Primitive reflex integration for attention and behavior is becoming an increasingly important area of discussion as therapists and educators seek to better understand the developmental foundations that influence learning, regulation, and participation. While attention and behavior difficulties are often viewed through the lens of classroom expectations or emotional regulation, emerging research and clinical observations suggest that early movement development and retained primitive reflexes may also play an important role.
During the 2026 Inclusive Classroom Summit, Sonia Story, M.S. Movement Science, explored how primitive reflexes and neurodevelopmental movements shape the development of the brain, sensory systems, posture, balance, and self-regulation – and how disruptions in these early foundations can continue to impact children throughout childhood.
Her work highlights an important perspective for therapists and educators: many children struggling with attention, anxiety, self-regulation, and learning may not simply be “misbehaving” or “not trying hard enough.” Instead, their nervous systems may still be operating from an immature developmental foundation.
What Are Primitive Reflexes?
Primitive reflexes are innate, automatic infant movement patterns that appear in response to specific sensory stimuli. These reflexes are present from infancy and are essential for survival, protection, and early brain and body development.
Healthy babies naturally express these reflexes during the first months of life. As the brain matures, the reflexes should gradually integrate, becoming dormant as higher brain centers take over.
These early reflexes are not optional developmental extras. They help build:
- Brain and nervous system organization
- Sensory processing systems
- Postural control
- Motor coordination
- Emotional regulation foundations
- Future learning and communication abilities
When primitive reflexes remain active beyond infancy, they are referred to as retained or unintegrated primitive reflexes. Retained reflexes can interfere with physical, sensory, emotional, social, and cognitive development.
For example, if the grasp reflex remains active, more advanced hand movements and motor skills may become difficult because the nervous system remains “stuck” at an earlier developmental stage.
Understanding Neurodevelopmental Movements
Sonia explains that neurodevelopmental movements are the innate movement patterns babies are biologically designed to experience in early life. These include movements such as rolling, crawling, standing, walking and running.
These movement experiences help develop:
- Sensory processing systems
- Brain maturity and connectivity
- Speech and language foundations
- Emotional and cognitive regulation
- Upright posture and core strength
Sonia highlights that many attention, behavior, speech, and learning difficulties may begin when children do not fully experience these foundational movement patterns in infancy.
An upright, aligned posture allows babies to explore and interact with their environment effectively. This exploration is critical for healthy nervous system development.
She emphasizes that many essential functions depend on these early movement experiences, including:
- Breathing
- Balance
- Coordination
- Core strength
- Focus and attention
- Speech development
- Social-emotional regulation
- Learning readiness
How Retained Primitive Reflexes Affect Attention and Behavior
The persistence of primitive reflexes past infancy is considered a soft neurological sign, meaning it may indicate immaturity or dysfunction within the central nervous system.
Sonia referenced research from Nelson Textbook of Pediatrics:
“The finding of two or more persistent soft signs correlates significantly with neurologic dysfunction including attention deficit disorder, learning disorders and cerebral palsy.”
— Behrman et al., 2000
Children with retained primitive reflexes may experience challenges such as:
- Poor brain connectivity and neurological immaturity
- Sensory processing difficulties
- Weak coordination and motor deficits
- Poor stamina and fatigue
- Weak core strength
- Balance and postural difficulties
- Increased effort required for daily tasks
- Emotional immaturity
- Difficulty with self-regulation
- Cognitive challenges
These challenges can show up in the classroom as inattention, impulsivity, emotional reactivity, poor endurance, or difficulty participating in learning activities.
The Moro Reflex and ADHD
One primitive reflex Sonia highlights as especially connected to attention and behavior is the Moro reflex.
The Moro reflex is the infant startle reflex. Babies typically respond with a sudden jerking movement, gasping, crying, or changes in skin tone.
This reflex:
- Emerges in utero
- Matures at birth
- Should integrate by approximately 2–4 months of age
In infancy, the Moro reflex serves an important survival function by alerting caregivers and activating the nervous system’s fight-or-flight response during emergencies. However, when the Moro reflex remains active beyond infancy, the nervous system may stay in a chronic state of stress reactivity.
Signs of an Unintegrated Moro Reflex
Sonia shared several challenges commonly associated with a retained Moro reflex, including:
- ADHD symptoms
- Anxiety
- Poor balance
- Weak core strength
- Poor stamina
- Motion sickness
- Visual difficulties
- Difficulty adapting to change
- Irritability
- Sensory hypersensitivity or hyposensitivity
- Sleep disturbances
- Emotional outbursts
- Social anxiety or shyness
- Learning difficulties
Older children or even adults who may still have retained primitive reflexes, might not visibly display the dramatic infant startle pattern or other visual cues anymore, but their nervous systems may still internally react as though they are under constant stress.
Why the Moro Reflex Impacts Attention and Behavior
Sonia explained three major reasons the Moro reflex is so connected to attention and behavioral regulation.
1. The Moro reflex is heavily connected to sensory processing
The reflex is stimulated by multiple sensory inputs, making it deeply tied to the maturation of the sensory system. When the reflex remains active, children may become overly sensitive to sound, touch, light, movement, or other sensory input.
2. The Moro reflex activates the fight-or-flight response
The Moro reflex stimulates the nervous system in the same way the stress response does. If the reflex remains active, stress hormones may remain elevated, leaving children in a chronic state of hypervigilance.
