The Importance of Reflexes in Developmental Delays
by Sally Goddard Blythe
Ever wonder why babies startle, grasp your ﬁnger or turn their heads toward an out-stretched arm? These behaviors are primitive reﬂexes that emerge as early as nine weeks in utero, and are fully present at birth. Primitive reﬂexes are automatic movements, executed without thinking. They assist in the birthing process, are essential for the infant‘s survival in the ﬁrst months of life, and provide training for many later skills.
Primitive reﬂexes are considered "aberrant," however, if they remain active beyond age 6 - 12 months. They should be inhibited by the brain, allowing more sophisticated neural structures to develop. The continued presence of any of twelve primitive and postural reﬂexes is a sign of central nervous system (CNS) immaturity, which can have a profound impact upon a child‘s development, learning and behavior.
What do reflexes have to do with learning and behavior?
Motor control lays the foundation for learning and self control. We acquire new skills by moving our bodies intentionally. To track visually left to right, to shape consonants in the mouth, and to form letters, we need to have intentional control of the muscles involved. When those muscles obey an unconscious reﬂex instead of responding to our intention, then the activity is confusing and cannot become an automatic learned skill.
Academic learning depends upon the automization of basic skills at a physical level. If a child fails to develop this automatic motor control, a teacher might observe such symptoms as reversals in reading and writing, misarticulations, poor impulse control, difﬁculty reading body language, or unsatisfactory peer relationships, despite good intelligence. Change is unlikely unless the underlying neuro-developmental problem is addressed.
What are some of the reflexes?
Three reflexes are so important in children with developmental problems that they deserve special attention. These are the Moro, Palmar and Asymmetrical Tonic Neck reflex (ATNR). These and others, their development and long term effects are elaborated upon in my book, A Teacher‘s Window into the Child‘s Mind: And Papers from the Institute for Neuro-Physiological Psychology.A Teacher’s Window Into The Child’s Mind.
- The Moro reﬂex, the earliest to emerge, forms a cornerstone for life. Characterized by rapid inhalation and sudden movement of the arms upward, followed by a cry, it is an involuntary reaction to threat. Normally inhibited by four months, it can be triggered in later life in situations of extreme danger. Long-term effects of a retained moro are vestibular-related problems such as motion sickness, poor balance and coordination, oculomotor and visual perceptual problems and hypersensitivity to light and sound. Psychological symptoms include free-ﬂoating anxiety, mood swings and insecurity.
- The palmar reﬂex, emerging at 11 weeks in utero, is characterized by an involuntary grasp with light touch to the palm. This primitive reﬂex goes back to past evolution, when neonates clung to their mothers for safety. Normally the reﬂex fades as reﬁned ﬁnger control and the ability to release develop. It is replaced by the pincer grip at age 36 weeks. Some long term effects of a retained palmar reﬂex are poor manual dexterity and handwriting, with lack of independent thumb and ﬁnger movements, no pincer grip, and hypersensitivity of the palm to tactile stimulation.
- The asymmetrical tonic neck reflex (ATNR) links turning of the baby’s head to one side with extension of the arm and leg on that side and ﬂexion of the limbs on the opposite side. In utero the ATNR provides continuous motion, stimulating balance mechanisms and increasing neural connections. It ensures a free passage of air when the neonate is prone, increases extensor muscle tone, and forms the basis for later reaching movements. After age six months, a persistent ATNR interferes with balance, crossing the midline, crawling, eye tracking, and visual- and ﬁne-motor control.
How are aberrant reflexes diagnosed and treated?
The Institute for Neuro-Physiological Psychology (INPP), Chester, UK has devised a protocol of standard neurological tests to demonstrate the presence or absence of primitive reﬂexes. On the basis of the child’s reﬂex proﬁle, the Institute prescribes a daily ﬁve to ten minute home program of reﬂex stimulation or inhibition exercises, spanning a period of 9 to 12 months. Fortunately, research shows that the "wiring" of the CNS is changeable, particularly in the early years. Follow-up studies conﬁrm progress in all areas of physical, academic and behavioral development.
Sally Goddard Blythe is a researcher and therapist at The Institute for Neuro-Physiological Psychology (INPP) in Chester, UK. Interventions such as occupational therapy, optometry, sensory integration training, and Brain Gym can help to inhibit aberrant reﬂexes. For more information about reﬂexes and for training programs in the speciﬁc techniques used at INPP, visit the INPP website at www.inpp.org.uk.[Initially published in New Developments: Volume 6, Number 4 - Spring, 2001]