Primitive Reflex Persistence as a Predictor of Bilateral Coordination Challenges in Thai School-Age Children With Developmental Coordination Disorder

Abstract

Background: Primitive reflexes are automatic movements present early in life, with most integrating by 4–6 months of age, while some integrate later, depending on the child’s motor developmental stage. If retained, they may indicate central nervous system immaturity and contribute to motor delays. In children with developmental coordination disorder, persistent reflexes—especially the asymmetrical tonic neck reflex (ATNR), the symmetrical tonic neck reflex (STNR), and the tonic labyrinthine reflex—can hinder bilateral coordination required for daily tasks. Methods: This study involved 34 children aged 7–12 years with coordination difficulties. Primitive reflexes (ATNR, STNR [flexion/extension], and tonic labyrinthine reflex) were assessed using Sally Goddard Blythe’s protocol. Bilateral coordination was evaluated using subtests from the Bruininks–Oseretsky Test of Motor Proficiency, Second Edition. Results: Most children showed mild to moderate retention of STNR and ATNR. Bilateral coordination was below average in 79.41% of participants. Significant negative correlations were found between retained reflexes and Bruininks–Oseretsky Test of Motor Proficiency, Second Edition coordination tasks (r = –.534 to –.539, p < .01). Regression analysis showed that total reflex scores significantly predicted coordination performance (B = –0.531, p = .014), with tonic labyrinthine reflex also being a significant predictor (B = –1.389, p = .049). Conclusion: Retained reflexes, especially ATNR and STNR, are linked to poor coordination in children with developmental coordination disorder. Early screening and reflex integration may help improve motor skills.