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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