ORIGINAL PAPER
Assessing primitive reflex retention and its effect on motor proficiency in Thai preschoolers
1
Master of Science Program in Human Development, National Institute for Child and Family Development, Mahidol University, Nakhon Pathom, Thailand
2
Innovative Learning Center, Srinakharinwirot University, Bangkok, Thailand
3
Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
4
Faculty of Physical Therapy and Sports Medicine, Rangsit University, Pathumthani, Thailand
5
National Institute for Child and Family Development, Mahidol University, Nakhon Pathom, Thailand
These authors had equal contribution to this work
Submission date: 2024-12-06
Acceptance date: 2025-03-30
Online publication date: 2025-09-10
Corresponding author
Kannika Permpoonputtana
National Institute for Child and Family Development, Mahidol University, Nakhon Pathom 73170, Thailand
National Institute for Child and Family Development, Mahidol University, Nakhon Pathom 73170, Thailand
KEYWORDS
reflex integrationneuromotor developmentearly childhoodfine motor developmentgross motor development
TOPICS
ABSTRACT
Purpose:
This study aims to examine the relationship between the retention of primitive reflexes and motor proficiency in preschool children, with a specific focus on healthy Thai preschoolers. In particular, we investigate key primitive reflexes associated with body positioning, including the Asymmetrical Tonic Neck Reflex (ATNR), Symmetrical Tonic Neck Reflex (STNR), and Tonic Labyrinthine Reflex (TLR), to determine their potential impact on motor proficiency.
Methods:
Data were collected from 65 children (26 girls and 39 boys) from Bangkok and the surrounding metropolitan area, with a mean age of 5.64 years (SD = 0.38). Each participant underwent assessments using the Primitive Reflex Test, focusing on the ATNR, STNR, and TLR, as well as the motor proficiency assessed with the Bruininks–Oseretsky Test of Motor Proficiency, second edition, Short Form (BOT-2SF).
Results:
Statistical analysis revealed a significant inverse correlation between the retention of three primitive reflexes (ATNR, STNR, TLR) and overall motor proficiency (r = –0.543, p < 0.001), indicating that higher reflex retention is associated with lower motor skills. Among individual reflexes, STNR showed the highest negative correlation (r = –0.498), followed by TLR (r = –0.361) and ATNR (r = –0.316). Fine motor precision was most affected by reflex retention. Persistent reflexes were found in 65% of participants, with those retaining 2–3 reflexes scoring notably lower on BOT-2SF assessments.
Conclusions:
This first Thai study on retained primitive reflexes and motor proficiency in preschoolers underscores the need for early assessment and timely interventions such as reflex integration therapy to support development.
This study aims to examine the relationship between the retention of primitive reflexes and motor proficiency in preschool children, with a specific focus on healthy Thai preschoolers. In particular, we investigate key primitive reflexes associated with body positioning, including the Asymmetrical Tonic Neck Reflex (ATNR), Symmetrical Tonic Neck Reflex (STNR), and Tonic Labyrinthine Reflex (TLR), to determine their potential impact on motor proficiency.
Methods:
Data were collected from 65 children (26 girls and 39 boys) from Bangkok and the surrounding metropolitan area, with a mean age of 5.64 years (SD = 0.38). Each participant underwent assessments using the Primitive Reflex Test, focusing on the ATNR, STNR, and TLR, as well as the motor proficiency assessed with the Bruininks–Oseretsky Test of Motor Proficiency, second edition, Short Form (BOT-2SF).
Results:
Statistical analysis revealed a significant inverse correlation between the retention of three primitive reflexes (ATNR, STNR, TLR) and overall motor proficiency (r = –0.543, p < 0.001), indicating that higher reflex retention is associated with lower motor skills. Among individual reflexes, STNR showed the highest negative correlation (r = –0.498), followed by TLR (r = –0.361) and ATNR (r = –0.316). Fine motor precision was most affected by reflex retention. Persistent reflexes were found in 65% of participants, with those retaining 2–3 reflexes scoring notably lower on BOT-2SF assessments.
Conclusions:
This first Thai study on retained primitive reflexes and motor proficiency in preschoolers underscores the need for early assessment and timely interventions such as reflex integration therapy to support development.
REFERENCES (31)
1.
Diamond A. Executive functions. Ann Rev Psychol. 2013;64:135–68; doi: 10.1146/annurev-psych- 113011-143750.
2.
Capute AJ, Accardo PJ, Vining EP, Rubenstein JE, Ronald Walcher J, Harryman S, Ross A. Primitive reflex profile. A pilot study. Phys Ther. 1978;58(9): 1061–5; doi: 10.1093/ptj/58.9.1061.
3.
Schott JM, Rossor MN. The grasp and other primitive reflexes. J Neurol Neurosurg Psychiatry. 2003; 74(5):558–60; doi: 10.1136/jnnp.74.5.558.
4.
Goddard S. Reflexes, Learning and Behavior. A Window into the Child’s Mind. A Non-Invasive Approach to Solving Learning and Behavior Problems. Eugene: Fern Ridge Press; 2002.
5.
van Kranen-Mastenbroek VH, Folmer KB, Caberg HB, Kingma H, Blanco CE, Troost J, Hasaart TH, Vles JS . The influence of head position and head position change on spontaneous body posture and motility in full-term AGA and SGA newborn infants. Brain Dev. 1997;19(2):104–10; doi: 10.1016/s0387-7604(96)00484-6.
6.
McPhillips M, Hepper PG, Mulhern G. Effects of replicating primary-reflex movements on specific reading difficulties in children: a randomised, double- blind, controlled trial. Lancet. 2000;355(9203): 537–41; doi: 10.1016/s0140-6736(99)02179-0.
