The reflex that is not “retained” because it never showed up

Most clinicians are trained to think about primitive reflexes in a simple way. A reflex is present, it should integrate, and if it stays around too long we call it retained. We design a plan to inhibit it.

That framework works in plenty of cases.

But it breaks down with some of our most complex kids, especially kids with significant communication delays, feeding history, mouth breathing, and low tone presentation in the face. In those kids, I see something different all the time.

The issue is not always a retained reflex.

Sometimes the reflex never developed in the first place.

Why that distinction matters more than you think

When a reflex is retained, your job is inhibition. You are trying to shut down a primitive pattern that is still running.

When a reflex is absent because it never developed, inhibition is the wrong first move. You cannot inhibit what does not exist. You have to build the loop first.

This came up in a clinical call with a provider running an intensive. The child had made major progress, reflexes had improved, and language was starting to show up. The clinician felt like they hit a wall and wanted to support the next leap in communication.

That is the exact moment where most people either try harder at speech drills or they keep layering more input without a clear target.

My first thought was the same one I have with a certain profile of kid.

Work the rooting reflex.

Rooting, the lateral cerebellum, and “building before inhibiting”

When I look at primitive reflex development, I think in loops.

There is a loop that has to develop through activation. That development is part of how the brain organizes early motor patterns and tone. Then, later, higher centers start to inhibit and regulate those primitive reflexes.

If a child had early feeding issues, trouble breastfeeding, poor oral tone, mouth breathing, and never organized that early oral motor system well, I start to wonder if that posterior loop never fully developed.

In that situation, you can stimulate the rooting pathway and see something interesting. Sometimes you start getting a rooting response as you stimulate consistently. That is a clue. It tells you the system is capable of building, but it did not get built at the right time.

Your immediate goal becomes presence first. Then inhibition.

That one shift changes how you treat.

Why this can unlock speech and communication

A lot of clinicians treat speech as a purely cortical skill. More repetition, more language exposure, more prompting.

But speech is not only cortex.

If the brainstem and cerebellar systems that support tone, oral motor coordination, and motor sequencing are underdeveloped, the “top level” work is going to stall. You can get regulation and connection, but the output does not come online like you expect.

When you build the foundational loop, you are not just chasing a reflex. You are supporting tone, patterning, and cerebellar involvement that can make communication easier for the brain to execute.

And once you see even a small increase in output, you have a window. That is when you keep feeding the system the right signal, not just more signal.

A practical add-on when the child is ready for it

When I have a kid who is already starting to show some language, I like leveraging targeted photobiomodulation protocols that are designed specifically around speech support. In practice, I often see meaningful output changes after a handful of sessions when the child is already on the edge of producing.

I am not saying light replaces rehab. It does not.

But when the child is sensitive, the family is working hard, the diet is cleaned up, reflexes are improving, and language is starting to peek through, this is where layering the right protocol can matter.

The clinical takeaway

If you are working with a child where communication is the next mountain, do not automatically assume every primitive reflex problem is retention.

Ask the better question.

Did this reflex integrate late, or did it never develop?

If it never developed, your job is to build the loop first. Once the system is present and stable, then you can talk about inhibition and refinement.

That is often the difference between spinning your wheels and watching a child finally start to produce.