SMART Pediatrics

11/06/2025

How Retained Reflexes Can Lead to Clumsiness and Poor Coordination

If your child always seems “off balance” or bumps into things more than other kids, it might not be just a phase; it could be a sign of retained primitive reflexes.

These early reflexes help babies learn to move, roll, crawl, and eventually walk. But when they don’t fully integrate, the brain and body stay a little “out of sync,” making coordination and motor planning harder than they should be.

Children with retained reflexes may have to work extra hard to do things like catch a ball, ride a bike, or even sit upright in a chair. These are automatic for most kids, but for them, every movement takes conscious effort.

The good news? Reflex integration therapy can help. Through specific movement patterns, we can support the nervous system in organizing and coordinating movement more efficiently, helping kids feel more confident in their bodies.

Have you noticed your child seeming clumsy or uncoordinated? It could be their nervous system asking for extra support.

11/04/2025

Does your child have trouble copying from the board? Here’s why.

Copying from the board might look like a simple classroom task, but for many kids, it’s actually a complex motor and visual skill that takes a lot of coordination.

To copy accurately, the brain needs to process what the eyes see, plan how to move the hand, and remember where they left off, all while managing posture and attention. That’s a lot of work for developing systems.

Kids with visual-motor integration challenges often lose their place, write unevenly, or take extra time to finish. Their eyes and hands just aren’t communicating smoothly yet.

Here’s what can help:
👀 Strengthen eye tracking with games like “I Spy,” mazes, or ball play.
✋ Build fine motor control through drawing, tracing, and using tongs or clothespins.
🧠 Practice copying short patterns, words, or shapes before full sentences to build confidence.

Visual-motor integration isn’t just about handwriting; it’s about the brain learning to connect what it sees with what the body does. And when those connections strengthen, focus and confidence grow, too.

Have you noticed your child struggling to copy from the board or with handwriting speed?

11/03/2025

This activity is called the Head Control and Righting Reaction Exercise, a foundational part of sensory-motor and reflex integration therapy.

In these images, the child is lying on the mat while gently guided to lift and move their head separately from their body. This might look simple, but it’s deeply powerful for the nervous system.

Here’s what this activity works on:
🧠 Neck and core coordination: Teaching the brain how to move the head independently from the trunk strengthens postural control.
⚖️ Balance and righting reactions: These are the automatic responses that help us stay upright and stable when our body position changes.
👀 Vestibular system activation: Controlled head movement helps the brain interpret motion, balance, and spatial awareness, key for kids who dislike tilting their heads or have poor coordination.
💪 Reflex integration: When primitive reflexes like the Tonic Labyrinthine Reflex (TLR) remain active, kids may resist certain movements. Exercises like this help the nervous system mature and improve postural responses.

This type of play-based exercise helps a child feel more comfortable moving their head separately from their body, which is essential for daily activities like reading, climbing, and even sitting still in class.

We use sensory and reflex-based movement to help kids build the strong neurological foundations they need for balance, focus, and coordination.

And if you’re a pediatric OT or PT passionate about helping kids move, learn, and thrive, we’re hiring! Join our growing team.

10/30/2025

Did you know?
If your child chews on their shirt, pencil, or sleeve, it’s not about “bad habits” or defiance; it’s their body trying to find calm.

Kids who seek oral input often do so because chewing helps them regulate their nervous system. It can improve focus, reduce anxiety, and provide the deep proprioceptive input their body craves to feel grounded.

🧠 Chewing is one of the most organizing forms of sensory input. It can help kids who feel overstimulated slow down, and kids who feel under-stimulated wake up and engage.

Instead of trying to stop the behavior, try offering a safe alternative, like a chewable necklace, silicone pencil topper, or crunchy snacks. Meeting the need helps the child regulate and reduces the urge to chew on non-safe items.

Have you noticed your child chewing when they’re focused, anxious, or tired? It might be their way of saying, “I need to feel calm.”

10/28/2025

Why do some kids seem clumsy even after lots of practice?

Sometimes it’s not about effort or motivation, it’s about what’s happening beneath the surface.

When reflexes like the Asymmetrical Tonic Neck Reflex (ATNR) or Symmetrical Tonic Neck Reflex (STNR) remain active, they can disrupt smooth, automatic movement patterns. That’s why a child who’s bright and motivated might still trip often, avoid sports, or struggle with tasks like jumping, catching, or riding a bike.

Reflex integration therapy helps the body build new connections that support stability, timing, and motor coordination. Once those foundational reflexes calm, movement feels easier, and confidence follows.

We see this transformation every day: kids who go from feeling “clumsy” to moving with control and joy.

Have you ever noticed your child bumping into things or avoiding movement-based play? It might be more than just coordination; it could be their reflexes asking for support.

10/27/2025

This activity is called the BOSU Ball Animal Toss, and it’s a favorite in pediatric occupational therapy sessions. 🧠✨

Here’s what’s happening in these photos:
The child stands barefoot on a BOSU balance trainer, tossing small stuffed animals into a target. It may look playful, but it’s a full-body brain workout.

