If you’ve been concerned about your child’s behaviour, it’s worth investigating if they have retained neonatal reflexes.
Retained neonatal reflexes (sometimes known as retained primitive reflexes) sounds very daunting.
There’s no doubt we live in a time of labels.
This isn’t necessarily a bad thing.
A proper diagnosis often means we can access adequate resources, treatment and support.
However, there are times when a label is overused.
What happens when there is an underlying condition but it’s masked by the wrong label?
New Study: What’s Really Behind Your Child’s Behaviour?
Before continuing, I should stress I am not suggesting Attention Deficit Hyperactivity Disorder (ADHD) doesn’t exist.
Neither am I suggesting you or your child have been improperly diagnosed.
The information in this article is concerned with another condition – one that can look like ADHD.
Some children who present with ADHD-like symptoms are found to have a retained neonatal reflex.
This reflex can cause involuntary behaviour that mimics symptoms of the more commonly diagnosed condition, ADHD.
Meghan Krouse is a licensed clinical social worker and certified sensory enrichment therapist.
She says, “Sometimes these retained reflexes look like ‘bad’ behaviours. Really they’re unconscious movements and not intentional behaviours”.
Retained Neonatal Reflexes And Why They Matter
A reflex is a response to a stimulus and occurs without conscious thought.
Neonatal reflexes are reflexes unique to infants. Most only last for a few months after birth.
Some reflexes, such as the gag reflex, exist beyond infancy.
Occasionally a neonatal reflex is retained beyond infancy.
In that case it can affect a child’s behaviour, motor development, balance and other important developmental skills.
What Are The Neonatal Reflexes?
- Root reflex. Touching or stroking the corner of an infant’s mouth or the side of one cheek causes the infant to turn his mouth to the direction of the touch. This reflex helps the baby find the breast or bottle, in order to feed.
- Suck reflex. When the roof of a newborn’s mouth is touched – for example, by a nipple, he will automatically suck. This reflex helps establish feeding.
- Moro reflex. Often referred to as the startle reflex, this occurs when a baby is startled by a movement or loud sound. In response, the baby throws back his head, extends arms and legs, then cries and pulls arms back in.
- Tonic neck reflex. When a baby’s head is turned, the arm on the side he is facing stretches out, while the opposite arm bends at the elbow.
- Grasp reflex. When a newborn’s palm is stroked, he will close his fingers and tightly grasp a finger or object.
- Babinski reflex. If the sole of a baby’s foot is stroked firmly, the big toe will bend back towards the top of the foot while the other toes fan out.
- Step reflex. When a newborn’s feet are touching a solid surface the baby appears to take steps forward (while fully supported).
- Spinal galant reflex. When an infant is held face down and his lower spine is touched on either side, a side flexion occurs and the hip rises towards the touch.
Most reflexes disappear at about 3-6 months; the Babinski reflex lasts for about 2 years.
How Do I Know If My Child Has Retained Neonatal Reflexes?
Shortly after birth, your care provider will evaluate your baby’s reflexes.
Having all neonatal reflexes present is a sign of proper neurological development and health.
Retained reflexes, or reflexes that disappear but return later, can be a sign of neurological conditions or damage.
It can also mean they simply didn’t integrate naturally for some reason.
My daughter, born at 31 weeks gestation, retained her moro reflex until she was more than a year old.
As well as being premature, she also had a few surgeries.
This led to less movement in early infancy, which might have impacted her brain’s ability to integrate this reflex.
Her therapists used large movement, swinging and even rough play, to help integrate this reflex.
Because she was so young, the moro reflex looked the same at 9 and 14 months as it did in her newborn days.
For older children, it can be harder to recognise as the reflex might look different.
Krouse says, “As a parent and a professional I think what’s difficult is that retained reflexes look a lot like other common childhood diagnoses or ‘bad’ behaviour.
“For example, ADHD, defiant behaviour, emotionally sensitive, etc look very similar to retained reflexes.
“The spinal galant reflex may cause a kid to fidget continually and kick items in front of them. It appears like defiant or ‘annoying’ behaviour but it’s not a conscious choice to be doing it.
“Moro reflex in an older child can mean that the system hasn’t developed properly and can cause kids to be stuck in ‘fight or flight’ mode, hypersensitive to sounds and other things in their environment.
