On retained primitive reflexes
Each year I receive several emails from colleagues about 'retained primitive reflexes.' I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.
Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.' Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen.
The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyrinthine Reflex, Asymmetrical Tonic Neck Reflex (ATNR) and Symmetrical Tonic Neck Reflex (STNR). If the primitive reflexes are retained past the first year of life (at the very latest) they can interfere with social, academic and motor learning. Basically, the perception of our inner and outer environment and our response to it may be disturbed; that is, conscious life may be disturbed. Each reflex is associated with one or more of the Sensory Processing Systems: Auditory, Taste, Tactile, Smell, Visual, Vestibular, Proprioceptive and/or Interoceptive (automatic “gut” responses related to emotions). Therefore, if retained, a child may experience dysfunction within one or several of the sensory processing systems. This can lead to what is known as Sensory Processing Disorder.
This is the kind of hokum that is being placed in the IEPs of our children and is being subsidized by taxpayers. This will ultimately lead to the demise of related services in schools if our tax-supported colleagues who work in educational programs don't get on board with science-based and evidence-based practices.
Reflexes are normal motor patterns that are developmentally specific and they tend to become 'integrated' as motor skill increases. In simple terms, a baby's initial movements will be reflex-based and those movements are predictable, repetitive, and subject to specific incoming stimulus. If a newborn baby is on its belly then it will tend to curl up into a ball. That reflex is integrated as the child learns to crawl and sit and walk.
In children who have nervous system damage, like cerebral palsy, some of those reflexes never go away. You can see them long after the child should have 'integrated' that reflex and those reflexes are often associated with motor delay.
There have been some observations over time that some children with mild learning problems have some small evidence of those reflexes. These children don't have the same motor deficits as a child who has cerebral palsy, but they may have some mild or even moderate motor incoordination even if they can walk and talk and keep up with their peers (to varying degrees).
There is great variability in whether or not there is any residual evidence of those reflexes in children with mild learning problems, and even more problematically, there has never been any research that indicates that 'integrating' those reflexes does anything to help the children! There is also no standard or recognized protocol for evaluating, quantifying, or even treating the problem - although the Internet is full of snake oil about this topic.
So what do we know:
1. Children who have severe nervous system damage (like cerebral palsy) don't develop their motor skills and primitive reflexes persist. We know that motor learning, normal practice, constraint-induced practice, and similar techniques help some children with these problems learn how to move with more skill. For many years therapists used techniques based around those reflexes and their was very little evidence that those techniques were helpful. Most therapists have largely abandoned those practices.
2. Children who have mild neurological or behavioral problems sometimes have very slight evidence of those residual reflexes. No one knows if that is significant, and in fact it likely is NOT significant because it is so variable and there is no evidence to support the premise. At best, there is a weak CORRELATION between those reflexes and some learning problems. We also know that CORRELATION DOES NOT INDICATE CAUSATION.
3. We know that there are no studies that indicate that any protocol to 'integrate' anything that is being called a 'retained primitive reflex' is effective for any child. Since there are many evidence-based methods which are KNOWN to help children who have specific motor or learning problems, it is UNETHICAL to subject children to experimental theories.
4. Practitioners who are not influenced by evidence, science, and standards of acceptable practice should be avoided. Seeing statements in an IEP that 'retained reflexes' and 'sensory processing disorder' causes 'conscious life to be disturbed' is an embarrassment to any thinking person who is actually trying to help children.
If parents see statements on their child's IEP about retained primitive reflexes they should immediately complain to their CSE and school board. Therapists or other practitioners have no right experimenting with outdated and largely discredited theories on children. Parents should demand that evidence-based methods are used to educate their children in public schools.