Assessing primitive reflex retention and its effect on motor proficiency in Thai preschoolers

Abstract

Purpose. This study aims to examine the relationship between the retention of primitive reflexes and motor proficiency in preschool children, with a specific focus on healthy Thai preschoolers. In particular, we investigate key primitive reflexes associated with body positioning, including the Asymmetrical Tonic Neck Reflex (ATNR), Symmetrical Tonic Neck Reflex (STNR), and Tonic Labyrinthine Reflex (TLR), to determine their potential impact on motor proficiency. Methods. Data were collected from 65 children (26 girls and 39 boys) from Bangkok and the surrounding metropolitan area, with a mean age of 5.64 years (SD = 0.38). Each participant underwent assessments using the Primitive Reflex Test, focusing on the ATNR, STNR, and TLR, as well as the motor proficiency assessed with the Bruininks–Oseretsky Test of Motor Proficiency, second edition, Short Form (BOT-2SF). Results. Statistical analysis revealed a significant inverse correlation between the retention of three primitive reflexes (ATNR, STNR, TLR) and overall motor proficiency (r = –0.543, p < 0.001), indicating that higher reflex retention is associated with lower motor skills. Among individual reflexes, STNR showed the highest negative correlation (r = –0.498), followed by TLR (r = –0.361) and ATNR (r = –0.316). Fine motor precision was most affected by reflex retention. Persistent reflexes were found in 65% of participants, with those retaining 2–3 reflexes scoring notably lower on BOT-2SF assessments. Conclusions. This first Thai study on retained primitive reflexes and motor proficiency in preschoolers underscores the need for early assessment and timely interventions such as reflex integration therapy to support development.