Why Crawling is Important: a look at primitive reflexes

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This blog is collaborated with Dr. Mikael Larsen (DC, MSc), co-creator of Path Child Development.

So often I have heard parents brag that their child "went straight to walking" and skipped the crawling phase. I have always been curious if that's actually a good thing or not. In my mind, crawling is an important part of development. Please know, I have no judgement what so ever! I, myself, was an early walker, and many of my curiosities have stemmed from that.

When my own chiropractor began teaching me about primitive reflexes, lightbulbs started to go off in my mind and dots began to connect (which only peaked my curiosity and love of learning more). He recommended I reach out to Dr. Mikael Larsen who is an expert on this topic.

Let's take a look at what he has to say below.

What are Primitive Reflexes?

Primitive reflexes are involuntary movements present at birth that play a critical role in survival and early development. These reflexes help babies exit the birth canal, initiate feeding, develop muscle tone, and process sensory information, all while stimulating the cerebral cortex to develop higher-level brain functions. Primitive reflexes are triggered by sensory input, such as touch, and are controlled primarily by the brainstem, which is relatively developed at birth, unlike the cortex, which matures over time.

One of the most well-known primitive reflexes is the rooting reflex—when a baby's cheek is touched, they automatically turn toward the stimulus and attempt to feed. This response is entirely involuntary, ensuring survival until the baby gains voluntary control over feeding movements.

What makes these reflexes fascinating is that as they are activated, they send sensory input to the brain, helping build an internal body map within the parietal lobe. This process stimulates the frontal lobe, particularly the motor cortex, which is responsible for voluntary movement. As the brain develops, babies gain greater control over their bodies, and primitive reflexes gradually integrate as they become unnecessary. In short,  these reflexive movements drive development of the brain by building connections between different regions of the brain. 

However, if these reflexes do not properly integrate, they can interfere with neurological function, leading to attention deficits, sensory processing challenges, behavioral issues, reading difficulties, and more. Ensuring that primitive reflexes are properly integrated supports healthy motor, cognitive, and emotional development, allowing children to move, learn, and interact with their environment more effectively. The rooting reflex is one of many.

Why is it Important for Babies to Crawl (Hands and Knees)?

Our nervous system follows a specific developmental path, but it can only progress when stimulated correctly through movement and sensory experiences. Crawling provides a unique and essential stimulus, helping to shape both neurological and physical development.

Crawling requires both hemispheres of the brain to work together, strengthening the pathways that connect the left and right sides of the brain. This improves bilateral coordination, which is important for higher-level motor skills, learning, and cognitive function. Since crawling is the first efficient way a baby moves independently, it also encourages exploration, spatial awareness, and problem-solving, all of which stimulate early cognitive growth.

Additionally, crawling plays a crucial role in visual development. As babies move, their eyes must track objects, converge (move together for close objects), and diverge (separate for far objects), helping to refine eye coordination and depth perception—skills that later support reading and hand-eye coordination.

Physically, crawling strengthens core muscles, shoulder stability, and postural control, helping develop the proper curvature of the lower back and neck. These foundational strength and movement patterns set the stage for upright posture, balance, and coordination in later developmental stages.

Because of its far-reaching benefits, crawling is an essential milestone for both brain and body development, creating stronger neural connections, improving visual function, and laying the groundwork for future motor skills.

What About Army Crawling?

Before babies develop the strength and coordination to crawl on hands and knees, they often go through an important preparatory stage—army crawling. This movement pattern serves as a crucial bridge, allowing babies to begin moving independently while their nervous system and muscles continue developing.

Army crawling lays the foundation for full crawling by strengthening core muscles, shoulders, and arms, which are essential for supporting body weight on all fours. Additionally, this early movement activates and strengthens connections between the left and right hemispheres of the brain, refining bilateral coordination and motor planning. As babies alternate their arms and legs, they strengthen the neural pathways necessary for smooth, controlled movement, setting the stage for efficient crawling and, eventually, walking.

Beyond physical development, army crawling also enhances visual tracking and depth perception. Since babies are lower to the ground, they must coordinate eye movements to track objects, shift focus between near and far, and refine convergence and divergence. These early visual skills support hand-eye coordination, spatial awareness, and later academic tasks like reading and writing.

By allowing time for army crawling before transitioning to crawling on hands and knees, babies develop the neurological and muscular strength needed for stable, controlled movement. Encouraging this stage provides a strong foundation for future mobility, coordination, and overall development.

When Should a Baby Start Crawling?

