Saturday, February 28, 2015

Why Are You So Jumpy?: A Handy Guide to the Moro Reflex

If you’ve ever spent any time at all with me, you’ve probably noticed that I seem a bit jumpy most of the time. It’s not uncommon to see my whole body splay out like I have just seen a ghost after hearing a noise that seems insignificant to everyone else in the room. Since questions and looks of puzzlement seem to pop up (no pun intended!) all the time about this particular quirk, I have finally decided to address it in writing.
Friends, meet the Moro reflex. Also called the infant startle reflex, or just “the startle” if you know the street lingo, this guy is a neurological leftover from infancy, a souvenir, you might say. When a baby is born, he or she has a set of primitive reflexes or automatic responses to stimuli that “integrate” or go away as an infant develops. One of these is the Moro reflex. When a baby feels like he or she is falling or has lost support, the arms, legs, and fingers will extend and then retract, and the body will appear to “jump” as if frightened. In typically developing babies, the reflex will go away between four and six months of age. For me, and a lot of others with cerebral palsy, it stuck around, and makes itself known several times a day. An unintegrated Moro reflex or “startle” means that my response to sudden stimuli is hyperactive and I will react strongly to triggers even if I don’t want to.
The most obvious trigger is a loud noise, but flashes of light, sudden movements, and even strong smells can also set off the response. I do happen to be a nervous person, but having a startle does not mean I am “just nervous”. It is also quite different than the natural jumping that neurologically typical people experience. It is true that everyone will startle somewhat after an exceptionally loud noise, but not everyone will experience the involvement of the entire body or jerk forward as though something has just exploded in response to the sound of bubble wrap. So I appreciate your good intentions when you say "that happens to me sometimes when I hear *fill in VERY loud noise *” but I assure you it is not the same thing. So what does this mean for me in practical terms? How does it affect my everyday life? Here are some things I would like you to know.

1.                    The startle reflex looks very goofy and sometimes it is very entertaining. I make jokes about it all the time, but sometimes it is not funny because my whole body jerks forward, my muscles get really tight, and my heart speeds up. The startles have become increasingly painful as I have gotten older and have more spasticity in my muscles.
2.                    You don't have to apologize for startling me if you didn't do it on purpose. Sometimes something as simple as saying hello can trigger me, but that doesn't mean I'm not happy to see you or that you did anything wrong. The response is so automatic that sometimes you will set it off without doing much at all. It is okay… it happens (a lot).
3.                    Please do not set it off on purpose. It causes me physical pain and it looks funny, not to mention it can make me spill or drop everything in my hands, make me drive my chair forward by accidently hitting the joystick, or cause me to fall if I am standing. I know it is very tempting to startle me sometimes to get a goofy reaction, but please don't.
4.                    Preparing me or warning me about a trigger won't change anything. Reflexes are so automatic that they happen anyway and sometimes the warning makes me tighten up my muscles in anticipation and worsens the response.
5.                    I have to be very careful with food and drinks in places where there might be a sudden noise or motion. A startle while I'm eating could cause me to choke or spill something that could burn me.
6.                    It’s a tough blow, but I will never be a firework technician, ambulance driver, balloon artist, or electronic scoreboard operator (that buzzer, though). My motor skills are probably further reason to stay away from these job offers. Just maybe.
7.                    I will probably never date anyone in the above professions. Sorry boys. As if I need another reason not to date a clown.
8.                    I prefer if you do not tap my shoulder or touch my hand suddenly to say hello. Please come in front of me and say hi. If I startle anyway, it’s because your smile is so dazzling. (Just kidding. Don’t flatter yourself.)
9.                    If I'm at a party with balloons and clowns it is hard to tell if I look keyed up because I hate clowns or because the balloons might pop. It might be a little of both. You be the judge.
10.                Several times a day I look like I've just arrived at a surprise party. You are a narcissist if you think running into you is that exciting every time. It's just my inner four month old coming out to play. Some say it's even more noticeable on Throwback Thursday.

So what does this neurological surprise party mean in practical terms for you, and for anyone I may meet in the future?

