treatments is advised.

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©2011, Balance Integrated Health acknowledges and thanks the contribution of the principal author of these pages in reference to Retained Neonatal Reflexes, Dr. Keith Keen, Sydney, 1997. Balance Integrated Health also acknowledges and appreciates the opportunity to present this information courtesy of the work of Dr Susan Walker, Dr Trent Banks and Dr Annika Jende. Pioneers in childhood developmental disorders. We thank you for your teaching, your guidance and for the chance to help a generation.