“Fight can look like defiance, or flight can look like avoidance. They are hypersensitive to sensory things”.
What Are The Signs Of Retained Reflexes?
Krouse also said the following can all be signs of retained reflexes:
- Difficulty with balance
- Trouble with reading and eye tracking
- Difficulty in turning the neck.
These are midline difficulties. The body’s midline is an invisible line down the centre of the body
Crossing the midline means the ability to reach across the middle of the body with the arms and legs crossing over to the opposite side.
What Should I Do About My Child’s Behaviour?
Perhaps you are already aware your child has a retained neonatal reflex and you’re wondering what it means.
Or your child has ADHD and you’re wondering whether they have received the right diagnosis.
Or maybe your child is at risk (born prematurely, had a head injury, etc.) and you’re wondering what to look for.
You may simply be at your wit’s end with your child’s behaviour and what to do about it.
Regardless of why you’re seeking answers, if you have concerns, an evaluation with a professional can be helpful.
If you have any concerns about your child’s behaviour, Krouse recommends seeking an evaluation with a health professional who is familiar with retained reflexes – some occupational therapists, for example.
Seek an evaluation if your child is:
- Struggling with age appropriate balance, such as learning to ride a bike
- Frequently fidgeting
- Struggling with class work.
Seek support if your infant or toddler is experiencing:
- Motor delays, such as late crawling (aged 12 months and not yet crawling on hands and knees)
- Late walking (over 18 months and not walking), even allowing for adjusted age if the baby was premature.
My Child Has An ADHD Diagnosis; How Do I Know If It’s Accurate?
As Krouse mentioned, the difficult thing with common childhood conditions is symptoms can be similar.
It’s important not to make any drastic changes to a child’s therapy, medication or education plan based on something like this article.
However, if your child’s behaviour leads you to suspect a retained reflex, you can look for a care provider who is familiar with the condition or ask your current provider about it.
Anytime you’re unsure about your child’s diagnosis, it is reasonable to seek second, third, or even more, opinions.
Sometimes a retained moro reflex might present like anxiety.
A retained moro reflex can keep a child in fight or flight mode. This will leave a child feeling anxious and exhausted.
However, some children experience generalised anxiety or anxiety from trauma without having a retained neonatal reflex.
Some children who seem extra fidgety might not have ADHD or even retained neonatal reflexes.
In some cases they’re simply trying to meet their body’s need for movement.
You can read Why Can’t My Kid Sit Still? Expert Shares The Reason Kids Fidget to learn more.
Children who are defiant and refuse to listen could have retained reflexes.
It’s common to have a classroom of typically developing children with immature proprioceptive and vestibular systems.
This means they can’t sit and listen in a classroom.
Instead, their bodies urge them to move to help these systems. This can look like your child’s behaviour in class is poor but they can’t help it.
You can read The Real Reason Your Kids Won’t Listen to learn more.
What Do Parents Need To Know About Neonatal Reflexes?
Most children will properly integrate these reflexes without any problems.
Many parents aren’t even aware of all the reflexes as they have little impact on everyday parenting.
However, if you have a child who was born prematurely, has any type of neurological diagnosis, or even if you’re just concerned about your child’s behaviour, it can be helpful to seek an evaluation.
Krouse also mentioned the importance of not being overaccommodating to a fault.
My daughter was very insecure in her body. This played a role in her motor delay, and her ability to sleep.
Initially, I completely followed her lead, but this meant she didn’t make much progress.
Then I added some physical and occupational therapy, and changed how I interacted with her.
I also helped her work through the behaviours that resulted from immature vestibular and proprioceptive systems and retained moro reflex.
Seek Professional Advice For Your Child’s Behaviour
As a parent, it’s important you take in a variety of evidence-based resources. You should also talk to professionals about your concerns, and trust your gut instinct.
If you have concerns about your child’s behaviour or development, seek support from a provider who is familiar with them.
You’ll learn the best way to treat and support your child. Sometimes you learn you needn’t be concerned at all.
Therapy is available to address both ADHD and retained neonatal reflexes.
The right techniques and therapy will help the integration of retained reflexes.
A therapist familiar with both reflexes and ADHD can help you figure out how best to support your child.