7.
Zafeiriou DI. Primitive reflexes and postural reactions in the neurodevelopmental examination. Pediatr Neurol. 2004;31(1):1–8; doi: 10.1016/j.pediatrneurol. 2004.01.012.
8.
Blythe SG. Assessing Neuromotor Readiness for Learning. The INPP Developmental Screening Test and School Intervention Programme. John Wiley and Sons; 2012.
9.
Blythe SG. Neuromotor Immaturity in Children and Adults. The INPP Screening Test for Clinicians and Health Practitioners. John Wiley and Sons; 2015.
10.
Blythe SG, Beuret LJ, Blythe P. Attention, Balance, and Coordination. The A.B.C. of Learning Success. Wiley-Blackwell; 2009.
11.
Canevska OR, Mihajlovska M. Persistence of primitive reflexes and associated problems in children. Ann Fac Philos Skopje. 2019;72(22):513–522; doi: 10.37510/godzbo1972513rc.
12.
Grigg T, Culpan I, Turnbull W. Primitive reflex integration and reading achievement in the classroom. J Neurol Exp Neurosci. 2023;9(1):18–26; doi: 10.17756/jnen.2023-103.
13.
Hickey J, Feldhacker DR. Primitive reflex retention and attention among preschool children. J Occup Ther Sch Early Interv. 2022;15(1):1–13; doi: 10.1080/19411243.2021.1910606.
14.
Gieysztor EZ, Choińska A, Paprocka-Borowicz M. Persistence of primitive reflexes and associated motor problems in healthy preschool children. Arch Med Sci. 2018;14(1):167–73; doi: 10.5114/ aoms.2016.60503.
15.
Blythe SG. Neuromotor Immaturity in Children and Adults. The INPP Screening Test for Clinicians and Health Practitioners. John Wiley and Sons; 2014.
16.
Berne SA. The primitive reflexes: considerations in the infant. Optom Vis Dev. 2006;37(3):136–45.
17.
Blythe SG, Duncombe R, Preedy P, Gorely T. Neuromotor readiness for school: the primitive reflex status of young children at the start and end of their first year at school in the United Kingdom. Education 3-13. 2022;50(5):654–67; doi: 10.1080/ 03004279.2021.1895276.
18.
Pecuch A, Gieysztor E, Telenga M, Wolańska E, Kowal M, Paprocka-Borowicz M. Primitive reflex activity in relation to the sensory profile in healthy preschool children. Int J Environ Res Public Health. 2020;17(21):8210; doi: 10.3390/ijerph17218210.
19.
Konicarova J, Bob P. Retained primitive reflexes and ADHD in children. Act Nerv Super. 2012; 54(3–4):135–8.
20.
Melillo R, Leisman G, Mualem R, Ornai A, Carmeli E. Persistent childhood primitive reflex reduction effects on cognitive, sensorimotor, and academic performance in ADHD. Front Public Health. 2020;8:431835; doi: 10.3389/fpubh.2020.431835.
21.
Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Melillo T, Carmeli E. The relationship between retained primitive reflexes and hemispheric connectivity in autism spectrum disorders. Brain Sci. 2023;13(8):1147; doi: 10.3390/brainsci13081147.
22.
Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla- Acosta M, Melillo T, Carmeli E. Retained primitive reflexes and potential for intervention in autistic spectrum disorders. Front Neurol. 2022; 13:922322; doi: 10.3389/fneur.2022.922322.
23.
Sigafoos J, Roche L, O’Reilly MF, Lancioni GE. Persistence of primitive reflexes in developmental disorders. Curr Dev Disord Rep. 2021;8:98– 105; doi: 10.1007/s40474-021-00232-2.
24.
Bruininks R, Bruininks B. Bruininks–Oseretsky Test of Motor Proficiency. 2nd ed. Minneapolis: NCS Pearson; 2005.
25.
Pecuch A, Gieysztor E, Wolańska E, Telenga M, Paprocka-Borowicz M. Primitive reflex activity in relation to motor skills in healthy preschool children. Brain Sci. 2021;11(8):967; doi: 10.3390/ brainsci11080967.
26.
Morrison DC, Hinshaw SP, Carte ET. Signs of neurobehavioral dysfunction in a sample of learning disabled children: stability and concurrent validity. Percept Mot Skills. 1985;61(3):863–72; doi: 0.2466/pms.1985.61.3.863.
27.
Yoon D, Choi D, Kim M, Ji S, Joung Y-S, Kim EY. Validity of the BOT-2 short form for Korean schoolage children: a preliminary study. Children. 2024; 11(6):724; doi: 10.3390/children11060724.
28.
Köse B, Kara ÖK, Kara K, Karabulut E, Şahin S. Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia. Appl Neuropsychol Child. 2022;11(3):391–9; doi: 10.1080/21622965. 2020.1862656.
29.
Cools W, De Martelaer K, Samaey C, Andries C. Movement skill assessment of typically developing preschool children: a review of seven movement skill assessment tools. J Sports Sci Med. 2009;8(2):154–68.
30.
Dana A, Ranjbari S, Chaharbaghi Z, Ghorbani S. Association between physical activity and motor proficiency among primary school children. Int J School Health. 2023;10(3); doi: 10.30476/INTJSH. 2023.98237.1295.
31.
Hopkins WG, Marshall SW, Batterham AM, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41:3–12; doi: 10.1249/MSS.0b013e 31818cb278.
| eISSN: | 1899-1955 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
