Understanding retained primitive reflexes in autism

Primitive reflexes are automatic movements present in infancy that help with early development. These reflexes should integrate naturally as the child matures, but in many autistic children, some reflexes remain active — contributing to challenges with sensory processing, motor coordination, and self-regulation. Research in Frontiers in Neurology (Melillo et al., 2022) describes the close relationship between retained reflexes and cognitive and motor function in autism spectrum disorder.

Reflexes our pediatric OT team most commonly screens for in autistic children:

• Moro reflex — can cause hypersensitivity, anxiety, and difficulty adapting to new environments. Learn about the retained Moro reflex →
• ATNR (Asymmetrical Tonic Neck Reflex) — contributes to challenges crossing the midline, handwriting, and hand-eye coordination. Read about retained ATNR →
• STNR (Symmetrical Tonic Neck Reflex) — impacts posture, attention, and bilateral coordination.
• Palmar reflex — affects fine motor skills and handwriting.
• Spinal Galant reflex — contributes to bedwetting, fidgeting, and sensitivity to clothing.
• Tonic Labyrinthine Reflex (TLR) — affects postural control, gravity awareness, and balance.

By addressing retained reflexes through targeted reflex integration sequences and manual therapy, we help the child's nervous system regulate, integrate sensory input, and develop motor skills more effectively. Read our complete primitive reflex guide →

Manual therapy and somatic work

Our pediatric OT team uses gentle, attuned manual therapy techniques that calm the autonomic nervous system and support neuroplasticity. The aim is not to "fix" the child but to give the body the input it needs to feel safe. These techniques:

• Reduce tension and tactile defensiveness in the body
• Improve proprioceptive and vestibular processing
• Enhance body awareness and motor planning
• Support emotional regulation and felt safety

Brain-boosting movement: the integration piece

Movement is the most powerful tool we have for shaping the nervous system. Combined with manual work, intentional movement reorganizes the brain's sensory and motor maps. In our Brewer, Maine clinic, this looks like:

• Cross-lateral movement — crawling patterns, marching, windmill arms — to support midline crossing and bilateral coordination
• Vestibular activities — swinging, spinning, balance work — to regulate sensory input and improve focus
• Proprioceptive tasks — pushing, pulling, resistance work — to build body awareness and reduce sensory seeking

How this approach benefits autistic children

Integrating manual therapy, primitive reflex integration, and intentional movement gives us a more complete framework for supporting autistic children:

• Improved sensory processing and regulation
• Enhanced motor coordination and balance
• Reduction in anxiety and emotional dysregulation
• Better attention, focus, and learning readiness
• Increased social engagement and participation in daily activities
• Stronger neural connections for cognitive function

OT-recommended tools for autistic kids

These are the sensory tools our team most often recommends to families supporting an autistic child at home:

• Weighted blankets and compression vests — deep pressure for nervous system regulation
• Sensory swings — rhythmic vestibular input that calms an overwhelmed brainstem
• Chewelry and oral motor tools — for kids who self-regulate through mouth input
• BrainMax Sensory Putty — proprioceptive hand input for in-the-moment regulation