Primitive Reflex

PRIMITIVE REFLEX Screening Checklist

DIGITAL COURSE
for Parents

NAME: AGE: DATE:

Check off any item that your child struggles with.

If your child struggles with the item 50% of the time or more, check it off.
If there are 3+ boxes checked in a reflex category, it's likely the reflex is retained.
Formal reflex testing is recommended.

MORO REFLEX TONIC LABRYNTHINE REFLEX

Motion sickness Poor balance

Poor eye contact Difficulty with ball games
Light /sound sensory sensitivity Visual-perception challenges

Allergies / chronic illness Auditory processing challenges

Adverse reactions to drugs Decreased organizational skills

Poor tolerance of change Spatial awareness difficulties

Anxiety / nervousness
Mood swings
Difficulty with ball games SPINAL GALANT REFLEX
Fight / Flight / Freeze
Fidgeting
Stressful birth
Decreased concentration
Challenges communicating feelings
Bed wetting beyond age 5
Poor impulse control
Sensory sensitivities
Cravings for sweets
Reading difficulties
Frequent headaches
"Ants in the pants'
Fatigues easily

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ATNR STNR

Poor handwriting Lays head on desk while writing

Eye tracking difficulty Decreased ball skills
Poor crossing midline Clumsy

Poor hand dominance Messy eater

Right/ Left confusion Decreased attention

Mixes b's and d's during writing Difficulty copying from the board

Clumsy gross motor skills Skipped crawling

Asymmetrical / poor crawling pattern

PALMAR GRASP REFLEX ROOTING / SUCK REFLEX

Poor handwriting Extreme picky eating

Tactile sensitivity Messy eater
Decreased upper body strength Speech / articulation challenges

Poor hand dominance Chewing / swallowing deficit

Right/ Left confusion Excessive drooling

Speech / articulation challenges Latch difficulties in infancy

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