RESOURCES

Reflexes & Sensory

Primitive Motor Reflexes

Palmar Grasp

When a baby’s palm is touched by their caregiver’s finger, a toy, etc, they will automatically grip and hold on.

ACTIVITIES

• Playing with finger puppets
• Playing an instrument
• Crafts that involve ripping or crumpling paper
• Playing with tactile/sensory bins – water beads, uncooked rice or beans, kinetic sand, little rocks, etc.
• Drawing
• Knitting, sewing, crocheting
• Digging with hands
• Clapping

Fine motor exercises with Play-doh

• Place small objects (beads, rocks, dry beans, toys, etc) in Play-doh and have the child take them out using their thumb and one finger.
• Have the child roll the Play-doh into a log-like shape then have them pinch the log multiple times between their thumb and each finger separately.
• Have the child roll the Play-doh into a ball-like shape and squeeze it with all their fingers, then squeeze the ball using one finger at a time.

Ball squeeze and finger dexterity exercises

• Palmar Grasp Reflex (Significance, Assessment & Integration Exercises) – YouTube
• Give the child a squishy ball (about the size of a tennis ball or smaller, depending on the size of the child’s hand) and have them squeeze it in their palm 10-15 times in each hand.
• Have the child hold their hands up and to the side to where they cannot see their hands. Then have the child slowly touch their thumb to the tip of each finger. Repeat 5-10 times.

Plantar Reflex

When the bottom of the baby’s foot is firmly stroked along the outer side of the sole, the toes will straighten up and spread out. Like the palmar grasp reflex, this reflex often spontaneously integrates once the moro, ATNR, and Galant reflexes are integrated.

Activities and exercises to integrate plantar reflex

• “Foot gymnastics”
  • Grasping and consciously releasing pencils with the toes
  • Writing with the feet
  • Digging with the feet
  • Gently rocking forwards and backwards on the feet.

Rooting and Sucking Reflex

Rooting: When the baby’s cheek is touched, they will automatically turn their head to the side that was touched.

Sucking: When a nipple from a breast/bottle or finger is placed into the baby’s mouth, they will automatically begin sucking by pressing the nipple/bottle/finger to the roof of their mouth with their tongue squeezing in a rhythmic movement.

Activities and exercises to integrate rooting and sucking reflex

• Sucking & Rooting Reflex | Reflex Integration Exercises – YouTube
• Cat whiskers exercise
  • Have the child stand in front of you, with their mouth slightly open. With your index finger, stroke child’s right cheek from ear to corner of mouth 3 times, repeat on the left side. Then stroke child’s face from the right corner of nose to right corner of mouth 3 times, repeat on the left side. Perform 2 times a day for 4-6 weeks.
• Oral Motor Exercises: Perform 4 times each, 2 times a day
  • Closed smiling
  • Puffing up cheeks
  • Sucking in cheeks
  • Curling in lips and closing mouth
  • Touching tongue to right and left cheek while keeping mouth closed
  • Switching between curling in bottom lip, then top lip
  • Folding tongue over top lip
  • Sticking tongue out and moving it right to left
  • Kissing motion by sucking in cheeks and puckering lips (like blowing a kiss)
  • Curling in lips and releasing, making a popping sound
  • “Clicking” tongue with relaxed mouth, then with mouth and lips back to show top and bottom teeth
  • Keeping teeth together while pulling lips and mouth back to show teeth
• Functional tasks
  • Chewing gum
  • Chewy necklaces
  • Drinking from a straw (if safe to do so)
• Cotton ball and straw activities
  • The child uses a straw to pick up a cotton ball, by maintaining a suction, and moves it to another area.
  • The child races another child or adult to see who can blow a cotton ball down a path the fastest
  • Painting with straws, by blowing watered-down paint around on paper/canvas.

Moro Reflex

The Moro reflex occurs when the baby is startled by sudden sensory stimuli (loud noise, unexpected touch, feeling of falling, bright lights, etc.) eliciting a fight, flight, or freeze response. The baby will sharply inhale, their arms and legs stretch out away from the body, their eyes will widen, and they freeze. The baby will then bring in their arms and legs and exhale or cry.

Activities and exercises to integrate moro reflex

• Functional Self-regulation Tasks
  • Sensory diet (see above)
  • Weighted blanket
  • Deep breathing routines
• Starfish Pose Exercise
  • The best Moro reflex integration exercise – YouTube
  • Have the child lay flat on their back with their arms crossed over their chest. Ask the child to bring their knees as close to their chest as possible and cross their feet at the ankles. Direct the child to hold their breath for 5 seconds. After 5 seconds, instruct the child to release their breath very slowly while also releasing their arms and legs (at a snail’s pace) outward. The legs and arms will straighten toward the sky and will slowly fall to the ground so the arms are pointed upward in a V shape and the legs are pointed downward in a V shape (the child will look like a star). The right arm must cross over the left arm and the right leg must cross over the left leg, and then alternate left over right. Once with the right one top and once with the left on top equals 1 set. Perform 10 times.
• Bridges Exercise
  • The Moro Reflex: “Bridges” – YouTube
  • Instruct the child to lie on the floor with their knees bent and their arms resting by their sides. Ask the child to lift their bottom in the air while keeping their arms to their sides. Hold the pose for 30 to 60 seconds. Bring the body back to a resting position. Complete this exercise 5 to 10 times.