Ideally, babies begin army crawling around 6 months and transition to hands-and-knees crawling within a few months. However, it is common for some babies to begin crawling between 7 and 10 months.

If crawling is delayed, it’s important to observe for other potential developmental delays to ensure overall progress is on track. Monitoring gross motor skills, coordination, and reflex integration during this time can help identify whether additional support or intervention may be beneficial. If there are concerns about delays or missing milestones, consulting a healthcare provider or developmental specialist can provide guidance on the best next steps.

How Long Should Babies Crawl Before Walking?

There is no exact timeframe for how long a baby should army crawl or crawl on hands and knees before walking, as every child’s neurological development and strength progression are unique.

However, on average, babies will army crawl for about 1 to 2 months before developing the strength and coordination needed to transition to hands-and-knees crawling (creeping), and will typically creep for several months before learning to walk.

In total, most neurotypical babies spend around 4 months with combined crawling experience (both army crawl and creeping) before taking their first steps, though this can vary between 3 to 6 months in healthy individuals. 

What if a Baby Skips Army Crawling?

If a baby skips army crawling and goes straight to hands-and-knees crawling (creeping), it generally does not have the same developmental impact as skipping creeping before walking. You can think of army crawling as the brain’s “training wheels” for creeping—it helps build strength, coordination, and neurological pathways that support crawling and, later, walking.

If a baby is already a confident and capable hands-and-knees crawler, intervention may not be necessary. However, if they struggle with endurance, coordination, or confidence in creeping, spending more time practicing army crawling may help them build these foundational skills more effectively.

WAYS TO ENCOURAGE ARMY CRAWLING:

• Provide frequent opportunities for floor time in a way that naturally encourages army crawling.

• Create mini obstacle courses using tunnels, low pillow forts, or cushioned ramps/inclines, which require them to use army crawling instead of creeping.

• Incorporate play-based encouragement to make army crawling a fun and engaging part of their daily routine.

What if a Baby Skips Hands and Knees Crawling (Creeping)?

Skipping hands-and-knees crawling (creeping), or having too short of a total crawling experience phase, can significantly impact a child’s neurological, motor, and sensory development. If a baby is skipping hands-and-knees crawling, parents can encourage pumping the brakes and working on these skills by incorporating crawling into daily play in fun and engaging ways:

• Encourage floor play with toys placed just out of reach to motivate crawling movements.

• Create obstacle courses using tunnels, tents, pillows, couch cushions, or foam mats to make crawling the easiest or most natural way to move.

• Use social motivation by arranging playdates with other crawling babies, leveraging mirroring and parallel play to encourage creeping.

• Provide unstable surfaces (such as soft mats or pillows) that make standing or walking more difficult, making crawling the preferred way to navigate.

  
  

With frequent floor-based play and social engagement, most babies can develop the necessary strength and coordination to successfully integrate creeping into their movement patterns, supporting overall development.

What if a Child is Well Past "Babyhood" and Never Crawled?

It is always important to consult with a qualified healthcare provider or developmental specialist if there are concerns about missed milestones or developmental delays. 

To provide support outside of the doctor’s office, the Path Child Development app offers guidance on checking for primitive reflexes at home and provides strategies to help get development back on track. If primitive reflexes remain active beyond their expected integration period, or if milestones were delayed or skipped, the app offers targeted activities to help strengthen the neurological and motor skills needed for proper development. By identifying and addressing retained reflexes and incorporating developmentally supportive activities, parents can take proactive steps to help their child build a strong foundation for movement, coordination, and learning.

Can Primitive Reflexes be Integrated Later in Life?

Primitive reflex integration occurs when higher-order brain regions mature and take over control, allowing involuntary reflexes to fade as voluntary movement develops. When primitive reflexes remain active beyond their typical timeline, it is a sign of neurological immaturity, indicating that higher brain regions have not fully developed or strengthened.

However, unintegrated primitive reflexes can be addressed at any age through the powerful mechanism of neuroplasticity—the brain’s ability to change, adapt, and reorganize based on experiences and stimuli. While neuroplasticity is strongest in early childhood, it remains active throughout life, meaning that targeted interventions can help integrate reflexes in older children and adults.

By strategically stimulating and activating the brain, neuroplasticity can be leveraged to strengthen delayed or underdeveloped areas. This can be done through specific movements, sensory experiences, and external stimuli such as:

• Targeted exercises that mimic early developmental movements.

• Vibration

• Electrical Stimulation.

