When Baby Reflexes Don't Go Away: What Retained Primitive Reflexes Mean for Learning and Attention

Every newborn arrives wired with a set of automatic movement patterns — reflexes that help them survive those first helpless weeks. But these reflexes are supposed to disappear. When they don't, the story gets more complicated, and more relevant to your child's classroom.

What Primitive Reflexes Actually Are

Primitive reflexes are involuntary, stereotyped movements that originate in the brainstem and are present at birth. Two of the most studied are the Moro reflex — that dramatic startle-and-fling-arms response to sudden stimulation — and the asymmetric tonic neck reflex (ATNR), in which turning the head to one side causes the arm on that side to extend and the opposite arm to flex, like a fencing pose.

These reflexes serve real purposes early in life. The Moro primes an infant's stress-response system; the ATNR supports unilateral movement and, later, the hand-eye coordination needed for reaching. Typically, both are integrated — meaning absorbed into more sophisticated motor control — by around six months of age (Leisman et al., Journal of paediatrics and child health, 2025).

The concern arises when they persist into the preschool and school years, a pattern researchers describe as retained or active primitive reflexes. (Leisman et al., Journal of paediatrics and child health, 2025) (Pecuch et al., Brain sciences, 2021)

The Normal Timeline (and What "Retained" Means)

Integration isn't a light switch. Reflex activity diminishes gradually as the central nervous system matures and higher cortical pathways gain control over subcortical ones. Studies confirm that in healthy preschool children aged four to six, detectable residual reflex activity is still relatively common — and that it correlates meaningfully with motor performance (Pecuch et al., Brain sciences, 2021).

A 2021 study examining 112 Polish preschool children found a statistically significant inverse relationship between reflex activity scores and motor efficiency scores: higher reflex activity, lower motor skill level (Pecuch et al., Brain sciences, 2021). Crucially, the relationship worked both ways in their regression model — older age and lower reflex activity together predicted better motor outcomes, pointing toward a developmental trajectory rather than a fixed deficit (Pecuch et al., Brain sciences, 2021).

What this tells parents: if your five-year-old is still showing a pronounced ATNR when assessed, that is not automatically cause for panic. But it is worth paying attention to, especially if it is accompanied by other developmental concerns.

The Link to Learning and Attention Difficulties

Here is where the science becomes genuinely interesting — and where parents most need clear information, because claims in this space can outrun the evidence.

Researchers have proposed that retained primitive reflexes may act as a potential biomarker for developmental disabilities, including difficulties with attention (Leisman et al., Journal of paediatrics and child health, 2025). The theoretical mechanism is neurological immaturity: if lower brainstem reflexes haven't been fully inhibited by maturing cortical systems, those same cortical systems may also be less efficient at tasks like sustained attention, reading, and coordinating both sides of the body (Leisman et al., Journal of paediatrics and child health, 2025).

The ATNR is particularly implicated in learning difficulties. Because it links head turning to arm extension, a child who has not fully integrated it may struggle to keep a pencil moving smoothly across the page — when they turn their head to look at the board, the reflex subtly interferes with their writing hand (Pecuch et al., Brain sciences, 2021). Studies have noted associations between active primitive reflex presence and problems with reading, writing, reduced mathematics skills, and dyslexia, as well as coordination difficulties and attention deficit (Pecuch et al., Brain sciences, 2021).

The Moro reflex retention carries different implications. A persistent hypersensitive Moro response means the nervous system fires an emergency alarm at minor sensory inputs — a car door slamming, a flickering light, an unexpected touch. That chronic low-grade hyperarousal consumes attentional resources and can look behaviorally very similar to ADHD (Leisman et al., Journal of paediatrics and child health, 2025).

An important caveat: this is correlational and mechanistic research. The field does not yet have large randomized controlled trials confirming that treating retained reflexes directly causes improvements in reading or attention. Parents should be cautious of practitioners who overstate the certainty of outcomes.

How Clinicians Screen for Retained Reflexes

Assessment is straightforward and non-invasive. For the ATNR, the examiner typically asks the child to adopt an all-fours position and then passively rotates the head; limb extension on the face side, above a threshold, indicates reflex activity (Pecuch et al., Brain sciences, 2021). The Moro is often assessed by observation of the child's startle sensitivity and through standardized movement protocols (Leisman et al., Journal of paediatrics and child health, 2025).

Primitive reflex evaluation is increasingly viewed as one component of a broader neuromotor developmental assessment, sitting alongside measures of balance, coordination, and sensory processing (Leisman et al., Journal of paediatrics and child health, 2025) (Kuiper et al., Brain and behavior, 2019). It is not a standalone diagnostic tool for ADHD, dyslexia, or any specific condition — and reputable clinicians will frame it that way.

If your child's pediatrician, occupational therapist, or developmental specialist raises the topic, the right follow-up questions are: What is the severity of the retained reflex? Is it affecting function that I can observe at home or school? And what does a complete developmental picture look like?

What You Can Actually Do

The most supported approach involves targeted movement programs designed to gradually inhibit retained reflexes through repetitive, specific exercises — essentially re-running parts of the early motor development sequence the child's nervous system may have rushed through (Pecuch et al., Brain sciences, 2021) (Leisman et al., Journal of paediatrics and child health, 2025).

The Pecuch et al. study specifically noted that properly selected exercises and therapeutic activities aimed at integrating active primitive reflexes can improve motor skills, perceptual abilities, and emotional behavior in children with developmental difficulties (Pecuch et al., Brain sciences, 2021). The qualifier "properly selected" matters — YouTube programs and informal approaches vary wildly in quality.

Practical steps for parents:

Ask your pediatrician for a neuromotor screen if your child is showing unexplained coordination problems, letter reversals beyond age seven, or extreme sensitivity to sensory input alongside attention difficulties.
Seek a qualified occupational therapist or physiotherapist with specific training in neurodevelopmental reflex integration — not all OTs have this specialization.
Keep a behavioral log noting when difficulties spike. Sensory overload environments (busy cafeterias, noisy gyms) can temporarily amplify retained reflex responses, and that pattern is useful clinical information.
Don't skip the full developmental workup. Retained reflexes overlap with several other developmental profiles. A child with attention difficulties deserves comprehensive evaluation, not a single-lens explanation (Duchan et al., FP essentials, 2021).

The evidence does not support reflexes as the sole cause of learning struggles, but it does support them as one piece of a larger neurological picture — a piece that is screenable, trackable, and potentially responsive to intervention (Leisman et al., Journal of paediatrics and child health, 2025) (Pecuch et al., Brain sciences, 2021).

If your child is struggling at school and nobody has checked their primitive reflexes yet, it is a reasonable question to raise at your next appointment. It won't cost anything to ask.

References

Leisman et al. (2025). Evaluating Primitive Reflexes in Early Childhood as a Potential Biomarker for Developmental Disabilities.. Journal of paediatrics and child health. https://pubmed.ncbi.nlm.nih.gov/40196932/
Pecuch et al. (2021). Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children.. Brain sciences. https://pubmed.ncbi.nlm.nih.gov/34439585/
Kuiper et al. (2019). The neurological phenotype of developmental motor patterns during early childhood.. Brain and behavior. https://pubmed.ncbi.nlm.nih.gov/30485703/
Duchan et al. (2021). Child Developmental Delays and Disorders: Motor Delay.. FP essentials. https://pubmed.ncbi.nlm.nih.gov/34709024/