Asymmetrical Tonic Neck Reflex (ATNR)

When a baby lays prone with their head turned to one side, their arm and leg on the side they are looking for will straighten out away from the body, while their arm and leg on the opposite side will bend in towards the body.

Activities and exercises to integrate asymmetrical tonic neck reflex

• Robot/Lizard Pose
  • Primitive Reflex Asymmetrical Tonic Reflex Lizard and Reverse Lizard Exercise 4 of 8 – YouTube
  • The child lays on their stomach, with their head turned to the right. With their left arm at their side and leg remaining straight, have them bend their right arm (palm down) and slide it up along the floor until it is in line with their nose. Next, have them bend their right leg until their knee is parallel with their elbow. Hold for 5-10 seconds, then have them turn their head to the left, straighten their right arm and leg, and bend their left arm and leg the same way and hold for 5-10 seconds. Repeat on each side 5-10 times.
• Zombie Marches Exercise
  • ATNR Exercise – YouTube
  • Kneel in front of the child and have them hold their arms straight in front, parallel with the floor while keeping their wrists loose and fingers pointed to the ground (like a zombie). Then have them turn their head to the right while keeping their body pointed forward and their arms straight. Next, have the child march in place 10-20 times, while you support their wrist/elbows with your hands, cueing the child to keep their arms straight. Have the child turn their head to the left and repeat marches.
• Floor Puzzles
  • Have the child piece together a floor puzzle while on their hands and knees. Participating in this position will require the child to turn their head left/right and reach with their right/left arm while supporting their body with their other arm. This will promote bilateral coordination, crossing their midline (middle of the body), eye-hand coordination, and develop muscle tone.
• Pushing a Shopping Cart while Looking Left and Right
  • When at the grocery store, have the child help push the cart and encourage them to turn their head to the left or right to locate grocery items.

Handwriting Exercises

• Have the child practice writing letters in flour, shaving cream, finger paint, etc.
• Writing and drawing with drawing tools of various sizes (crayons, thick markers, pencils, chalk)
• Have the child complete handwriting worksheets – free printables can be found here – Handwriting – The OT Toolbox

Symmetrical Tonic Neck Reflex (STNR)

When a baby’s head bends down – chin to chest – their arms will bend in towards the chest and their legs will extend out away from the body. When a baby’s head bends back as if to look up, their arms will extend out away from their body and their legs will bend in towards the body.

Activities and exercises to integrate symmetrical tonic neck reflex

• Sustained attention activities
  • Have the child repeat a series of letters, numbers, colors, grocery lists, ect.
  • Board games
  • Arts and crafts
  • Have the child sing a song while performing an activity
  • Freeze dancing – Child dances to music and freezes when the music stops.
• I Spy – Describe an object in the room and give clues to help the child find it.
  • Have the child bounce on a yoga ball while playing a game
• Somersaults
  • Find an open area with carpet or soft padding on the ground. Have the child squat down and put their hands flat on the ground in front of them, with hands in-line with their shoulders. Then have them tuck their chin, round their spine, and push with their legs. Next, have them press off their feet and roll over, along their spine while keeping their chin tucked.
• Cat/Cow Exercise
  • STNR Exercise Cat/Cow – YouTube
  • With the child on hands and knees, have them bend their head in towards the chest (chin-to-chest) and arch their spine up to the ceiling (like a stretching cat), keeping arms straight, with hands and feet flat on the floor. Hold for 3-5 seconds. Then have the child look up to the ceiling while dropping their belly to the floor. Again, keeping their arms straight, with hands and feet flat on the floor, holding for 3-5 seconds. Repeat 3-5 times.
• Head Lift
  • Instruct the child to lie on the floor face down and arms stretched outward to their shoulders (making a T shape). Ask the child to loft their head upward, look at the ceiling and hold for 10 seconds. Direct the child to bring the head back down to a resting position. Repeat the exercise 10 times, 3 to 5 times a week.

Tonic Labyrinthine Reflex (TLR)

Forward TLR – When the baby’s head bends forward, it causes the body and limbs to bend in towards the body.

Backward TLR -When the baby’s head bends backward, it causes the body and limbs to straighten away from the body.

