Prevention/Activities for Primitive Reflex Integration

For infants:

  • Lots of floor play. Decrease the amount of awake time spent in containers.
  • Lots of movement. Provide natural movement that is not from a container.
  • Avoid carrying your infant in their carseat when out and about. Try to carry them, wear them, or sit them in the cart if they have adequate head control.

For older children who exhibit signs of retained Primitive Reflexes, engage them in various activities such as:

  • Rock climbing.
  • Swimming.
  • Horesback riding.
  • Hopscotch.
  • Swinging & sliding.
  • Jumping rope.
  • Rolling down hills.
  • Riding bikes.
  • Obstacle courses.
  • Therapy ball activities.
  • Traditional sports.
  • Gymnastics.
  • Yoga.
  • Karate classes.

References: Sensory Project Podcast Primitive Reflex Crash Course

The OT Toolbox Summer Activity List


  • Obstacle course
  • Nature walk
  • Climb a tree
  • Kick a ball
  • Driveway chalk
  • Go for a hike
  • Roll down a hill
  • Make a hideout
  • Draw the clouds
  • Run around the house
  • Pick flowers
  • Do jumping jacks
  • Fly a kite
  • Draw with chalk
  • Go swimming
  • Ride a bike
  • Watch the birds


  • Animal walks
  • Couch cushion course
  • Balloon toss
  • Bowl plastic cups
  • Indoor balance beam
  • Freeze dance
  • Yoga
  • Build puzzles
  • Hand clapping games
  • Board games
  • Catch socks
  • Write in a journal
  • Wheelbarrow walks
  • Army crawls
  • Wall push-ups
  • Dance party
  • Play with stickers


  • Water sensory bin
  • Spray bottle art
  • Squirt gun painting
  • Paint with water
  • Swim
  • Play in a sprinkler
  • Make a sensory bottle
  • Make sponge balls
  • Play in the hose water
  • Water flowers
  • Wash a car
  • play in the rain
  • Water table
  • Water balloons
  • Play in soapy water
  • Bubbles
  • Sink or float tests


  • Red rover
  • Play tag
  • Hide and seek
  • Play Uno
  • Play cards
  • Soccer
  • Catch a football
  • Board games
  • Hopscotch
  • 4 Square
  • Basketball
  • Relay Race
  • Charades
  • 7 Up
  • Mr. Wolf
  • Tug of war
  • Lawn tic tac toe
  • Bean bag toss


  • Torn paper art
  • Make play dough
  • Build with LEGO
  • Finger paint
  • Make a fort
  • Make a recipe
  • STM project
  • Make lemonade
  • Paint rocks
  • Leaf resist art
  • Coffee filter butterfly
  • Toilet paper roll craft
  • Paper bag puppets
  • Make bird treats
  • Create a song
  • Write a letter
  • Bake cookies
  • Draw


  • Think of a goal for you to accomplish
  • Dress up
  • Make up a play
  • Invent something
  • Make up a dance
  • Act out a story
  • Write a story
  • Imagine a cardboard box is something unique
  • Pretend to be something or someone else
  • Think of a new ending to a movie
  • Imagine all the things you are grateful for
  • Imagine you had $1,000. What would you do?
  • Think of a random act of kindness. And do it
  • Imagine you were…whatever you could do or be. How can you get to that point? Make a list of the steps.

OT this Week

I am revisiting one activity I recommended a few weeks ago because of how beneficial this position is for improving sensory, body awareness, strength, vision, attention and engagement. If your child has trouble sustaining this position for ball play, allow them an alternate activity while lying on their belly (play-doh, coloring or even an educational game on the iPad if they won’t do anything else). Aim for 5 minutes and try to complete a couple times every day over the next week. 


  • To provide touch pressure to body from floor
  • To increase back and neck extension strength
  • To develop arm strength
  • To develop good eye tracking (roll ball)



Trigger-handled spray bottle

Bucket of water for refilling bottles

Targets-playground cement, beach ball with shaving cream, bubbles.


