Understanding Dyspraxia and Retained Primitive Reflexes: More Than Just “Clumsiness”

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Dyspraxia, also known as Developmental Coordination Disorder (DCD), is a neurodevelopment condition that affects a child’s ability to plan, coordinate, and carry out movement. While it’s often described as a motor coordination difficulty, the reality is more complex. Dyspraxia can influence how a child learns, organizes tasks, and interacts with the world around them.

However, dyspraxia is not linked to intelligence. Many children with DCD have average or above-average cognitive abilities, but struggle with tasks that require smooth, efficient, and coordinated movement.

Retained primitive reflexes can absolutely play a role in Dyspraxia, but they are not considered a sole cause. Instead, they can be one contributing factor that interferes with how the brain develops efficient motor control and coordination.

What Does Dyspraxia Look Like?

Performance in daily activities that require motor coordination can be exceptionally lower than the child’s chronical age and level of academic ability when a child has dyspraxia. This may be due to delayed milestones, inability to coordinate when involved in sports, or poor handwriting skills.

A child with dyspraxia may also have immaturity in the organization of movement, especially when it involves problems with coordination and sensory-motor function.

Dyspraxia also impacts the child’s perception, language development, thoughts, and behavior. While they are secondary outcomes from the primary sensory-motor problem, they still play a large role in how the child learns in the classroom.

Every child is different and can experience different circumstances when it comes to dyspraxia, but some of the signs include the following:

• Clumsiness or frequent tripping
• Difficulty with balance and coordination
• Messy or slow handwriting
• Trouble using scissors, buttons, or utensils
• Delayed milestones like crawling or walking
• Challenges following multi-step instructions

These difficulties often become more noticeable when a child enters school. Teachers or parents may begin to notice motor and organizational demands increase, while learning begins to present its challenges.

How Dyspraxia Affects Learning

Although dyspraxia is primarily a motor disorder, its effects extend into the classroom. When movement and coordination require extra effort, it can impact the following learning areas:

• Attention and concentration
• Organization and planning (executive function)
• Writing and copying notes from the chalkboard
• Reading and visual tracking across the page
• Memory and processing information

Over time, children may become frustrated or avoid tasks they find difficult, which can affect confidence and participation.

The Role Dyspraxia Plays in Sensory-Motor Integration

Dyspraxia when broken down is when a child has difficulty with sensory-motor integration — the brain’s ability to process sensory information and use it to guide movement.

When a child is diagnosed with dyspraxia, you may begin to notice the child struggling with the following:

• Poor body awareness
• Difficulty judging distance or force
• Hesitation during movement
• Movements that become difficult instead of automatic

Cognitively, the brain knows what it wants to do, but struggles with how to do it efficiently and execute when they child wants to act in the moment.

The following developmental areas may be impacted when a child has dyspraxia:

Motor Planning Challenges

Retained reflexes can interfere with intentional movement, making actions feel uncoordinated or inconsistent. Dyspraxia is connected to retained reflexes because it involves difficulty planning and executing movement. If primitive reflexes remain active, they can “override” intentional movement patterns. The child tends to experience the following:

• Movements are involuntary, inefficient, or poorly timed
• Sequencing actions become delayed (i.e., catching a ball, tying shoes)
• The brain has to “work around” reflex-driven responses, increasing effort and inconsistency

Poor Posture and Stability

Children may struggle with balance, core strength, or sitting upright, often compensating with awkward positions. You may see the following in the classroom or at home if a child has dyspraxia:

• Core stability may be weak
• Balance reactions may be immature
• The child may rely on compensatory movements (i.e., slouches, locks joints)

Sensory Processing Difficulties

The child may be overly sensitive to movement, touch, or sound, which affects coordination and focus. Sensory issues may impact a child with dyspraxia in the following ways:

• Avoids sensory stimuli or seeks sensory input for calming
• Has difficulty integrating visual, vestibular, and proprioceptive information
• Has poor body awareness and spatial awareness

Bilateral Coordination Issues

Tasks that require both sides of the body, like writing or sports, can become especially difficult. You may also see issues with the following:

• Trouble crossing the midline
• Difficulty coordinating both hands together
• Challenges with activities like writing, cutting, or holding a pencil

Retained Primitive Reflexes and Dyspraxia

One contributing factor sometimes seen in children with dyspraxia is the presence of retained primitive reflexes. Retained Primitive Reflexes often interfere with a child’s foundational and motor development when they remain active.

If a child retains one or multiple retained Primitive Reflexes, it begins to impact the child’s movement and mobility. As a child grows, parents and teachers start to notice gaps in motor skills where dyspraxia plays a role.

Retained Primitive Reflexes and dyspraxia often go hand-in-hand. When the reflexes are retained, you may see the following reflexes retained:

Moro Reflex (Startle Reflex)

Because a retained Moro reflex is closely tied to a child’s sensory-motor development, kids with Dyspraxia retain this one the most often. Children with a retained Moro reflex tend to struggle with balance and coordination issues, which is one of the signs or symptoms of Dyspraxia. These kids typically avoid playing, climbing, tumbling, and amusement park rides.

Asymmetrical Tonic Neck Reflex (ATNR)

The ATNR reflex helps a child develop motor skills, including rolling and crawling. When these skills are underdeveloped or missed during the milestone development phase, they child may have dyspraxia. Retention of an ATNR reflex contributes to dyspraxia and is responsible for a host of developmental and neurological delays.

