Primitive Reflex Integration Case Studies

Submitted by D.P., OTR

BS is a student, 15 years old, who has difficulty with visual tasks, teaming eyes and tracking. Difficulty expressing herself through verbal communication. Poor bilateral coordination. BS has Autism. She has had significant meltdowns related to transition. She also has significant social/emotional challenges that lead to poor peer relationships.

It is also important to note that BS rides horses quite well. She has done this activity for the past 5 years. She is outstanding at taking care of the family horse “Spirit” who pulls the wagon. BS has chores at home that she must complete on a daily basis.

Signs of Unintegrated Reflex:

• Balance problems
• Dis-coordination
• Poor bilateral coordination
• When walking downstairs: student holds the right arm in extended position with wrist slightly flexed behind her

I have worked with BS since the beginning of this school year.

Taught student rhythmic movements in the Fall with another student. She has been using it episodically with a therapist since that time. Building foundation for function.

Months later…

I am now beginning intensive work with this student over the next month. Therapist will be working with this student 3x’s/week.

I chose these particular exercises because BS is in need of calming activities.

The Rhythmic movement will also help as we begin integration of the reflexes.

It is difficult for student to get the rhythmic movement going herself. Began with passive movement. After about

30 seconds she was able to get the rhythmic movement herself.

Assigned Rhythmic movement #1 and #2 for 1 month. Sent an email home with parents and sent handout explaining the rhythmic movements. I have worked with these parents for the past 3 years. Step-mom is a paraprofessional and is excellent at working with her girls. I also sent home Brain Tune up to work on every evening. Student responded positively to the rhythmic movements and Brain Tune up [from the Brain and Sensory Foundations course]

Therapist also did the ATNR [Asymmetrical Tonic Neck Reflex] check and stimulation with BS. No meltdown related to choir (it had been occurring on a daily basis for the past 2 weeks).

Brought Step mom in for training so that they could work on the Rhythmic movements and ATNR exercises at home. BS reports that she has been doing the exercises a “little bit” at home. BS has continued with some of her meltdown’s related to choir.

She is very cooperative with the exercises.

Continued with Brain Tune up, Rhythmic movements on back and on side. She is able to get into the rhythm this week without therapist having to start her.

ATNR Integration Exercises: When completing the exercise in supine with head turned, BS is now able to keep her eyes on her outstretched hand, with verbal cue about 20% of the time. [I am seeing] significant improvement with the fluidity and rhythm of this movement.

Therapist worked on STNR [Symmetrical Tonic Neck Reflex] Activities with Student. Student actually has a relatively strong Core because she works with horses in her home environment. Therapist thought this might be helpful in integrating some of the visual skills.

The Moro Reflex and FPR [Fear Paralysis Reflex] from the Brain and Sensory Foundations course] were completed for last two weeks. Student has huge pupils. She always seems to be in Fight/flight/freeze mode. She is easily triggered. She is hypersensitive to light, difficulty adapting to change. She also seems to get fatigued easily. Challenges filtering out extraneous stimuli. We completed the Moro Reflex Stimulation exercises about 4-5 times for two weeks. This is when we finally had a break through on her ability to manage going to choir. We also used a therapy dog to go with her.

BS seemed much happier in general. Her pupils seemed to decrease in size and she seemed calmer. Therapist used the 5 step balance process with her [from the Brain and Sensory Foundations course]. The goal was to walk to choir with a happy heart. She followed along with the 5 step with no problem. She was playful in acting out the goal. There were definitely noticeable results in a short period of time.

All the teachers were commenting on it. I fessed up that I was doing intense reflex integration work with the student. She has not resisted going to choir since integrating the Moro and FPR. She has a wonderful step mom and father who are helping her. Step mom was very willing to do exercises at home in the evening. I think this makes a tremendous difference.

Both school and parents noticed that she was communicating better. Especially when she was relaxed. There was a time she was in my office and she just started talking about things about her animals at home. I was a bit in shock at the amount of words that were coming out of her mouth.

Coordination improved significantly as evidenced by her ability to complete 2 handed, crossing midline exercises with therapist and another student that she was unable to complete in the beginning of the year. I believe it had to do with integration of her reflexes and repetition of the practice.

Social/emotional challenges have improved slightly, but have a long way to go. Throughout the school year she was known to punch and kick her sister and her sister’s boyfriend who goes to the school. We had to keep them separated at lunch because of this behavior. At the end of the school year, there was a time they were all sitting at the picnic table laughing and talking. I stood there with my mouth gaping open. The other staff did also.

I am very grateful to have learned about reflex integration.

There were some significant physical changes and confidence in some of our students as a result of this [Brain and Sensory Foundations course] and these exercises.

(Edited, emphasis added)