# Primitive Reflex Integration Case Studies

##  Bedwetting, Fine Motor Skills, and Focus Improve with Primitive Reflex Integration

   August 23, 2024

## Rhythmic movements and primitive reflex integration help with bedwetting, handwriting skills, and ability to independently complete multi-step tasks.

This little boy with ADHD experienced frequent bedwetting, was unable to complete multi-step tasks without redirection, and struggled with fine motor skills such as handwriting. See how his occupational therapist used innate rhythmic movement and primitive reflex integration—including Spinal Galant—to initiate improvements in all these areas.

Submitted by Tiffany Sinovic, MS,OTR/L

![Bedclothes over a bedwetting accident. Text: 8year-old gets relief from bedwetting, handwriting improvements.](https://moveplaythrive.com/images/2023_Case_Studies/CS_TiSi_Pt.webp)

 | Before | After |
|---|---|
| Messy handwriting | Handwriting improvements |
| Inability to focus | More focus |
| Frequent bed wetting | So far, up to two weeks without a bed wetting accident |

Pt is an 8 year 7 month old male diagnosed with ADHD. Mom reports difficulty at school especially with messy handwriting and focus on tasks. Mom also reports frequent bed wetting at night. Current goals:

- Pt will complete 3 sentences or 3 to 4 words on practice paper with fair form, finger spacing, and fair size 2x this interim to improve handwriting in school and home.
- Pt will complete active spinal galant movements \[from the [Brain and Sensory Foundations course](https://moveplaythrive.com/index.php?Itemid=362 "Top Rated Primitive Reflex Integration Course")\] at the beginning of each session this interim to help promote reflex integration to help with bladder control at night.
- Pt will complete 3 step obstacle course with one undesired task for 10 mins included following directions and maintaining focus with min vc to improve attention and focus at desk in school.

Each session we begin with rhythmic rocking \[from the [Brain and Sensory Foundations course](https://moveplaythrive.com/index.php?Itemid=362 "Top Rated Primitive Reflex Integration and Rhythmic Movement Course")\] in all four positions followed by brain tune up. The patient completes at least one active spinal galant exercise.

So far the patient that I am continuing to currently see has displayed significant improvement in handwriting even receiving a sticker multiple times for good handwriting. Mom reports less bed wetting currently going as long as 2 weeks without an accident at night, which in the past he was having accidents a few times a week.

Pt completed at least 20 \[min\] each hour session of rhythmic rocking and reflex integration whether its active, passive, or isometric.

I have noticed an extreme change in wanting to complete the handwriting component of treatment sessions. Also noted that he is more focused during therapy and completes undesired activities without any redirection. I have learned the importance and power of rhythmic rocking and reflex integration on my ADD/ADHD population and how when the body is in rhythm the patient’s handwriting significantly improved and focus and attention. This patient has completed 6 sessions using these techniques.

(Edited, emphasis added)

- [ From Occupational Therapy Professionals: ](https://moveplaythrive.com/component/tags/tag/case-studies-from-ots)
- [ ADHD & ADD ](https://moveplaythrive.com/case-studies-conditions/adhd-and-add)
- [ Fine Motor Skills ](https://moveplaythrive.com/case-studies-conditions/fine-motor-skills)
- [ Handwriting ](https://moveplaythrive.com/case-studies-conditions/handwriting)
- [ Bedwetting, Bladder, & Bowel ](https://moveplaythrive.com/case-studies-conditions/bedwetting-bladder-bowel)