  • Line up your children (if siblings want to participate) and give each child one spray bottle. The children use the spray bottle to draw letters, shapes and numbers on the cement. If you child has difficulty drawing something specific, just work on the act of spraying water on the sidewalk. 
  • Place a beach ball on top of the bucket, 5 feet for the children. Draw a happy face, number, or letter on the ball with shaving cream, and have the children take turns squirting the water at the beach ball until the cream is washed off. 
  • Have the children spray a stream of water to pop bubbles blown by the parent. 

Bissell, Julie, M.A., OTR, J. Fisher, M.A., OTR , C. Owens, OTR, P. Polcyn, OTR. Sensory Motor Handbook. A Guide for Implementing and Modifying Activities in the Classroom. Therapy Skill Builders Copyright 1998, Sensory Integration International.

OT Activities this Week: Sensory Experiences

Activities are to be completed with parent supervision at all times for safety. 

  1. Deep pressure; “These sensations often help to organize a child who is overly sensitive to touch or who exhibits hyperactivity or distractibility in situations where tactile input causes irritation to the child. I have listed some activity suggestions. 
  • Wrap your child up in a blanket like a “taco.” You could also use a yoga mat or towel for this activity. Give them big squeezes once he or she is wrapped up. Make a game out of this using language like “Ready, Set, Go,” “Go, Go, Go, Stop,” “Roll, Roll, Roll, Squish” for example. This can also be a turn taking opportunity between siblings or with you as the parent. Use simple language like “My turn,” “Your turn”, “His turn.” 
  • Squish between two pillows like a “hamburger.” You can give additionally deep pressure by putting on “toppings” like ketchup, mustard, cheese, pickle and so on. 
  • Have your child lay on the floor and roll a large ball (exercise balls work best) over most of their body. 
  • Deep pressure massage using lotion as tolerated
  • Give bear hugs often
  1. Vestibular and Proprioceptive Activities; Some children enjoy excessive doses of movement, while others may be very sensitive to any type of body movements, including car rides, swings, tilting head back in the bathtub, so cautiously observe your child during any of these activities and discontinue if your child appears to not enjoy the stimulation. 
    • Rocking in a rocking chair
    • Jumping on a trampoline 
    • Climbing outdoors or indoors on old furniture or stairway (with supervision)
    • Backyard swing
    • Hikes in the hills
    • Rolling over an exercise ball with assistance (on belly or on back)
  1. Academics 
    • Hand over hand practice of shapes or lines
    • Drawing letters and numbers in sand or shaving cream
    • Puzzles
    • Cut a slit in a plastic food container and practice putting coins in
    • Stacking blocks (if you do not have blocks, use anything in your pantry)

Activities for the Week

Aim to complete 10 minutes of each type of activity per 3-4 days per week to support healthy brain and body development. Your child should be supervised for safety during these activities.

Vestibular (Movement Input); This kind of sensation helps support our balance, postural control, muscle tone, spatial orientation, alertness and eye movements. There is a link attached for a video regarding vestibular input.

  • Swinging– in blankets, hammock, toddler swing
  • Rocking in a rocking chair
  • Helping your child go “upside down.” You can lay them over your lap or lay off the couch to give them inverted input. This is the strongest type of movement input you can give a child, so only do for 10 seconds at a time. This is also very stimulating for the eye muscles, so you may notice your child blinking or closing their eyes. 
  • Bouncing-large balls, old mattress or old couch cushions 

Proprioception (Joint and Muscle Input); This kind of sensation is very calming and organizing for the nervous system. This system helps our body’s know how to move, how much force to use for things like putting on our socks and shoes and coordinating our body in space. The video link to follow is a good explanation of this system.

  • Stair climbing/sliding– bumping down on bottom
  • Crawling-through tunnels or boxes on all fours, or under chairs
  • Roughhousing-play wrestling
  • Silly animal walks– crab, bear, slithering like a snake, frog hop
  • Squishing between pillows or blankets
  • Massage
  • Hanging-from adult hands or trapeze bar

Tactile (Touch Input); The kind of sensation allows us to feel with our skin. This system is very important for everything we do with our hands. 