Here’s what this activity supports:
💪 Core strength & stability: Keeping balance on an unstable surface strengthens the core, which is key for posture and fine motor control.
⚖️ Balance & weight shifting: The BOSU challenges equilibrium, teaching the child’s body to make micro-adjustments for stability.
👀 Visual scanning & tracking: Watching and aiming for the target enhances eye-hand coordination and visual-motor skills.
✋ Grasp, release & motor planning: Picking up and tossing requires sequencing, timing, and coordination between both sides of the body.
🧠 Focus & sensory regulation: The multi-sensory challenge keeps the brain engaged while promoting body awareness and attention.

This is what functional play looks like; every movement supports stronger connections between body and mind.

We’re passionate about helping kids move, grow, and thrive through sensory-motor play.
✨ We’re also hiring pediatric OTs and PTs who share that same passion for helping children reach their full potential!

10/23/2025

Did you know?
A child who avoids climbing stairs may be showing more than hesitation; it can signal weak leg muscles or difficulty with motor planning. 🏡

Climbing stairs is actually a complex motor skill. It challenges balance, coordination, strength, and timing, all skills that help a child move confidently through their environment.

When kids avoid stairs, they might be struggling with:
🦵 Lower body weakness or core instability
🧠 Poor body awareness or motor planning (figuring out how to move)
⚖️ Balance and vestibular challenges that make them feel unsteady

Practicing stairs safely in therapy builds much more than strength. It supports sensory integration, confidence, and endurance for everyday play and participation.

💡 The goal isn’t just getting up the stairs; it’s helping the body and brain learn to work together with ease.

Have you noticed your child hesitating on stairs or preferring to crawl instead? It might be their body’s way of asking for support.

10/21/2025

Here’s how it works:

Primitive reflexes are automatic movements babies rely on for survival.

If these reflexes don’t integrate, the nervous system keeps getting “false alarms.”

That means the body reacts as if it’s in danger, even during everyday tasks.

The result? Quick frustration, meltdowns, or difficulty calming down.

✨ OT insight: Emotional regulation isn’t just about teaching coping strategies. It often starts with the body. By addressing retained reflexes, we can help kids feel safer in their own skin, making it easier to manage big feelings.

When a child’s body isn’t stuck in fight-or-flight mode, their brain has the freedom to focus, connect, and learn.

👉 Parents and therapists, have you ever noticed emotional ups and downs that didn’t quite make sense until you looked deeper?

10/20/2025

10/16/2025

✅ Reality: Many children internalize their discomfort. Instead of saying “this is too much,” they might:

Zone out or look “spaced”

Withdraw from the group

Show big emotions later when the sensory load builds up

Just because a child isn’t verbalizing distress doesn’t mean their nervous system isn’t overwhelmed. Some kids shut down quietly, which can be missed as “shy” or “tired.”

Supporting sensory needs starts with observation. Notice the subtle cues, the fidgeting, the sudden quiet, the avoidance. Those behaviors often tell the story before words ever do.

👉 Parents and therapists, have you noticed kids who don’t speak up but still show signs of overload? How do you help them feel safe?

10/14/2025

How Cutting with Scissors Builds the Foundation for Handwriting

At first glance, cutting and writing seem like totally different skills. But in therapy, we see how closely they’re connected, especially for kids with ADHD or fine motor challenges.

🖐️ When a child cuts with scissors, they’re strengthening the same muscles and coordination patterns needed for writing:
✂️ Hand separation: learning to use some fingers for strength and others for control.
✂️ Bilateral coordination: using both hands together with different roles (one to hold, one to cut).
✂️ Eye-hand coordination: tracking the line and adjusting movements in real time.

For kids with ADHD, these foundational skills can be harder to master because attention, motor planning, and regulation all work together. Cutting activities offer built-in structure and sensory feedback that help organize the brain and body, making it easier to focus during writing tasks later on.

💡 When we target fine motor skills through movement and play, we’re not just building handwriting ability. We’re supporting self-regulation, attention, and confidence, all essential for learning.

October is ADHD Awareness Month, a great reminder that movement-based activities like cutting aren’t just busy work; they’re brain work.

👉 Have you noticed how your child’s focus changes when they’re engaged in hands-on tasks? Share your thoughts below or tag a parent who’d love to know this.

10/13/2025

Why do kids gravitate toward stretchy, squishy, or colorful fidgets?
Because these tools give the body and brain exactly what they need: regulation, focus, and calm.

Here are a few you see in the photos:
🟣 Stretch Caterpillar: Provides resistance when pulled, great for strengthening little hands while calming the nervous system.
🌈 Rainbow Squish Tube: A bendy, squeezable tool that supports tactile input, stress relief, and bilateral coordination.
🎨 Bathtub Finger Paint Soap: Combines sensory play with self-care routines. Perfect for tactile exploration and making hygiene fun.
🔴🟢 Liquid Motion Timer: A visual regulation tool that slows the body and mind, teaching patience and attention.

💡 OT insight: These aren’t “just toys.” When used intentionally, they help kids with sensory processing challenges build regulation skills, improve attention for learning, and find safe outlets for big feelings.

We love using sensory tools to match each child’s unique needs. They’re a simple way to connect body and mind while making therapy (and everyday routines) more fun and meaningful.

👉 Which one would your child pick first? Share in the comments!

PS: We’re hiring! If you’re a pediatric OT or PT who’s passionate about helping kids thrive through sensory and reflex integration, we’d love to meet you.