Primitive Reflex Integration Case Studies

6-year-old improves spatial awareness, coordination, and ability to keep hands to self

This first-grader with ADHD characteristics had poor spatial awareness, often accidentally hurting his classmates. He found it hard to be still or keep his hands to himself, and he exhibited poor focus and self-esteem. His mother provided rhythmic movements and reflex integration from the Brain and Sensory Foundations course, and in four months he made great progress with all of these challenges.

Submitted by Sarah Sponenburg, Physical Therapist

My son is a 6-year-old boy with undiagnosed/suspected ADHD, and challenges in the classroom and playground. For this case study he wishes to go by the name of Tom Nook. Challenges in his first grade class include difficulty keeping his hands to himself, accidently hurting children by flinging arms out while spinning and being careless and very uncoordinated with movements while in the classroom, standing in lines, and during recess especially with ball play and games of tag. Additional challenges include talking too much during class, poor focus, difficulty sitting still in seat or standing in line, and negative self talk.

Goals: Keeping hands to self; loving self with positive talk, and forgiving himself when he makes mistakes; able to listen to teacher without talking, remaining in his seat; improve coordination and body awareness in order to participate at recess without hurting anyone.

I checked all reflexes, with particular focus placed on TLR [Tonic Labyrinthine Reflex], ATNR [Asymmetrical Tonic Neck Reflex], STNR [Symmetrical Tonic Neck Reflex], FPR [Fear Paralysis Reflex] and Moro reflexes due to his challenges. TLR for balance/coordination problems and difficulty judging distance, space, depth and speed. ATNR for poor focus and coordination difficulties. STNR for squirming/fidgeting, poor hand-eye coordination and trouble staying on task. FPR for low self-esteem, low tolerance to stress and fear of failure. Moro for difficulty catching a ball, easily distracted, and poor coordination/balance. I began with rhythmic movements in order to provide a foundation.

Responses:

Rhythmic Movements from the Brain and Sensory Foundations course: Tom Nook enjoyed RM1 [rhythmic movement #1] and was compliant when singing his favorite songs for rhythm, as well as with the rhythmic movement to target ATNR integration. RM 4 he enjoyed as well with the wheels on the bus song. He did not like the other 2 rhythmic movements, and so we focused on RM 1 and 4 as they both helped integrate all the reflexes we were focusing on. We preformed these movements every morning before school for 2 minutes each, and every evening before going to bed for the same time, he did not tolerate longer periods when I tried to advance the time.

Reflexes: We did a variety of playful developmental movements and other activities from the Brain and Sensory Foundations course for a few minutes daily—or in some cases twice daily—to address TLR, ATNR, STNR, Moro, and FPR. Tom Nook had difficulty with isometric activities that required neck or arm strength.

Tom Nook and I participated in these activities 5 days a week morning and evening for a period of 4 months from October 21st, after his first parent/teacher conference, to February 14th (his 2nd parent/teacher conference). This was a total of 160 sessions including morning and night. There were 2 weeks during December that we only performed activities at night before bed. In addition to the above stated rhythmic movements and integration activities, Tom Nook was given sensory and movement breaks within the classroom time, asked to carry heavy books or carts to the front office. He had difficulty with and did not enjoy isometric activities.

Noted Changes/Improvements:

After four months of rhythmic movements and integration activities, Tom Nook was observed by his teacher and parents to have improved self control during lessons at school and at church, still requiring reminders to stop talking (however much less often), and was able to focus for longer periods during active instruction with less fidgeting.

Tom was better able to keep hands to self when standing in lines and had less incidents on the playground of accidentally hurting kids. Prior to intervention parents had calls from the principal at least once a week regarding these incidents. After intervention parents no longer received phone calls and his teacher stated she no longer saw him spinning and was more thoughtful and careful when moving his body around others. He was able to play tag without hurting others, better able to judge the speed at which he was coming towards a kid, measure the distance and accuracy of where he was going to tag the kid, and modifying how hard he tagged his playmate. Hand/eye coordination improved slightly with ball play, no longer hitting kids with balls. Negative self-talk improved as well, and he was less hard on himself when he made mistakes. He continues to need reminders for positive self talk, but he appears less anxious when he does make a mistake.

Learned Experience:

Working with Tom Nook, I learned to listen to his words and the reactions to his body when performing RM and integration activities, I felt I became a better observer even to subtle movements. I actively saw his system calm when performing these movements, and his movements become more intentional and focused. I learned that his body was craving more deep pressure stimulation. I learned that his neck, core and proximal upper extremity strength was weak and fatigued quickly which explained a lot regarding his difficulty remaining seated in a chair. I was surprised to see he had difficulty remaining in a hand and knee position. There were some activities and movements he craved and some he didn’t like at all. All in all, I became more in tune with my son’s needs and how I was able to observe them better. I paid more attention to my mood and sense of well being before giving stimulation and working on integration activities with him. It was also a very bonding experience which we both enjoyed.

(Edited, emphasis added)