Retained primitive reflexes: what they are, why they matter, and what you can do
By Yelena | Holistically Speaking Speech Therapy · Flower Mound, TX
In my work as a speech-language pathologist, I often meet children who are bright, engaged, and clearly trying — but something keeps getting in the way. They struggle to sit still during a task. Their speech is hard to understand. They have trouble processing directions or getting words out, even when they clearly know what they want to say. Parents have often been told to "wait and see," or have cycled through evaluations without a clear picture of what's driving the difficulty.
One piece of the puzzle that frequently gets overlooked: retained primitive reflexes.
What are primitive reflexes?
Primitive reflexes are automatic, involuntary movements that originate in the brainstem. They're present at birth and serve a vital purpose in early survival and development — helping a newborn breathe, feed, orient toward sound, and begin to move through the world. You may have seen the Moro reflex (the startle response where a baby throws their arms wide), the palmar grasp (when a baby automatically grips your finger), or the rooting reflex (turning toward touch on the cheek to find the breast).
Under typical development, these reflexes integrate — they become absorbed into the nervous system as the brain matures, making way for voluntary, controlled movement. This process happens primarily in the first year of life, as higher brain structures come online and take over functions the brainstem was managing automatically.
When that integration doesn't happen fully, the reflex remains active. And an active primitive reflex in an older child is not a neutral thing — it creates ongoing interference in the nervous system that can affect attention, coordination, sensory processing, emotional regulation, and communication.
The research connection to speech and language
This isn't fringe territory. A study published in the Journal of Speech, Language, and Hearing Research found that children with developmental language disorder showed significantly higher levels of persistent primitive reflexes compared to typically developing peers. Research published in The Egyptian Journal of Otolaryngology explored the specific relationship between retained reflexes and speech intelligibility, finding connections between reflex persistence and difficulties with articulatory precision.
The mechanism makes sense from a neurological standpoint. Speech is an extraordinarily fine motor task — it requires precise, coordinated movement of the tongue, lips, jaw, and breath support, all while simultaneously processing incoming language and formulating a response. When a retained reflex is still active, it can interrupt that coordination. Poor postural control reduces airflow and affects voice quality. Retained oral reflexes interfere with the nuanced movements needed for clear articulation. Sensory processing disruptions make it harder to tune into the sounds of language.
When the body hasn't finished its earliest developmental work, everything built on top of that foundation is harder.
Which reflexes are most commonly retained?
Several reflexes show up frequently in children with developmental and communication challenges:
Moro reflex — the startle reflex. When retained, children may be hypersensitive to sensory input, emotionally reactive, and have difficulty with transitions or unexpected changes. This reflex is closely tied to the stress response and sympathetic nervous system activation.
Asymmetrical Tonic Neck Reflex (ATNR) — when the head turns, the arm on that side extends while the opposite arm bends. Retained ATNR can interfere with midline crossing, handwriting, and the ability to track visually across a page — skills essential for reading and writing.
Palmar grasp — the automatic grip reflex. When retained, it can affect fine motor precision, including the oral motor control needed for clear speech.
Spinal Galant reflex — triggered by touch along the lower back. Retention is associated with difficulty sitting still, poor bladder control, and sensitivity to clothing or touch at the waist.
Tonic Labyrinthine Reflex (TLR) — governs muscle tone in relation to head position. Retention affects posture, balance, and spatial orientation.
What this looks like in real children
Children with retained primitive reflexes often present with a constellation of challenges that can look like attention difficulties, behavioral concerns, or simply developmental delay — without anyone identifying the underlying neurological pattern. Common signs include:
Difficulty sitting still or maintaining posture at a desk
Poor balance or coordination
Delayed or unclear speech
Trouble with reading, writing, or handwriting
Sensitivity to sound, touch, light, or movement
Emotional dysregulation or heightened anxiety
Difficulty with bilateral coordination (using both sides of the body together)
If this list sounds familiar, it's worth asking whether retained reflexes have been considered as part of the picture.
How I approach this as an SLP
As a holistic speech-language pathologist, I look at the whole child — not just the sounds they're producing or the words they're missing. When I suspect retained reflexes may be contributing to a child's communication difficulties, I consider this in my assessment and work collaboratively with families and other providers.
Reflex integration work involves movement-based activities that reactivate and complete early developmental sequences — things like tummy time variations, specific crawling patterns, cross-lateral movement, and oral motor exercises targeting the muscles involved in both eating and speech. These aren't exercises for their own sake; they're designed to give the nervous system the input it needs to finish work it started in infancy.
Alongside movement-based approaches, I incorporate:
Sensory regulation strategies to reduce the nervous system load that retained reflexes create
Oral motor therapy targeting the specific articulatory patterns affected
Collaboration with occupational therapists, who often lead reflex integration work from a motor development perspective
Energy balancing approaches, including biofrequency assessment, which I use to support the nervous system's capacity to shift and integrate
A word on the holistic framework
Retained primitive reflexes don't exist in isolation. They're often part of a broader picture of nervous system dysregulation — one that may also involve chronic stress, sensory processing differences, nutritional factors, and early adverse experiences. This is why I believe so strongly in treating the whole child rather than targeting a single symptom.
A child whose nervous system is chronically overwhelmed will have a much harder time integrating reflexes — just as they'll have a harder time learning language, regulating emotions, or sitting still in a classroom. Addressing the underlying nervous system environment matters as much as any specific technique.
If you're noticing signs that might point to retained primitive reflexes — delayed speech, coordination difficulties, sensory sensitivities, or trouble with attention and regulation — I'd love to connect. I offer a free consultation for families in the Flower Mound and DFW area.
You may also find my posts on chronic stress and nervous system development and the importance of proper swallowing helpful as you explore these connections.
References: Matuszkiewicz, M. & Gałkowski, T. (2021). Developmental language disorder and uninhibited primitive reflexes in young children. Journal of Speech, Language, and Hearing Research, 64(3), 935–948. · El-Sady, S. et al. (2025). Retained primitive reflexes and their relation to speech intelligibility. The Egyptian Journal of Otolaryngology. · Goddard Blythe, S. (2017). Reflexes, Learning and Behavior. Fern Ridge Press.