This is the sixth post in a series on primitive reflexes and Blomberg Rhythmic Movement Training (BRMT). If you’re new here, start with the Field Guide to Primitive Reflexes for the big picture. The previous post covered the Landau Reflex — the bridge between lying down and rising up.
There’s a child in every classroom. The one who can’t stop fidgeting. Who squirms in the chair, shifts their weight side to side, leans forward, tilts back, tucks one leg under. Who pulls at the waistband of their pants. Who scratches at shirt tags. Who slumps forward onto the desk, then gets told to sit up, sits up for thirty seconds, and slumps again.
Adults see this and think: distracted. Or: not trying. Or: needs more discipline. Or, increasingly: ADHD.
But sometimes, the simplest explanation is the one nobody has considered. Sometimes the child literally cannot stop moving, because a reflex governing muscular control in their lower back is still active, and every time their spine touches the back of the chair, every time fabric brushes their waist, every time they shift their weight, that reflex fires and the hips have to move.
This is the Spinal Galant Reflex. And it might be the most misread reflex in childhood.
Born to Move Through the Birth Canal
The Spinal Galant Reflex (sometimes called the Galant or truncal incurvation reflex) emerges around twenty weeks in utero and is fully present at birth (Zafeiriou, 2004; Goddard, 2005). It’s triggered by stimulation along one side of the lower spine: when you stroke down the lumbar region, from mid-thoracic levels downward next to the spine, the hip on that side flexes toward the stimulus, and the trunk curves laterally; the whole body bends like a crescent toward the touch.
Try it on a newborn lying on their tummy and you’ll see it clearly. Stroke down the left side of the spine, and the left hip kicks out and the trunk curves to the left. Stroke the right side, and the mirror response occurs. It’s elegant, immediate, and unmistakable.
This reflex exists, first and foremost, to get the baby born.
During labor, the contractions of the uterus create rhythmic pressure against the baby’s lumbar spine. Each contraction stimulates the Spinal Galant, which triggers hip movements that help the baby rotate and descend through the birth canal. Working in partnership with the ATNR (the Asymmetrical Tonic Neck Reflex), the Spinal Galant helps the infant make the turns required to navigate the tight passage of natural birth (Goddard, 2005; Blomberg, 2015).
This is one of the reasons why birth method matters for reflex development, though it’s never the whole story, and never a reason for blame. In a vaginal delivery, the Spinal Galant gets activated intensely and repeatedly during the birth process itself, which contributes to its development and eventual integration. In a cesarean delivery, that particular pattern of stimulation doesn’t occur. This doesn’t mean every C-section baby will have a retained Spinal Galant — many other factors are involved — but it’s a key piece of the developmental picture worth understanding.
What the Spinal Galant Is Building
After birth, the Spinal Galant continues working. It serves several developmental functions during the first months of life before it integrates, typically between three and nine months of age (Zafeiriou, 2004; Goddard, 2005).
Hip mobility and crawling preparation. The Spinal Galant drives lateral hip movement, the side-to-side shifting that prepares the body for creeping and crawling. When the baby is on their tummy and begins making those early wriggling, fish-like movements across the floor, the Spinal Galant is a significant part of what’s powering those motions. It synchronizes simultaneous upper and lower body movement, helping the baby discover that the hips and shoulders can move in coordinated lateral patterns (Blomberg, 2015).
Back muscle development. Each activation of the Spinal Galant engages the muscles along the spine - particularly in the lumbar and lower thoracic regions. This repetitive activation builds strength and flexibility in the spinal muscles, contributing to the postural foundation the baby will need for sitting, standing, and walking.
Auditory processing. This is the connection that surprises most people. The Spinal Galant plays a role in the development of auditory processing, the brain’s ability to make sense of what it hears. How? In utero, the fetus experiences sound as vibration transmitted through the amniotic fluid and the mother’s body. The spine is a primitive sound conductor - it picks up those vibrations and transmits them through the body. The Spinal Galant’s activation in response to spinal stimulation is part of the neural circuitry that allows the fetus to begin processing auditory input before the ears are fully mature (Goddard, 2005; Blomberg, 2015). This early vibratory experience through the spine lays groundwork for the auditory processing skills that will eventually be essential for language, reading, and learning.
Balance and vestibular development. The lateral trunk movements driven by the Spinal Galant contribute to vestibular calibration, the brain’s developing sense of where the body is in space and how gravity is influencing it. Each side-to-side shift sends proprioceptive and vestibular information to the brainstem and cerebellum, refining the internal balance map that the TLR began building.
