The Relationship Between Primitive Reflex Activity Levels and Motor Skills in Preschool-Aged Children: A Systematic Review
DOI:
https://doi.org/10.20956/7ey7pg57Keywords:
Primitive Reflex, Child Development Disorders, Neurodevelopmental Disorders, Psychomotor Performance, Preschool ChildrenAbstract
Aims: This literature review aims to analyze and synthesize existing studies that explore the relationship between primitive reflex activity levels and motor skills in preschool-aged children, and to identify how unintegrated reflexes influence motor development and school readiness.
Methods: A systematic literature review was conducted using databases including Google Scholar, PubMed, Scopus, Taylor & Francis, Sage, ClinicalKey, ProQuest, EBSCOhost, and Springer. Articles published between 2015 and 2025 in English or Indonesian were included. Eligible studies applied correlational, observational, or quasi-experimental designs focusing on primitive reflexes and motor skills in preschool children. A total of 10 studies were selected after screening and critical appraisal following Aveyard guidelines.
Results: The review findings indicate a significant inverse relationship between primitive reflex activity and motor skills. Children with retained reflexes such as ATNR, STNR, TLR, and Moro reflex demonstrate poorer gross and fine motor performance, including deficits in balance, coordination, posture, and bilateral integration. Persistent reflexes are also associated with neuromotor immaturity, sensory processing issues, and lower academic readiness.
Conclusion: Unintegrated primitive reflexes negatively affect motor skill development in preschool-aged children and may hinder learning readiness. Early identification and intervention are essential to support optimal neuromotor development. These findings highlight the importance of incorporating reflex assessment into early childhood screening and physiotherapy practice
References
Andrich, P., Wrenhaven, S. L., & Glenn Goodman, O. D. (2018). Statistical Relationships Between Visual Skill Deficits and Retained Primitive Reflexes in Children. Optometry & Visual Performance, 6(3).
Bastiere, J., Lussiana, T., Patoz, A., Gindre, C., & Mourot, L. (2024). Active primitive reflexes obstruct tactical and technical skills in football players. Journal of Sports Sciences, 00(00), 1–11. https://doi.org/10.1080/02640414.2024.2434800
Bastiere, J., Lussiana, T., Young, D., Gindre, C., & Mourot, L. (2024). Persistence and activity levels of primitive reflexes in young high-level football players. Frontiers in Sports and Active Living, 6(July), 1–8. https://doi.org/10.3389/fspor.2024.1409257
Bilbilaj, D. S., G, D. A., & S, D. F. (2017). Measuring Primitive Reflexes in Children with Learning Disorders. European Journal of Multidisciplinary Studies, 5(1), 285. https://doi.org/10.26417/ejms.v5i1.p285-298
Bogdanoviča, I., & Lāriņš, V. (2020). Case Study of Primitive Reflexes Impact on Swimming Skill Acquisition By Healthy Children. SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference, 6, 89. https://doi.org/10.17770/sie2020vol6.5180
Bogdanoviča, I., & Lāriņš, V. (2021). Backstroke Teaching Methods in Healthy Children With Residual Primitive Reflexes. SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference, 4, 318–332. https://doi.org/10.17770/sie2021vol4.6256
Chandradasa, M., & Rathnayake, L. (2020). Retained primitive reflexes in children, clinical implications and targeted home-based interventions. Nursing Children and Young People, 32(1), 37–42. https://doi.org/10.7748/ncyp.2019.e1132
Chinello, A., Di Gangi, V., & Valenza, E. (2016). Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder. Research in Developmental Disabilities, 83, 287–295. https://doi.org/10.1016/j.ridd.2016.07.010
Damasceno, A., Delicio, A. M., Mazo, D. F. C., Zullo, J. F. D., Scherer, P., Ng, R. T. Y., & Damasceno, B. P. (2005). Primitive reflexes and cognitive function. Arquivos de Neuro-Psiquiatria, 63(3 A), 577–582. https://doi.org/10.1590/s0004-282x2005000400004
Domingo-Sanz, V. A. (2024). Persistence of primitive reflexes associated with asymmetries in fixation and ocular motility values. Journal of Eye Movement Research, 17(2), 1–33. https://doi.org/10.16910/jemr.17.2.5
Feldhacker, D. R., Cosgrove, R., Feiten, B., Schmidt, K., & Stewart, M. (2022). The Correlation between Retained Primitive Reflexes and Scholastic Performance among Early Elementary Students. Journal of Occupational Therapy, Schools, and Early Intervention, 15(3), 288–301. https://doi.org/10.1080/19411243.2021.1959482
Gieysztor, E., Choińska, A. M., Kowal, M., Pecuch, A., Borowicz, W., & Paprocka-Borowicz, M. (2019). The level of primitive reflex integration in children who play a musical instrument. Pediatria Polska, 94(5), 293–298. https://doi.org/10.5114/polp.2019.89865
Gieysztor, E., Kowal, M., & Paprocka-Borowicz, M. (2022). Primitive Reflex Factors Influence Walking Gait in Young Children: An Observational Study. International Journal of Environmental Research and Public Health, 19(7). https://doi.org/10.3390/ijerph19074070
Gieysztor, E., Pecuch, A., Kowal, M., Borowicz, W., & Paprocka-Borowicz, M. (2020). Pelvic symmetry is influenced by asymmetrical tonic neck reflex during young children’s gait. International Journal of Environmental Research and Public Health, 17(13), 1–12. https://doi.org/10.3390/ijerph17134759
Gieysztor, E. Z., Choińska, A. M., & Paprocka-Borowicz, M. (2018). Persistence of primitive reflexes and associated motor problems in healthy preschool children. Archives of Medical Science, 14(1), 167–173. https://doi.org/10.5114/aoms.2016.60503
Goddard Blythe, S., Duncombe, R., Preedy, P., & Gorely, T. (2022). 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, 50(5), 654–667. https://doi.org/10.1080/03004279.2021.1895276
Grigg, T. M. (2018). The influences of a primitive reflex integration programme within the classroom: Teacher/parent perspectives and student results. A thesis submitted in partial fulfilment of the requirement for the degree of Doctor of Philosophy in Education by. October.