This can contribute to:
- Anxiety
- Emotional reactivity
- Attention difficulties
- Behavioral outbursts
- Difficulty adapting to change
3. The Moro reflex is linked to vestibular function and balance
Vestibular development plays a major role in physical balance, spatial awareness, and feelings of safety within the body. Improved balance can reduce anxiety and improve self-esteem.
The Role of Rhythmic Movements in ADHD and Regulation
Primitive reflexes are not the only developmental movements connected to attention and behavior. Sonia also mentions the important role of innate rhythmic movements – the spontaneous, repetitive movement patterns infants naturally perform during early development, such as sucking, rocking, crawling, and rocking on hands and knees.
These movements were studied extensively by physical therapist Esther Thelen in the late 1970s. At the time, researchers did not fully understand the purpose of these repetitive infant movements, but Thelen’s work helped demonstrate that they are not random. Instead, they are part of a biologically driven repertoire of movements that support healthy brain and nervous system development.
These rhythmic movements help mature the brain, support primitive reflex integration, and stimulate the foundational sensory systems – particularly the tactile, vestibular, and proprioceptive systems. These systems then support the later development of vision, hearing, speech, coordination, learning, and self-regulation.
Research has shown that poor rhythmic ability is strongly associated with ADHD and is often part of the broader ADHD profile. Difficulties with rhythmicity have also been linked to speech and language disorders, developmental coordination disorder, dyslexia, and autism.
Sonia explains that rhythmic movements are calming and organizing for the nervous system and are often associated with developmental bursts, particularly in areas such as speech and motor development. Research on rhythmic movement interventions has shown connections with primitive reflex integration, reduced ADHD-related behaviors, improved balance, increased reading ability, stronger self-regulation skills, and improved fine motor coordination.
ADHD as Developmental Immaturity
Sonia also shared insights from Harald Blomberg, M.D., who describes ADHD as a form of stalled neurodevelopment rather than simply a behavioral disorder.
Many characteristics associated with ADHD resemble behaviors expected in toddlers, including:
- Difficulty sustaining attention
- Impulsivity
- Excessive movement
- Interrupting others
- Trouble organizing activities
From this perspective, ADHD may reflect immaturity in brain development and underdeveloped neural connections.
This developmental lens shifts the conversation from blame and compliance toward understanding nervous system development and support.
ADHD Often Co-Occurs With Other Challenges
Sonia explains that ADHD frequently occurs alongside:
- Sensory processing challenges
- Motor deficits
- Anxiety
- Learning difficulties
- Speech and language challenges
- Emotional and behavioral disorders
- Headaches
Children with ADHD are also more likely to experience sensory sensitivity, sensory seeking, sensory avoidance, or low sensory registration.
Sonia emphasized that reflexes and sensory systems cannot truly be separated. Reflexes are stimulated by sensory input, and reflex expression in turn helps mature the sensory systems and the brain.
Should Schools Screen for Primitive Reflexes?
Sonia believes schools and therapists should be more aware of retained primitive reflexes because of how strongly they are associated with participation, learning, sensory processing, and regulation challenges.
Possible areas to observe or screen include:
- Balance abilities
- Motor skills
- Sensory processing
- Rhythmic ability
- Visual-motor skills
- Individual primitive reflexes
However, she also notes that screening for primitive reflexes can be challenging. Children often develop compensatory strategies, meaning the actual reflex movement may no longer be obvious even though the nervous system is still affected.
One simple observation Sonia shared is asking a child to stand and tilt their head backward. Difficulty maintaining balance or signs of stress or agitation during this movement may suggest retained tonic labyrinthine reflex activity.
Supporting Regulation Through Movement
Sonia emphasized that movement-based interventions should feel calming, safe, and regulating for the child.
Some important principles when using rhythmic movement activities include:
- Ensuring both the child and facilitator are comfortable
- Following the child’s preferred rhythm and tempo
- Watching for feedback through breathing, facial expressions, or relaxation
- Keeping movements pleasant and non-threatening
- Maintaining a calm, positive presence
The goal is not forceful correction, but rather supporting nervous system maturation through safe and developmentally supportive movement experiences.
Rethinking Attention and Behavior Through a Developmental Lens
Attention challenges, emotional reactivity, sensory sensitivities, and difficulties with regulation may not simply be behavioral issues to manage, but signs that the brain, body, and sensory systems are still immature or underdeveloped.
Neurodevelopmental movements are not optional – they are foundational for healthy sensory processing, balance, posture, emotional regulation, learning, and participation. When children miss or struggle to fully integrate these early movement patterns, the nervous system may remain in a state of stress, compensation, or inefficiency, making everyday tasks far more effortful.
When we support the nervous system through movement, balance, rhythmic activities, and primitive reflex integration, we are not simply targeting behavior. We are helping children build stronger neurological foundations that can improve regulation, confidence, attention, learning, and overall participation in daily life.
This is just a glimpse: get the full interview plus 11 other expert-led talks on mastering MTSS in schools.
About Sonia Story
Sonia Story holds a Master’s degree in Movement Science. She has worked with all ages, infant to elder with a focus on school-aged children. She developed the Brain and Sensory Foundations curriculum to provide comprehensive training in neurodevelopmental movements that address the root causes of anxiety, sensory processing issues, and ADHD along with learning, physical, behavioral, emotional, social, and speech challenges.
Website: https://moveplaythrive.com/