  • Massage/back rubs– varied lotions, powders
  • Tactile adventure bins– cornmeal, oatmeal, water, sand, lentils
  • Hand and finger squeezes
  • Brushing-varied brushes
  • Sticky play– tape, contact paper, glue
  • Bath time– bubbles, crayon soap, back scrub brushes
  • Play-doh

Activities for the Week

  • To provide deep pressure touch to hands and tummy
  • To increase body awareness through up, down, sway
  • To develop back and neck extension muscles 
  • To promote basic balance
  • To provide firm pressure touch to hands
  • To increase body awareness through push-pull activity
  • To develop upper body strength
  • To promote standing balance
  • To provide touch pressure input to hands during weight bearing
  • To increase upper back extension strength
  • To build arm strength

(Smooth surface such as wood or linoleum are best for this activity. I have kids go under chairs or “bridge” to give them a reference of how to move in this position. This may be difficult for your child, so build tolerance for being on tummy to start, which is very important for building strength). 

  • Massage the hands prior to dressing, eating or completing fine motor activity to get your child ready for the task. If you can feel your hands, your hands will work more efficiently.
  • Provide your child with a chewie or similar oral activity to keep the mouth busy while the hands are learning.
  • Have your child practice cleaning up after himself or herself.
  • Promote independence in self care.
  • Use spray bottles, playing cards, blocks, puzzles and containers to practice opening/closing of the hands and manipulating the pieces with their small muscles.

Sensory Integration Exercise

Complete these OT activities throughout the week. The more you do, the more the following skills will improve. Descriptions are included above each exercise. 

  • To provide touch pressure to body from floor
  • To increase back and neck extension strength
  • To develop arm strength
  • To develop good eye tracking (roll ball)
  • To provide touch input to back from carrying an object
  • To increase body awareness
  • To develop upper body strength
  • To promote motor control by moving fast versus slow
  • To provide deep-touch pressure to body
  • To provide calming head movement
  • To promote language skills

Chant: “Rock the boat ‘til we laugh and shout, rock the boat ‘til we all fall out”


  1. Tactile adventure bins- cornmeal, oatmeal, water, sand, lentils
  2. Bath time- bubble bath, crayon soap, back scrub brushes
  3. Foam soap or shaving cream- draw, blow
  4. Sticky play- tape, contact paper, painters tape
  5. Kitchen time- mixing tasting, smelling, washing up

While playing with tactile materials, you can practice drawing shapes, letters, drawing faces, drawing a person, etc with your child. Talk about what you are doing and encourage them to engage in the play with you or with a sibling.
References: Building Bridges Through Sensory Integration. Yack, E, Aquilla P and Sutton S. Future Horizons 2002

Home Exercises

Parent Activity Suggestions; 20+minutes recommended daily. These activities are especially important for children who have fine motor concerns, learning difficulties, attention deficits and language delays. Children who have not spent enough time practicing “developmental movements” (tummy time, playing on belly, rolling, belly crawling and crawling) are likely to struggle with formal learning later on at school. These activities are highly encouraged to improve the foundational skills needed for academic learning. 

  1. Weight bearing on the arms; lay and play on tummy
  2. Rolling; body completely straight with arms above head and going both directions
  3. Army crawling on slick surface with bare feet
  4. Crawling on hands and knees (over and under furniture, through an obstacle course, tunnel, doing relay races)
  5. Animal walks; crab, bear, turtle, snake slithers, cat stretch, etc
  6. Superman; laying on belly and extending arms and legs in the air
  7. Hanging and climbing on monkey bars
  8. Tactile play; food, finger painting, play-doh, clay, rice, sand, shaving cream while practicing letters, shapes or drawing
  9. Swinging and hanging upside down
  10. Childrens yoga; down dog, cat stretch, cobra pose, etc
  11. Lacing, puzzles, mazes, tracing, beads, pop beads, use tweezers/tongs, opening/closing containers, squeeze a stress ball, cutting cardboard, squeezing glue, etc
  12. READ to your child EVERY night