Hernandez, A., Yolanda, S., & Guti, D. (2023). Relationships among integration of Primitive reflexes , Motor competence and Crawling in children. 1–10.
Hickey, J., & Feldhacker, D. R. (2022). Primitive reflex retention and attention among preschool children. Journal of Occupational Therapy, Schools, and Early Intervention, 15(1), 1–13. https://doi.org/10.1080/19411243.2021.1910606
Kalemba, A., Lorent, M., Blythe, S. G., & Gieysztor, E. (2023). The Correlation between Residual Primitive Reflexes and Clock Reading Difficulties in School-Aged Children—A Pilot Study. International Journal of Environmental Research and Public Health, 20(3). https://doi.org/10.3390/ijerph20032322
Konicarova, J., & Bob, P. (2013). Asymmetric tonic neck reflex and symptoms of attention deficit and hyperactivity disorder in children. International Journal of Neuroscience, 123(11), 766–769. https://doi.org/10.3109/00207454.2013.801471
Latash, M. . (2020). On primitives in motor control. Motor Control, 2(24), 318–346.
Marinov, E., Tsvetkova, S., & Staneva, K. (2015). Primitive reflexes of children with developmental coordination disorder. Yale Review of Education and Science, 1, 616–622.
Martello, J. M. (2023). Persistent Primitive Reflex and Developmental Delay in the School-Aged Child. Journal for Nurse Practitioners, 19(10), 104767. https://doi.org/10.1016/j.nurpra.2023.104767
McWhirter, K., Steel, A., & Adams, J. (2024). The association between learning disorders, motor function, and primitive reflexes in pre-school children: A systematic review. Journal of Child Health Care, 28(2), 402–428. https://doi.org/10.1177/13674935221114187
Melillo, R. J., Leisman, G., Machado, C., & Carmeli, E. (2023). Identification and reduction of retained primitive reflexes by sensory stimulation in autism spectrum disorder: Effects on qEEG networks and cognitive functions. BMJ Case Reports, 16(12), 1–11. https://doi.org/10.1136/bcr-2023-255285
Naufal, A. F., Wibowo, O. S., Hidayati, A., Nabilah, H. L., Almadani, Z., & Arwida, N. (2023). Hubungan antara refleks primitif terhadap kemampuan motorik kasar pada anak cerebral palsy spastik. Journal Physical Therapy UNISA, 3(1), 11–18. https://doi.org/10.31101/jitu.3008
Noegroho, A. (2021). Perkembangan Refleks dalam Assesmen dan Intervensi Anak.
Pecuch, A., Gieysztor, E., Wolańska, E., Telenga, M., & Paprocka-Borowicz, M. (2021). Primitive reflex activity in relation to the sensory profile. Brain Sciences, 11(8), 1–16.
Pecuch, A., Telenga, M., Pecuch, A., Gieysztor, E., & Wola, E. (2021). Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children.
Rathod, D. H. P., Mishra, D. A. K., & Dr. Sneha Somrajan. (2024). Children with Attention Deficit and Hyperactivity Disorder: Persistence of Primitive Reflexes and Related Motor Activity Issues. International Research Journal on Advanced Engineering and Management (IRJAEM), 6(07), 2170–2178. https://doi.org/10.47392/irjaem.2024.0318
Rathod, D. H. P., Mishra, D. A. K., & Somrajan, D. S. (2024). Prevalence of active primitive reflexes and its impact on motor skills and sensory processing in preschool children. 6(8), 3059–3078. https://doi.org/10.48047/AFJBS.6.8.2024.3059-3078
Ryani Daeng, T. H., Noviana, M., Nasaruddin, F., & Noviana, M. (2020). Relationship between primitive reflex values and gross motor abilities in children with spastic cerebral palsy. Journal of Physics: Conference Series, 1529(3). https://doi.org/10.1088/1742-6596/1529/3/032041
Sheedy, A. J., Brent, J., Dally, K., Ray, K., & Lane, A. E. (2021). Handwriting Readiness among Digital Native Kindergarten Students. Physical and Occupational Therapy in Pediatrics, 41(6), 655–669. https://doi.org/10.1080/01942638.2021.1912247
Sunarto, Sentot Imam Suprapto, Yuly Peristiowati, Byba Melda, & Yuly Peristiowati. (2023). Metode Persalinan, Berat Badan Lahir dan Refleks Primitif Pada Kemampuan Motorik Anak Usia Dini. Jurnal Penelitian Kesehtan Suara Forikes, 14(2), 410–413. doi: http://dx.doi.org/10.33846/sf14235
Wagh, S. C., Malawade, M. R., & Vardharajulu, G. (2019). Effect of Specific Reflex Integration Approach on Primitive Reflexes in Spastic Cerebral Palsy Children. International Journal of Health Sciences & Research (Www.Ijhsr.Org), 9(6), 87. www.ijhsr.org
