Integrating Primitive Reflexes Through Play and Exercise

Kokeb McDonald, OTR/L · September 24, 2025

An Introductory Course for Therapists, Parents, and Educators

A 1-hour CEU training based on the RITP Book Series


Why this matters

Primitive reflexes shape early development—and when they linger, they can impact attention, posture, handwriting, vision skills, and classroom participation. This fast, practical training shows you how to spot key patterns and integrate simple, play-based activities right away.

Who it’s for

  • Occupational & Physical Therapists (clinic or school-based)
  • Educators & Parent Coaches supporting movement and learning
  • Parents & Caregivers looking for clear, doable strategies

What we’ll cover (in just 60 minutes)

  • A clear framework for linking reflex patterns to functional goals
  • Quick screening & observation you can do in minutes
  • Play-based activities drawn from the RITP Book Series
  • How to embed movement into daily routines at home and school

Learning Objectives

By the end of this one-hour introductory course, participants will be able to:

  1. Identify the role of primitive reflexes in early development and their impact on functional performance in children.
  2. Recall the importance of reflex integration for motor skills, attention, regulation, and learning.
  3. Recognize common signs of retained primitive reflexes that may present in clinical, school, or home settings.
  4. Identify play-based reflex integration strategies and exercises to meet functional goals.

Based on the RITP Book Series

This course distills core concepts from Integrating Primitive Reflexes Through Play and Exercise and designed to give you practical, play-based tools you can start using right away.

Course Content

Introduction (5 minutes)

  • Welcome and overview of course objectives
  • Brief review of the Reflex Integration Through Play framework

Section 1: Understanding Primitive Reflexes (15 minutes)

  • What primitive reflexes are and why they matter
  • The developmental role of reflexes in early childhood
  • Impact of active reflex patterns on function (motor, sensory, regulation, learning)

Section 2: Clinical Observation and Common Reflex Patterns (15 minutes)

  • Examples of Primitive Reflex Patterns
  • Identifying retained reflexes in everyday tasks
  • Case examples highlighting challenges and opportunities

Section 3: Reflex Integration Through Play (15 minutes)

  • Principles of the RITP method
  • Why play and movement-based interventions are effective
  • Demonstration of sample activities and strategies that therapists can implement immediately

Section 4: Application and Next Steps (10 minutes)

  • Linking reflex integration to treatment planning, goals, and outcomes
  • Resources for further study
  • Questions / reflection

Section 5: Quiz 

Section 6: Survey 

References

AOTA Best Practices Recommendations (Choosing Wisely), #8: Don’t use reflex integration programs for individuals with delayed primary motor reflexes without clear links to occupational outcomes. https://www.aota.org/practice/practice-essentials/evidencebased-practiceknowledge-translation/aotas-top-10-choosing-wisely-recommendations

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo T, Carmeli E. Front Neurol. 2022 Jul 7;13:922322. doi: 10.3389/fneur.2022.922322. PMID: 35873782; PMCID: PMC9301367. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301367/

Persistent childhood primitive reflex reduction effects on cognitive, sensorimotor, and academic performance in ADHD. Melillo, R., Leisman, G., Mualem, R., Ornai, A., & Carmeli, E. (2020). Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.431835

Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children. Anna Pecuch, Ewa Gieysztor, Ewelina Wolańska, Marlena Telenga, and Małgorzata Paprocka-Borowicz. (2021) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394673/ 

Integration exercise programme for children with learning difficulties who have preserved vestigial primitive reflexes. Grzywniak C. Acta Neuropsychol. (2017)

Integration of Infant Dynamic and Postural Reflex Patterns-MNRI (Masgutova Neurosensorimotor Reflex Integration). Svetlana Rihanna Masgutova Ketubah, PhD. (2007)

Reflexes, Learning and Behavior: A Window into the Child’s Mind. Sally Goddard. (2002) 

Can Replicating Primary Reflex Movements Improve Reading Ability? Timothy Wahlberg, PhD, Dennis Ireland, OD, Med. Optometry and Vision Development. (2005)Persistent Primitive Reflexes in Elementary School Children. Bein-Wierzbinski, W.. Presented at the 13th European Conference of Neuro-Developmental Delay in Children with Specific Learning Difficulties Chester, UK (2001).

Average Review Score:
★★★★★
By vignesh OT
★★★★★

Amazing explanation

Integrating Primitive Reflex Through Play & Exercise
★★★★★

Presenter moved quickly through information. Would have liked more discussion on treatment strategies for treatment sessions.

Physical Therapist
★★★★★

Good introduction to reflexes and their impact as well as reflexes to go more in depth.

You must log in and have started this course to submit a review.

About Instructor

Kokeb McDonald, OTR/L

I'm a pediatric occupational therapist, author, and coach with a strong passion for helping people develop into their healthiest selves. As a mother of two wonderful children, I bring genuine care and compassion to my mission to transform occupational therapy. As the creator of the Reflex Integration Through Play method and book series, I created these resources not only because they offer fellow professionals a tool to expand their clinical reach, but also because they are empowering and reassuring tools for frustrated parents. Join me in learning to better serve the children around us.

19 Courses

+347 enrolled
Not Enrolled

Course Includes

  • 3 Lessons
  • 2 Quizzes
  • Course Certificate
  • 0.1 AOTA CEUs
  • 1.0 Contact Hours

AOTA does not endorse specific course content, products, or clinical procedures.