Bladder function. The neural pathways that control the Spinal Galant in the lumbar region are closely linked to the neural pathways that control bladder function. The integration of the Spinal Galant is associated with the maturation of voluntary bladder control. When the reflex integrates on schedule, these neural circuits mature alongside it. When it doesn’t, the connection between spinal stimulation and bladder response can remain immature, with consequences we’ll discuss below (Goddard, 2005; Blomberg, 2015).
When the Spinal Galant Doesn’t Integrate
The Spinal Galant should integrate between three and nine months of age as the baby develops higher-level motor skills for sitting and crawling (the more mature movement patterns that replace and absorb the primitive reflex). When it doesn’t integrate, the consequences are distinctive, highly visible, and frequently misinterpreted.
Fidgeting and hyperactivity. This is the hallmark presentation of a retained Spinal Galant, and it’s the one most often confused with ADHD. When the reflex remains active, any stimulation along the lower spine triggers the hip movement response. What counts as stimulation? The back of a chair. A waistband. A seatbelt. A hand resting on the lower back. Fabric moving across the skin. In a classroom, a child with a retained Spinal Galant is being stimulated constantly, and their body is responding constantly (think: shifting, squirming, fidgeting, unable to stay still). This isn’t a choice. It isn’t defiance. It isn’t poor self-regulation. It’s a reflex firing in response to input that most people wouldn’t even notice (Konicarova & Bob, 2012; Goddard, 2005; Blomberg, 2015).
The distinction matters enormously, because the standard interventions for “fidgeting” (sit still, try harder, use a fidget tool, take medication) don’t address the underlying cause. A fidget spinner doesn’t integrate a reflex. Neither does a behavioral reward chart. The child isn’t choosing to move. Their brainstem is telling them to.
Tactile sensitivity along the back and waist. Children with a retained Spinal Galant are often intensely sensitive to touch along the lower back, the sides of the waist, and the hip area. They may hate tight waistbands, pull at tags in shirts, refuse to wear belts, and react strongly to being touched on the back, even lightly. Ticklishness along the spine is often extreme. These sensitivities are frequently interpreted as “sensory issues” or “sensory processing disorder”; and while they certainly fall within the sensory domain, the underlying driver may be a specific reflex that’s still active and responding to input (Goddard, 2005).
Bedwetting. This is the connection that most parents haven’t been told about, and it can be a significant relief to learn. Like I said above, the neural circuitry controlling the Spinal Galant in the lumbar region overlaps with the circuitry that controls bladder function. When the reflex remains active past its integration window, the immature neural pattern can interfere with the development of full voluntary bladder control — particularly at night, when conscious override isn’t available. Bedwetting that persists past age five, especially when it occurs in a child who also fidgets, is sensitive along the waist, and has difficulty sitting still, may have a retained Spinal Galant as a contributing factor (Goddard, 2005; Blomberg, 2015).
This doesn’t mean a retained Spinal Galant is the only cause of enuresis; it isn’t. But it’s a cause that’s frequently overlooked, and when reflex integration work addresses the Spinal Galant, bladder control often improves as a secondary benefit, without ever having been the direct target of intervention.
Posture and spinal alignment. A retained Spinal Galant can contribute to asymmetry in the trunk; the reflex may be more active on one side than the other, creating a habitual lateral curve. Over time, this can show up as functional scoliosis, a rotated pelvis, or chronic one-sided muscle tension patterns. Physical examination may reveal a pelvic tilt, one shoulder higher than the other, or a subtle trunk rotation that the child has been compensating for without realizing it (Gieysztor et al., 2018; Blomberg, 2015).
Attention and concentration. A child who cannot stop moving cannot fully attend. It’s that simple and that consequential. But the connection goes deeper than just distraction. The brain develops from the bottom up. The prefrontal cortex (the seat of sustained attention, impulse control, working memory, and executive function) is the last brain structure to mature, and it depends on the stability of everything below it. When the brainstem is still running unfinished reflex programs, the foundation the prefrontal cortex needs to develop properly isn’t in place. The dopaminergic circuitry that serves attention and executive function doesn’t calibrate in a vacuum, it calibrates on top of a brainstem and cerebellum that need to be doing their jobs. When those lower structures are still occupied with unintegrated reflexes, the higher systems develop on an incomplete foundation (Blomberg, 2015; Konicarova & Bob, 2012).
This is why so many children with retained primitive reflexes (including the Spinal Galant) present with symptoms identical to ADHD. It’s not a coincidence or a misdiagnosis. It’s the predictable result of a developmental sequence that didn’t complete from the bottom up. The attention difficulty isn’t a separate condition layered on top of the reflex, it’s a downstream consequence of it (Pecuch et al., 2021).
