When we look around the classroom, primitive reflexes may not be the first thing that comes to mind. We often associate them with infants and early intervention. But what happens when these reflexes don’t integrate as expected? For many students, retained primitive reflexes continue to shape their development well into the school years – impacting learning, behavior, and participation every day in the classroom.
To unpack this important topic, we’ll draw on insights shared with us from our Inclusive Classrooms Summit with Kim Wiggins, OTR/L. Kim is a pediatric occupational therapist with over 20 years of experience working in schools, outpatient clinics, and homes.
Let’s start at the beginning - what are primitive reflexes?
Primitive reflexes are automatic movement patterns that develop in utero and typically integrate as the central nervous system matures. By the age of one or two, they should no longer be visible.
When reflexes persist beyond that stage, however, they can influence a child’s:
- Sensory processing
- Attention
- Emotional regulation
- Reading and writing
- Posture and motor coordination
- Behavior in the classroom
Instead of supporting development, these reflexes can interfere with higher-level skills like academics, impulse control, and social interaction – all skills critical for the classroom.
Kim often uses a tree analogy to illustrate this:
- The leaves represent higher-level skills such as cognition, behavior, social skills, and academics.
- The trunk includes language, visual-motor skills, and body awareness.
The roots form the sensory foundation – interoception, proprioception, vestibular, tactile, visual, auditory, olfactory, and gustatory systems.
When the roots are strong, the tree thrives. But if reflexes are retained, development at the trunk and leaf levels can be disrupted. Students who remain “stuck” in the roots or trunk often end up compensating, working much harder than their peers – or giving up altogether because the effort is simply too overwhelming.
Research has also shown that children who skip certain developmental milestones, such as crawling, have a higher prevalence of retained reflexes. In these cases, the tree’s leaves never fully develop, which can explain ongoing difficulties with academics, behavior, and attention later in the classroom.
Why Screening in Schools Matters
There are no standardized tests for screening for retained primitive reflexes in a school setting – it’s about observation, collaboration, and targeted follow-through. Often, the first clue comes when teachers or parents notice something that just doesn’t add up: a child who’s been in therapy for years without much progress, or a puzzling barrier the whole team can’t quite explain. These are often the students who benefit most from reflex screening.
Kim emphasizes a two-step process:
- Symptom Checklist – Focused on functional concerns like attention, posture, handwriting, and behavior. If a child shows three or more symptoms tied to a specific reflex, that raises a red flag.
- Physical Assessment – Conducted only if the checklist suggests retained reflexes. Each reflex has its own assessment, scored on a 1–4 scale. A 3 or 4 often provides strong insight into the “why” behind a child’s struggles.
Importantly, therapists only screen for reflexes connected to observed symptoms, and interventions only target reflexes that test positive. This ensures screenings remain objective, efficient, and classroom-relevant. With teachers, therapists, and parents working together, strategies can be carried over consistently – making the biggest difference where it matters most: in the child’s daily learning environment.
Techniques for the Classroom
When addressing retained primitive reflexes in the classroom, Kim highlights a three-part approach: assessment, compensation, and exercises.
1. Assessment
The first step is to identify which reflexes are interfering with a child’s participation. This is typically done through observation, symptom checklists, and physical screenings, as described earlier.
2. Compensation Strategies
While exercises help to integrate reflexes over time, children also need immediate strategies that make classroom life more manageable. These compensations allow students to learn and participate while integration work is ongoing and will depend on what kind of primitive reflex needs to be integrated, for example:
- Moro Reflex (sensitivity to sensory input): Children with a retained Moro reflex may be overly reactive to sound, light, or movement. Helpful supports include noise-reducing headphones, calming music, minimizing visual clutter, sunglasses, weighted tools, chewing gum, or teaching relaxation and breathing techniques. Teachers play a central role in carrying these strategies into daily routines.
- TNR and STNR Reflexes (linked to head and neck movements): For these more physical reflexes, classroom setup can make a big difference. Simple adjustments like tilting desks, allowing students to stand, or offering opportunities to work on the board, can reduce the strain of extending or turning the neck.
Even classroom furniture arrangements can have an impact. For example, when desks are grouped in clusters or children sit at round tables, students may have to twist or turn their heads repeatedly to see the board. For those with retained reflexes, this can create unnecessary challenges. By adjusting seating or offering visual supports, teachers can remove barriers to learning.
3. Exercises
Targeted exercises help gradually integrate reflexes, but they must be practiced consistently, ideally for at least 30 days, to be effective. Each exercise is linked to a specific reflex and should only be introduced if screening shows it’s necessary.
As Kim notes, certain academic skills are particularly vulnerable when reflexes remain unintegrated. For example, educational researcher Sally Goddard has observed that handwriting is often the greatest casualty of the ATNR reflex. In such cases, integrating the reflex may improve skills, but children may also need access to assistive technology to keep pace with classroom demands in the meantime.
Sometimes the missing piece isn’t another strategy, more medication, or more behavioral plans – it’s looking deeper at the foundational reflexes still lingering in the background. And when those are addressed consistently, the results can be life-changing.
Primitive reflexes aren’t just a topic for early intervention – they have real, lasting impacts in the classroom. By learning how to identify, screen, and address them, therapists, teachers, and parents can better support children in reaching their full potential.
This is just a glimpse: get the full interview plus 13 other expert-led talks on mastering push-in therapy in schools.
About Kim Wiggins
Kim Wiggins, OTR/L, is an experienced pediatric occupational therapist with over 20 years in school-based, outpatient, and home settings. She currently works full-time in an upstate NY school district and owns OTKimWiggins LLC, providing educational resources for parents and professionals. A sought-after speaker for 15 years, Kim has presented nationally and internationally and co-authored Just Right! A Sensory Modulation Curriculum for K-5.
You can visit her website https://www.otkimwiggins.com/ for more information