• Visual stimulation

• Auditory Stimulation 

• Light Therapy 

When consistently applied, these interventions activate and reinforce the correct brain regions, allowing the nervous system to integrate primitive reflexes and improve the functional abilities associated with weak or delayed areas of the brain. By understanding neuroplasticity, we can take an intentional approach to reflex integration, helping individuals develop better coordination, sensory processing, focus, and emotional regulation—all of which rely on a well-organized and mature nervous system.

What can cause a primitive reflex to remain active past the time it should?

Several factors can contribute to retained primitive reflexes, but much is unknown. Common causes being environmental influences, injury, autoimmunity, metabolic or genetic factors, and lack of stimulation/movement. However, there are likely additional contributors that have yet to be fully identified.

• Environmental Factors – Exposure to mold, heavy metals, or inadequate nutrition may interfere with brain development and reflex integration.

• Injury to the Nervous System – Events such as concussions or anoxic injuries can not only prevent primitive reflexes from integrating but may also cause previously integrated reflexes to reappear.

• Autoimmune Conditions – Some undiagnosed autoimmune responses target specific brain regions, disrupting their development and function.

• Lack of Stimulation – The brain requires consistent movement and environmental interaction to develop properly. Limited opportunities for physical activity and sensory experiences can delay reflex integration.

• Metabolic and Genetic Factors – The brain relies on a steady supply of energy to build and strengthen neural pathways. If there is a metabolic deficiency or mitochondrial dysfunction, the brain may struggle to produce enough energy for proper development, contributing to delayed reflex integration and neurological immaturity. Some genetic conditions may also affect how efficiently the brain processes nutrients and generates energy, further impacting development.

  
  

A striking example of the impact of insufficient stimulation comes from case studies on Romanian orphanages in the late 1900s, where children who lacked attention and interaction did not develop properly. Their brains were not receiving the necessary sensory and motor input, leading to widespread developmental delays.

How to Find a Primitive Reflex Provider

There are providers across different fields who have been trained to identify and address primitive reflexes through targeted rehabilitation. These practitioners may include chiropractors, pediatricians, occupational therapists, and physical therapists. However, not every provider within these fields is specifically trained in primitive reflex integration, making it challenging for parents to find the right specialist.

Path recognizes this difficulty and Is actively working to create a referral map that will help parents easily locate trained practitioners in their area. This resource aims to connect families with qualified providers who specialize in primitive reflex integration, ensuring that children receive the support they need for optimal development.

For now searching for “primitive reflex providers near me” may be the best way to start. Look for a provider that has good reviews and call to ask about their methods. You want a provider that takes a holistic approach by incorporating exercises, sensory stimulation, nutrition, and if needed supplementation. You want to find a provider that can help identify any key stressors that are contributing to the delay such as mold exposure, autoimmunities, or other environmental factors that need to be eliminated.

Dr. Larsen has seen cases of primitive reflexes that integrate within a week, as well as some that take months. So you want to find a provider that can set up a game plan for you to either get therapy, start a home program, or a combination. 

Other Clinically Relevant Primitive Reflexes:

Palmar Reflex: 

The palmar reflex is an involuntary response where a baby’s hand automatically contracts into a grasp when pressure is applied to the palm. This reflex is present at birth and plays a role in early sensory-motor development, helping infants explore their environment through gripping and grasping movements.

Typically, the palmar reflex integrates by 4-6 months of age, allowing for more controlled and intentional hand movements. However, if this reflex remains active beyond infancy, it can interfere with fine motor skill development. A retained palmar reflex can make it difficult for a child to develop a proper pencil grip, manipulate small objects, or perform precise hand movements, all of which are essential for writing, cutting, and self-care tasks like buttoning clothes.

Babinski Reflex: 

The Babinski Reflex is observed when the outside edge of the bottom of the foot is stroked from the heel toward the toes. If the reflex is present, the big toe extends upward while the other toes may flare out. This response is normal in infants up to 12 months of age, as their nervous system is still developing. However, if the Babinski Reflex remains active beyond this period, it may indicate delayed neurological development or dysfunction of the corticospinal tract.

The corticospinal tract is the neurological pathway responsible for voluntary movement, allowing the brain to control and coordinate purposeful actions. As the nervous system matures, this reflex naturally integrates, allowing for proper foot control, balance, and coordination. A retained Babinski Reflex may interfere with gait mechanics, postural stability, and fine motor control of the lower limbs, affecting a child’s ability to walk, run, or engage in complex movements.