1.    You probably don't want to sit next to me or in front of me at a combat movie. You just may get popcorn or soda showered all over you, which isn’t ideal, unless you're into that kind of thing.
2.    Don't be offended if I don't want to accompany you to a production of “Annie Get Your Gun”. You can call me though if she decides to get a super soaker.
3.    If you're sitting across from me and you plan on being loud, you may want to wear goggles because my food or whatever is in my hands may well come flying at your face.
4.    Note that I still love the Fourth of July, but the song “Firework” has a whole new meaning for me.
5.    If you have any children that like to sing, “Pop Goes the Weasel” I make a pretty adorable weasel.
6.    I will love you forever if you knock on my door softly. If you pound on it, I blame you if I punch myself in the face.
7.    I probably won't come to game night at your house if we’re playing “Operation”. Don't ask me to play “Chutes and Ladders” either. Real life has enough access fails.
8.    I have only startled due to a smell one time. So if it happens in your presence, you must smell pretty bad.
9.    Your attempt to say “Boo” in a creepy voice isn’t actually as authentically ghost-like as you think. My reflexes just make me a good audience. You are not a ghost. Don't quit your day job.
10.Feel free to throw me a surprise party (see 10 above). You don't even need to hide and jump out to get the perfect reaction, so if you're a lazy party planner, I'm your girl.

I hope that this guide has demystified the Moro (startle) reflex for you, or at least helped you to realize why I turned down your invitation to a Civil War reenactment. It’s not you, it’s me. But if I startle because of your smell, trust me, it’s you.


  1. My gosh, I adore this post. As a fellow CP blogger with a healthy dose of startle refle, this is amazing. I wrote my own (less humorous take) on this last summer:

  2. You're a great writer....Thanks for articulating something I understand all too intimately. :D

  3. LOVE this!! I've been wanting to write a post about this too, because I've had similar experiences and I was starting to wonder if my easy startling was a CP-related thing. I have one friend in particular who loves to come up behind me and scare me -- and I love her to death, but she keeps doing it, even after I explained that my startle reflex is so exaggerated that her startling me could make me fall! She only means to startle me as a joke, but I think it's hard for people to understand if they haven't personally experienced it.

    Another thing I've noticed is that if I'm REALLY startled for some reason (e.g., a really loud fire alarm), sometimes my legs will start spasming, and it's really painful...I was wondering if you've ever had that happen to you?

    I'm so excited to have found your blog (via Tonia's blog), and I can't wait to look around!

  4. Thanks for writing about this! My 2 year old son has this and it's been refreshing to have a name for it and to know he's not the only one who has to deal with it.

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  6. Thank you! If you have any questions, feel free to send me a message in the contact form.

  7. Hi I have cp as well and this is all too relatable even up to the pain .... Thankyou for making me laugh and have a great day :)

  8. Loved this post. Was researching the moro reflex as my 2 year old CP girl startles all the time and what a joy to stumble across this. So well written.

    1. Thanks! This is why I blog. I love helping people and connecting them with info. If you ever need advice or a chat, email me in the contact form.

  9. Hi my name is Juan Carlos I'm a person with CP I also started off really easily or get scared really easily I would like to have a chat with you because nobody understands me but thank you for your coming it made me feel

  10. My cousin has cerebral palsy and she cannot walk. She also gets startled very easily, where even when something like a pen falls on the ground she would shudder. I thought it had to with her CP, and it turned I was right. Very interesting.

  11. Is there any medication that helps with this ? My son's reflex is very frequent and strong. I want to help him.

    1. Hi! There is no medication to directly treat an exaggerated startle but mine did improve some when I got an intrathecal baclofen pump

  12. Dear Kathleen,
    Thank you so much for this post. It finally helped me understand my lovely 8 year old daughter Saya.
    I've always wondered what it was and no specialists could really explain it to me.
    It's what stops her from walking on her own.
    Her biggest trigger is moving fur (dogs!)
    Have you find a way to manage it? I.e. not suppress it but catch yourself when it's happening to reduce the potential danger from it? (Saya chipped her front teeths last time).
    Thank you so much for writing this with such an up beat mood!