Coordination and gait. Because the Spinal Galant drives hip movement, a retained reflex can affect walking patterns, hip rotation, and lower body coordination. The individual’s gait may look slightly unusual (hips swinging more than expected, an asymmetrical stride, or difficulty with cross-pattern movements like skipping or marching). Lower body coordination in sports (kicking, running, changing direction) may be notably harder than expected for their age.
Digestive issues. The chronic misalignment of the trunk and pelvis that can accompany a retained Spinal Galant may contribute to digestive discomfort. When the abdomen is constantly compressed or shifted by postural asymmetry, the organs of digestion don’t have the space and alignment they need to function comfortably. Some practitioners report an association between a retained Spinal Galant and chronic stomach aches, constipation, or general digestive sensitivity in children.
The Spinal Galant in the Developmental Sequence
In the BRMT Level 1 curriculum, the Spinal Galant follows the TLR, Landau, and Babinski in the developmental sequence. Where the TLR orients the body within gravity and the Landau builds the capacity to rise, the Spinal Galant introduces lateral movement - the first departure from the purely forward-and-back axis of the earlier reflexes. This is the body learning to move side to side, to shift weight from one hip to the other, to curve and rotate the trunk. These movements are precursors to crawling, which requires alternating lateral hip shifts coordinated with contralateral arm movements.
The Spinal Galant also works in partnership with the ATNR (the Asymmetric Tonic Neck Reflex) that we’ll cover in later posts. Both reflexes were involved in the birth process, both involve asymmetrical body movements, and both contribute to the development of cross-lateral coordination. When these reflexes are both retained, the child often has significant difficulty with any task that requires crossing the body’s midline, like reaching across the center of the body, tracking eyes across a page, or using the left and right sides of the body in coordinated but different patterns (Goddard, 2005).
The “Just Sit Still” Problem
Here’s what I want to name directly, because it matters for every parent, teacher, and therapist reading this.
A child with a retained Spinal Galant is living in an environment (for most kids, its the modern classroom) that is specifically designed to trigger their reflex, continuously, for six to eight hours a day. They sit in a chair with a back that presses against their spine. They wear clothes with waistbands that brush against their lower back. They sit still (or try to) while their body is being told by the brainstem to move.
And then we tell them to stop fidgeting.
And when they can’t, we interpret their inability as a behavioral problem, a motivational problem, an attention deficit, or a discipline issue. We try reward charts, consequences, special seating, medication. All pointless, really. The medication piece, not only doesn’t help, it causes long term neurological issues (including the potential for more serious addiction problems). And the reflex, the actual, neurological, testable, addressable pattern driving the behavior, goes unidentified and untreated.
This is not to say that every fidgeting child has a retained Spinal Galant. It’s to say that when a child cannot stop moving despite genuinely wanting to (when they’re trying their best and still can’t sit still), the Spinal Galant is worth checking.
Research has documented a significant association between retained primitive reflexes (including the Spinal Galant) and ADHD symptoms in children (Konicarova & Bob, 2012; Pecuch et al., 2021). From a developmental perspective, this makes sense. The ADHD presentation (the inattention, the impulsivity, the hyperactivity) is what happens when the prefrontal cortex tries to come online on top of a brainstem that hasn’t finished its work. Medicating the dopamine system may help manage the symptoms. But it doesn’t address why the dopamine system didn’t calibrate properly in the first place. This approach, i.e. covering up the symptom with medication, eventually causes deeper issues that will show up later on in life. And this is a true pity, when the reflex is the root that needs addressing. And addressing the root is a simple thing. The neurotransmitter profile is the downstream expression of an active reflex. Integrate the reflex, give the brainstem what it needed to complete its developmental program, and practitioners consistently report that the attention picture recalibrates — sometimes dramatically — because the foundation the prefrontal cortex depends on is finally stable.
This isn’t a dismissal of ADHD as a real experience. The child’s struggle is real. The family’s struggle is real. But the developmental framework suggests that what we’re calling ADHD may, in many (I would argue, MOST) cases, be the visible surface of a deeper, addressable pattern; and that pattern has a name, a test, and a gentle, rhythmic solution.
What Can Be Done
Like all the reflexes in this series, the Spinal Galant can be integrated at any age. The brain’s capacity for developmental reorganization doesn’t expire.
In BRMT, Spinal Galant integration involves specific rhythmic movements that gently stimulate and then help resolve the reflex pattern. These movements work with the lateral hip and trunk movements the reflex was originally designed to build, giving the nervous system the input it needs to complete the developmental sequence. The movements are slow, rhythmic, and done on the floor, typically one to two minutes per day, with rest to allow integration.