Activities and exercises to integrate tonic labyrinthine reflex

• Positioning Activities
  • Encourage the child to lay on their belly, on the floor, while participating in games and activities such as jigsaw puzzles, reading, playing with toys, coloring, etc.
• Meatball Exercise
  • Tonic Labyrinthine Reflex: “The Meatball” – YouTube
  • Have the child lay on their back with arms at their sides and legs bent. Then have the child cross their arms over their chest, and cross their ankles. Next, have the child lift up their chest and legs, squeezing legs to the chest to form the “meatball” shape. Have the child hold the pose for 15 seconds and release back to the floor Repeat 2 times a day.
• Superman Exercise
  • Tonic Labyrinthine Reflex (TLR): “Superman” – YouTube
  • Ask the child to lay on their tummy with their feet straight, flat on the ground (arms to their sides). In the beginning, only ask the child to lift their arms in front of them like Superman with their fingers almost touching together and raise their head at the same time. Hold the position for at least 5 seconds if possible and return to the resting position. When the child is strong enough to hold the arms and head straight for 5 to 10 seconds, incorporate the legs. Ask the child to lift their arms, head, and legs at the same time as Superman and hold for 5 to 10 seconds. Ensure the legs stay straight and do not bend ( you may have to assist the legs in the beginning). Repeat 2 times a day.
• Chin Tuck Crawling
  • TLR #3 Chin Tuck Crawl and Roly Poly – YouTube
  • Have the child hold a small squishy ball or stuffed animal between their chin and chest and get on all hands and knees. Then, have the child crawl a short distance and drop the item in a designated area. This can be turned into a relay race with other children.

Spinal Galant Reflex

When the baby’s back is stroked when the right or left side is stroked, they will rotate the hip on the same side.

Activities and exercises to integrate spinal Galant reflex

• Snow Angels Exercise
  • Spinal Galant: “Angels in the Snow” – YouTube
  • Ask the child to lay flat on their back, legs straight with their arms beside them. Instruct the child to very slowly (snail’s pace) bring their arms outward first until their arms get to their shoulders and then begin to bring the legs outward at the same time the child is creating a snow angel. Direct the child to extend their legs as wide as they can and lift their arms to their ears. When the arms reach the child’s head, ask them to bring the snow angel back down to the resting position (continue to perform the exercise slowly as the child comes back to a resting position. Remember, this exercise must be done slowly. Encourage the child to go slowly.
• Ball Wall Squat Exercise
  • Spinal Galant #1 : Ball wall Squat – YouTube
  • Help the child place a ball (like a kickball) in the curve of their back, then have them press the ball with their back against a wall with their feet in front of them. Their feet should be out far enough to look like they’re sitting in a chair when they bend their knees. Next, have the child lower to a seated position and raise back up to standing, repeat 10 times building up to 20 times.
• Hip Walk Exercise
  • Spinal Galant #4 Hip Walk – YouTube
  • Have the child sit on the floor with their legs straight in front of them and keep their arms up near their chest. Then have the child scoot their hips forward, one at a time, 10 times.
• Roly Poly
  • Galant #0 Roly Poly – YouTube
  • Have the child lay on their back and bring their knees up to their chest. Then have the child lift their head and cross their arms over their chest or hug their knees. Next, have the child rock back and forth along their back like a roly poly.

Landau Reflex

When the baby lifts its head and chest, its legs will lift automatically.

Activities and exercises to integrate Landau Reflex

• Modified Sit Ups Exercise
  • Place the child on the floor or soft surface. Pull the child’s hands gently at the same time and let the child use abdominal muscles to pull themselves upright into a seated position.
• Row, Row, Row Your Boat Exercise
  • Child sits on the floor facing another individual and each holding onto one end of a jump rope or onto each other’s wrists. As both sing the song, one person leans back as the other leans forward and then the opposite.
• Feet Kick
  • Child lies on the floor on their back with feet in the air. Parent throws a large bouncy ball toward the child’s feet. The child kicks the ball upwards and back towards the therapist.
• Leg Lifts
  • Child lies flat on the floor and raises and lowers legs off the floor
• Backward Flip
  • Child lies on their back on a yoga ball and then places their arms on the floor above their head to support themselves. Child then flips their body over (parental support may be needed in the beginning).

APPS

Sensory Diet

The ability to process one’s environment through the senses

• Brain Works | iOS

Proprioceptive Input

• The Adventures of Super Stretch | iOS/Android
• Moovosity-movement skills | iOS

Vestibular Input

• iMav Vestibular Therapy | iOS
• VertiGo Exercise (AR) | iOS/Android
• Moovosity-movement skills | iOS

Tactile Input

• Gravitarium | iOS
• Fidget Toys Set! Sensory Play | iOS/Android
• Sensory Fidget Toys No Anxiety | iOS/Android

Auditory Input

• Gravitarium | iOS
• Therapeutic Listening | iOS/Android

Visual Input

• Gravitarium | iOS
• Sensory Magma | iOS
• Sensory Electra | iOS/Android

Still have questions? We are here to help!