Spinal Galant:

The Spinal Galant Reflex is triggered when the muscles along one side of the lower back are stroked, causing involuntary contraction of those muscles and resulting in the hip moving toward the side of stimulation. This reflex plays an important role during birth, assisting in exiting the birth canal, while also contributing to the early development of the cerebellum and cortex through repeated activation.

Typically, this reflex integrates by 8 months of age as voluntary movement control improves.

However, if the Spinal Galant Reflex remains active beyond infancy, it has been linked to developmental challenges. Research suggests (1,2,3,4) that a retained Spinal Galant Reflex may contribute to difficulties with attention, fidgeting, and bedwetting, as the involuntary muscle responses can cause postural instability and sensitivity to tactile stimuli.

Additionally, studies have explored the connection between the Spinal Galant Reflex and ADHD symptoms, indicating that children with a retained reflex are more likely to exhibit hyperactivity, impulsivity, and difficulty sitting still. Since the Spinal Galant is closely connected to sensory processing and motor control, its persistence may interfere with a child’s ability to focus, maintain posture, and regulate movement in structured environments.

If a child exhibits signs of difficulty with attention, sensory sensitivity, or persistent bedwetting, assessing for a retained Spinal Galant Reflex may be beneficial. Reflex integration exercises and targeted movement activities can help encourage proper neurological development and support self-regulation skills.

Moro:

The Moro Reflex, also known as the startle reflex, is one of the most well-known primitive reflexes and can be observed when a newborn experiences something unexpected, such as a loud noise, sudden movement, or a change in head position. In response, the baby will startle, extend their head and spine, and throw their arms into a “field goal” position before bringing them back in. This reflex serves as the first “fight or flight” response, helping infants react to their environment before they develop voluntary control over their body.

The Moro Reflex plays a crucial role in the early development of the autonomic nervous system and vestibular system. It is closely connected to all sensory systems, integrating information from sight, sound, touch, and movement to help regulate a baby’s stress response and postural control.

However, if the Moro Reflex remains active beyond infancy, it can contribute to sensory processing issues and an overactive fight-or-flight response. This may lead to challenges such as:

• Heightened anxiety or social immaturity due to an exaggerated stress response.

• Difficulty focusing and regulating attention, often seen in children with ADHD-like symptoms.

• Balance and coordination problems, as the reflex impacts the vestibular system.

• Poor impulse control, as the nervous system remains in a heightened state of reactivity.

  
  

Because of its far-reaching effects on neurological and sensory processing, ensuring that the Moro Reflex integrates properly is essential for emotional regulation, focus, and motor development. If a child exhibits signs of sensory sensitivity, hyperactivity, or difficulty self-regulating, assessing for a retained Moro Reflex and working on reflex integration exercises may help support a calmer, more balanced nervous system.

Asymmetric Tonic Neck Reflex: 

The Asymmetrical Tonic Neck Reflex (ATNR) is a primitive reflex that can be observed when a baby’s head is turned to one side. In response, the arm on the side they are facing extends outward, while the opposite arm flexes in. This reflex plays an important role in early movement development, helping infants build hand-eye coordination, visual tracking, and muscle tone.

The ATNR should integrate by around 6 months of age, allowing for more coordinated and voluntary movement. If this reflex remains active beyond infancy, it can interfere with higher-level motor and cognitive functions. Research (5) has linked retained ATNR to:

• ADHD-like symptoms, including difficulty focusing and impulsivity.

• Reading challenges and dyslexia, due to poor eye tracking and visual processing difficulties.

• Difficulty telling time, as understanding clock faces requires coordinated eye movements and spatial awareness.

• Poor hand-eye coordination, affecting skills such as writing, catching a ball, and using utensils smoothly.

  
  

Since the ATNR is heavily involved in early movement patterns and visual-motor development, a retained reflex may cause learning difficulties, trouble with coordination, and even postural instability.

Symmetric Tonic Neck Reflex: 

The Symmetric Tonic Neck Reflex (STNR) is a transitional reflex that emerges around 6-9 months of age and plays a critical role in postural development and movement coordination. This reflex can be observed when a baby’s head tilts up or down:

• When the head tilts upward, the arms straighten, and the legs bend.

• When the head tilts downward, the arms bend, and the legs straighten.

• You may also notice movement in the feet and pelvis as the baby responds to head positioning.

  
  

The STNR is crucial for the development of posture, hand-eye coordination, focus, and gross motor skills. It helps babies transition from lying on their stomach to hands-and-knees crawling, allowing them to learn how to separate upper and lower body movements—a necessary skill for more advanced motor patterns like sitting upright, walking, and climbing.