For young children, activities that naturally promote Spinal Galant integration include crawling (especially cross-pattern crawling), rolling, and any movement that involves coordinated lateral hip action. Swimming (which involves rhythmic lateral body movement in a low-gravity, low-friction environment) is particularly beneficial.
For the child in the classroom right now, some immediate accommodations can reduce the constant reflex triggering while integration work proceeds: a backless chair or stool, permission to stand while working, loose-fitting clothes with soft waistbands, and, critically, understanding from adults that the fidgeting is not a choice. That understanding alone changes the emotional environment for the child, which supports integration in its own right.
Looking Ahead
The Spinal Galant introduced the body’s first lateral movement. In the next post, we’ll look at a reflex that’s all about the interplay between the upper and lower body, the Babinski Reflex, which builds the foundation for standing, walking, and the stability of the feet that carry us through every moment of our lives.
If you’re recognizing these patterns and want to explore whether primitive reflex integration might be relevant for you or your child, consider connecting with a certified BRMT practitioner. You can find more information at blombergrmt.com.
Next in the series: The Babinski Reflex: From Toes to Stability
Learn This Work From the Inside Out
If this knowledge has you wanting to move beyond reading and into practice, I’m teaching BRMT Level 1 this summer. Online (via Zoom), over eight Monday evenings (June–July, 6:30–8:30 PM ET), you’ll learn the foundational reflexes, how to test for them, and the specific rhythmic movements and isometric techniques used to integrate them. Whether you’re a parent, therapist, educator, or someone who simply recognizes these patterns in your own body, this course gives you the tools to work with them directly. No prerequisites. Just curiosity and a willingness to get on the floor.
Ready to join? Register via the link below. A $100 non-refundable deposit secures your spot, and the remaining $295 will be billed after sign-up. The full course cost of $395 includes your printed manual, which will be mailed to you upon registration.
Once you click the link below, from the dropdown menus, select:
Payment: non-refundable deposit
Taught By: Dr. Amanda Conta Steencken
Date & Location: Weekly online sessions from June 1 - July 20th, 6:30-8:30pm ET
References
Blomberg, H. (2015). The Rhythmic Movement Method: A Revolutionary Approach to Improved Health and Well-Being. CreateSpace Independent Publishing Platform.
Blomberg, H., Dempsey, M., & Smyth, M. (2011). Movements That Heal: Rhythmic Movement Training and Primitive Reflex Integration. (1st ed.). Beyond the Sea Squirt.
Capute, A. J., Accardo, P. J., Vining, E. P. G., Rubenstein, J. E., & Harryman, S. (1978). Primitive reflex profile: A pilot study. Physical Therapy, 58(9), 1061–1065. https://doi.org/10.1093/ptj/58.9.1061
Gieysztor, E. Z., Choińska, A. M., & Paprocka-Borowicz, M. (2018). Trunk rotation due to persistence of primitive reflexes in early school-age children. Advances in Clinical and Experimental Medicine, 27(3), 363–366. https://doi.org/10.17219/acem/67458
Goddard, S. (2005). Reflexes, Learning and Behavior: A Window into the Child’s Mind. (2nd ed., rev. expanded). Fern Ridge Press.
Goddard, S. (2005). The Well Balanced Child: Movement and Early Learning. (Rev. ed.). Hawthorn Press.
Goddard, S. (2023). Reflexes, Movement, Learning & Behaviour: Analysing & Unblocking Neuro-Motor Immaturity. Hawthorn Press.
Grigg, T. M., Fox-Turnbull, W., & Culpan, I. (2018). Retained primitive reflexes: Perceptions of parents who have used Rhythmic Movement Training with their children. Journal of Child Health Care, 22(3), 406–418. https://doi.org/10.1177/1367493518760736
Konicarova, J., & Bob, P. (2012). Retained primitive reflexes and ADHD in children. Activitas Nervosa Superior, 54(3–4), 135–138. https://doi.org/10.1007/BF03379591
Pecuch, A., Gieysztor, E., Wolańska, E., Telenga, M., & Paprocka-Borowicz, M. (2021). Primitive reflex activity in relation to motor skills in healthy preschool children. Brain Sciences, 11(8), 967. https://doi.org/10.3390/brainsci11080967
Zafeiriou, D. I. (2004). Primitive reflexes and postural reactions in the neurodevelopmental examination. Pediatric Neurology, 31(1), 1–8. https://doi.org/10.1016/j.pediatrneurol.2004.01.012