Primitive reflexes are automatic stereotypic movements directed from the brainstem and require no cortical involvement (thought). They are needed for survival and development in the womb and in the early months of life. However, as higher more sophisticated centers of the brain begin to mature, these primitive reflexes become a nuisance and must be abated in order for proper neurological organization of the brain to develop, which includes the development of vision.

Many children and some adults whose vision has not properly developed have retained primitive reflexes. Some of the primitive reflexes that affect vision are described below:

Moro Reflex (also called startle reflex)

This reflex is set off by excessive information in any of the baby’s senses. For example, a loud noise, bright light, sudden rough touch, sudden stimulation of the balance mechanism such as dropping or tilting.It is the earliest form of adrenal “fight or flight response”. This response prepares for fighting or running and if not integrated leads to hyperactivity.As the adrenal glands are a large part of our immune system; constantly being turned on can lead to adrenal fatigue and therefore asthma, allergies, and chronic illness.Retained Moro Reflex may lead to:

• Hypersensitivity to sudden noise, light or movement
• Difficulty with new or stimulating experiences
• Impulsive behavior
• Distractibility– has to pay attention to everything
• Anxiety, particularly anticipation anxiety
• Emotional and social immaturity
• Sensitivity to foods or food additives
• Inappropriate behavior
• Hyperactivity
• Adrenal fatigue, leading to allergy, asthma or chronic illness

Asymmetric Tonic Neck Reflex (ATNR)

In the neonatal display of the ATNR, the hand moves in conjunction with the head. This connection between touch and vision helps to establish distance perception and hand eye co-ordination. If retained, the hand and eye want to move together, making it difficult to look up at a blackboard and write. When walking, turning the head results in the straightening of the arm and leg on the same side, upsetting balance and normal walking pattern.Looking at the hand tends to weaken other muscles. This affects ability to catch a ball and other sporting activities.In early months, ATNR locks vision on to anything which catches the attention. If inappropriately retained, the child (or adult) is easily distracted by anything that attracts the attention.ATNR retention may lead to:

• Hand-eye co-ordination difficulty
• Poor handwriting
• Awkward pencil grip
• Difficulty copying from a blackboard
• Missing parts of a line when reading
• Difficulty catching a ball
• Unable to cross the vertical midline (for example, a right-handed child may find it difficult to write on the left side of the page)
• Discrepancy between oral and written performance
• Disturb the development of visual tracking (necessary for reading and writing)
• Balance may be disturbed
• Bilateral integration (integrated use of the two sides of the body) may be poor.
• Establishment of a dominant hand, eye or ear may be difficult
• Judgment of distance may be affected
• Poor at sports
• In adults there can be chronic shoulder and/or neck problems

Tonic Labyrinthine Reflex (TLR)

TLR involves the vestibular system which regulates our balance and our sense of position in space. If the TLR is not integrated by twelve months of age it will constantly interact with, and may disturb, the balance system. This may interfere with other sensory systems including visual function. The child who still has a retained TLR may:

• Experience difficulty in judging space, distance, depth, speed and walking security.
• Be more likely to slump when sitting at a desk or a table, sit on his legs or generally twist and turn resulting in what appears to be inattentiveness and possibly hyperactivity.
• Tend to be slow at copying tasks.
• Affect the integration of movement of the upper and lower limbs simultaneously such as when walking and swimming. These children are often diagnosed with dyspraxia (poor co-ordination) and ridiculed by other children for being clumsy.
• Suffer motion sickness. Integration of retained TLR often assists those susceptible to motion sickness.

Fortunately primitive reflexes can be “integrated”, or their effects minimized through occupational therapy and Vision Therapy. The doctors and staff at Virginia Vision Therapy Center can help. If your child is experiencing any of the problems noted above call our office and schedule a developmental vision exam.


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