A child with this retained reflex and a diagnosis of Dyspraxia, may have trouble with the following:

• Movement and coordination
• Vision and balance
• Cognition
• Learning challenges
• Joint and bone misalignment

These issues may lead to obstacles with the following:

• Crawling
• Walking
• Reading
• Handwriting
• Sports
• Behavior

Children with dyspraxia and a retained ATNR have difficulty crossing the midline of the body and choosing a dominant side for handwriting development. As a result, there is hesitation in movement mobility, which leads to unnecessary confusion and clumsiness. The child’s movements will then appear to be different, which makes them a target for bullying.

When fine motor skills are underdeveloped as a result of a retained ATNR and Dyspraxia, the child may apply excessive pressure when writing with their pencil. The child often appears to be fighting against an “unseen” force.

A combination of a retained ATNR reflex and dyspraxia may cause issues with the child’s shoulder and neck muscles when working independently of each other, preventing normal muscle function.

Symmetrical Tonic Neck Reflex (STNR)

Because the STNR reflex is tied to a child acquiring intentional movement, including the position of the head and body, this can cause a number of problems for kids with dyspraxia.

A child with both dyspraxia and retained reflexes tend to have floppy muscle tone, poor standing posture, and stooped shoulders.

Kids with Dyspraxia that also have a retained STNR reflex may experience the following:

• Slumped posture at a desk
• Difficulty sitting still
• Trouble coordinating upper and lower body movements (i.e., crawling-like patterns persist)

The child may also find it more comfortable to lay their head on their desk while working or sitting back in the chair with their feet wrapped around the legs of the chair. Or, the child may prefer to lie on the floor or couch when doing homework rather than sitting upright in a chair.

Dyspraxia and a retained STNR reflex may also delay a child’s ability to swim and use the arms and legs in tandem with each other when playing sports or participating in physical activities. Additionally, these kids will struggle with handwriting and poor development of eye-hand coordination.

A retained STNR reflex may create issues with impulse control and concentration in children with Dyspraxia when trying to learn in the classroom.

Tonic Labyrinthine Reflex (TLR)

Children with a retained TLR reflex and dyspraxia may have a number of complications when it comes to movement, balance, and behavior. Like with a retained STNR reflex, the child will display weak muscle tone when the TLR reflex remains present in kids with dyspraxia.

Many times, children with dyspraxia experience incomplete right and left-brain dominance, which creates problems when using their arms and legs interchangeably, indicating the presence of a retained TLR reflex.

The child may struggle with midline crossing as well as difficulty with the following:

• Poor balance and spatial orientation
• Stiff or floppy muscle tone
• Difficulty judging distance and movement
• Stiff, jerky movements
• Trips on flat surfaces
• Self-esteem trouble

Children with dyspraxia and a retained TLR reflex may also experience visual disorientation when playing or when reading words on the page. They often are targeted as the child who has repetitive dysfunctional behavior.

Palmar Reflex

In some children with dyspraxia, the Palmar reflex may become partially retained, which can interfere with the development of fine motor control. As a result, tasks that require precise hand movements (i.e., writing, buttoning clothes, or using utensils), may feel awkward or tedious.

A retained Palmar reflex can contribute to increased muscle tension, making coordinated, intentional hand movements more difficult. While not all children with dyspraxia have retained Primitive Reflexes, their presence is one of several neurological factors that may help explain the motor planning and coordination challenges of retention.

If the Palmar reflex is retained, you may find the following problems in kids with dyspraxia:

• Immature pencil grip
• Hand fatigue
• Difficulty with fine motor precision

Spinal Galant Reflex

If the Spinal Galant reflex is retained, a child with dyspraxia may struggle early on with controlling the legs when walking or running. The child may have an unbalanced gait, including impaired hip rotation. A child with a retained Spinal Galant and dyspraxia tends to shy away from playing sports and other physical activities. Kids with a retained Spinal Galant reflex are known for ADHD-like symptoms and impairment of fine motor skills, which can impact handwriting development.

In addition, the child may also experience the following with a retained Spinal Galant reflex:

• Fidgeting, inability to sit still
• Poor posture
• Distractibility (especially when seated)

Dyspraxia is often misunderstood as simple clumsiness, but it reflects deeper challenges in how the brain plans and executes movement. When factors like retained reflexes are involved, they can further complicate coordination, posture, and learning.

Understanding these underlying mechanisms helps parents, educators, and caregivers provide better support, and helps children feel more capable in their everyday lives.

Reference Materials

Chandradasa, M., & Rathnayake, L. (2020). Retained primitive reflexes in children: Clinical implications and targeted home-based interventions. Nursing Children and Young People, 32(1), 37–42. https://doi.org/10.7748/ncyp.2019.e1132

Polatajko, H. J., & Cantin, N. (2005). Developmental coordination disorder (dyspraxia): An overview of the state of the art. Seminars in Pediatric Neurology, 12(4), 250–258. https://doi.org/10.1016/j.spen.2005.12.007

Al-Yahya, E., Esser, P., Weedon, B. D., Joshi, S., Liu, Y.-C., Springett, D. N., Salvan, P., Meaney, A., Collett, J., Inacio, M., Delextrat, A., Kemp, S., Ward, T., Izadi, H., Johansen-Berg, H., Ayaz, H., & Dawes, H. (2023). Motor learning in developmental coordination disorder: Behavioral and neuroimaging study. Frontiers in Neuroscience, 17, 1187790. https://doi.org/10.3389/fnins.2023.1187790

O’Dea, Á., Stanley, M., Coote, S., & Robinson, K. (2021). Children and young people’s experiences of living with developmental coordination disorder/dyspraxia: A systematic review and meta-ethnography of qualitative research. PLOS ONE, 16(3), e0245738. https://doi.org/10.1371/journal.pone.0245738

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