Typically, this reflex integrates by 9-12 months. If it remains active beyond this period, it can interfere with:

• Postural control, leading to slouched sitting or difficulty maintaining an upright posture.

• Hand-eye coordination, making tasks like catching a ball or copying from a board in school challenging.

• Focus and attention, as a retained STNR is associated with difficulty switching between near and far vision (affecting reading and writing).

• Gross motor coordination, making activities that require smooth upper and lower body movement, such as swimming or riding a bike, more difficult.

  
  

Tonic Labyrinthine Reflex:

The Tonic Labyrinthine Reflex (TLR) is a postural reflex that can be observed when a child closes their eyes and tilts their head forward or backward while standing. This reflex is critical in the early development of muscle tone, postural control, coordinated eye movements, and spatial awareness.

The TLR plays a significant role in integrating the vestibular system’s functions into the rest of the nervous system. The vestibular system, located in the inner ear, is responsible for tracking head position and movement, helping us maintain balance and posture against gravity. As this reflex activates, it helps the nervous system build a strong foundation for stability, coordination, and movement control.

Typically, the TLR integrates by 3.5 years of age. If it remains active beyond this stage, it may contribute to:

• Poor posture and muscle tone, leading to slouching or difficulty sitting upright for long periods.

• Challenges with balance and coordination, making activities like jumping, skipping, or riding a bike more difficult.

• Difficulty with visual tracking and eye coordination, affecting reading, writing, and focus.

• Problems with spatial awareness, leading to clumsiness or difficulty judging distances.

  
  

Since the TLR is closely connected to the vestibular system, its retention may interfere with motor planning, body control, and even attention regulation.

Curious to learn more about child development and how to support your little one's journey? Check out Path: Child Development on the Apple App Store today!

A Little Bit About Path

We created Path after speaking with hundreds of parents of children experiencing developmental delays, all sharing a similar story. They sensed something wasn’t quite right but didn’t have the knowledge or resources to understand what was happening. Many of the signs were there—small indicators that, if recognized earlier, could have led to earlier intervention and support.

Our goal with Path is to empower parents by providing education and guidance through each stage of their child's development. By helping parents recognize potential delays early, we hope to make it easier to seek support when needed—giving every child the best opportunity to thrive.

But Path isn’t just about identifying delays—it was also designed to help optimize your child’s development. The app provides tips and activities to actively promote healthy neurological growth, supporting strong motor skills, coordination, sensory processing, and cognitive development. Since the nervous system controls everything we do, enhancing its function can lead to improvements in movement, learning, behavior, and overall well-being—setting the foundation for success in everyday life.

@pathchilddevelopment (instagram and facebook)

@dr.mikaellarsen (instagram)

@dr.cordellmiller (instagram)

About Dr. Larsen

Dr. Mikael Larsen is a dedicated healthcare professional with a deep passion for helping others through natural and holistic approaches.

After experiencing the benefits of chiropractic care as a child, Mikael set his sights on a career in healthcare, with a particular interest in non-pharmaceutical treatments. He graduated from Parker University in 2019 with a Doctor of Chiropractic degree and a master's in neuroscience.

Mikael also holds a bachelor degree for Anatomy and Physiology as well as Health and Wellness. While in chiropractic school, Mikael attended a seminar that introduced him to functional neurology and the concept of neuroplasticity—how the nervous system can adapt, strengthen, and heal through strategic activation. This eye-opening experience was further deepened when he discovered Dr. Robert Melillo's book "Disconnected Kids," which demonstrated the profound impact of Functional Neurology interventions on children's lives.

After completing his education, Mikael began his professional career in Corpus Christi, TX, where he helped expand a practice, open a new office, and gained extensive experience. After two and a half years he was presented with an opportunity to work at a renowned pediatric focused functional neurology office in Austin, TX, where he spent two years making significant changes in the lives of children with developmental delays and other neurological disorders.

During this time treatment was heavily focused on primitive reflex integration, sensorimotor integration, vestibular and cerebellar rehab, Vagus nerve stimulation, and eye movement exercises. During this time Mikael had the opportunity to speak with hundreds of parents of children with developmental delays. Most of them had a suspicion that their child was not developing on time from an early age, but were often pushed along through the system without receiving proper care and often told "let's wait and see". These children absolutely would have benefited from an earlier intervention, but most people are unaware of these therapeutic options. This realization led him to co-create Path, a tool designed to empower parents with the knowledge and resources necessary to support their children's development and connect them with comprehensive care solutions.

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