Primitive Reflex Integration Case Studies

Addressing anxiety about new situations and sensitivity to noise and light with primitive reflex integration

Find out how this occupational therapist helped herself and her 5-year-old son with sensory processing and anxiety issues using rhythmic movements and primitive reflex integration techniques from the Brain and Sensory Foundations Course.

Submitted by LN, Occupational Therapist

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The client is a 5-year-old male who is having challenges with sensory sensitivity (loud noises such as smoke alarms and sirens, visually stimulating environments, etc.), anxiety that occasionally interferes with daily activities (related to new experiences), auditory processing (difficulty attending to his name and 2-step directions due to internal distractions), and transitions (frequently yells when asked to transition and occasionally spits, kicks, hits, and/or appears silly such as laughing). His personal goals are to get better at drawing, to have fun this summer, and to feel brave when trying new things.

Rhythmic movements [from the Brain and Sensory Foundations course] were introduced as part of the client’s bedtime routine approx. 2x per week for 2 months. At the same time, massaging the ears was used occasionally to support relaxation before bedtime. During this preparatory period, the client’s TK teacher and parents observed the client making new growth including reducing anxiety, sharing more in class, mastering the ability to write his name (a skill he had been working on all school year), and improving representational drawing skills.

I checked the client’s reflexes and he showed signs of a retained TLR (Tonic Labyrinthine Reflex), ATNR (Asymmetric Tonic Neck Reflex), STNR (Symmetric Tonic Neck Reflex), Palmar and Babkin reflex (both hands), Babinski reflex (both feet), and Spinal Galant reflex (especially on the right side). He also showed signs of a retained FPR (Fear Paralysis Reflex) and Moro reflex based on the handout [Reflex Integraion Checklist].

I decided to continue to offer rhythmic movements. I also used integrations for Moro Reflex, Tonic Labyrinthine Reflex, Fear Paralysis Reflex, and Hand Reflexes [from the Brain and Sensory Foundations course].

The client had an overall positive response to the rhythmic movements, reflex stimulation, and integration activities. One of the changes observed is that the client often seemed more relaxed and more connected to his own body and to his parent by the end of the session. He sometimes appeared “silly” and made loud noises at the start of a session and after he engaged in the rhythmic movements and reflex integration activities he appeared calmer and quieter. He asked more questions, showed improved listening, and requested more movements when he was enjoying them. During the 5th session, he showed an improved ability to sustain supine flexion and required less support while engaging in the Moro and TLR integration activities. After engaging in the Moro, TLR, and hand reflex integration activities, he finished a drawing that had been difficult for him before and formed a hand on the drawing that was smaller and more controlled. On another occasion, after engaging in Moro, TLR, and hand reflex integration activities, he showed increased finger movements while coloring and increased endurance and interest in writing and coloring activities. He also used a more developed grasp for the majority of the activity (a tripod instead of a digital pronate grasp). He showed some signs of decreased anxiety around new experiences. He tried out his balance bike again, although just for a short duration since it was a very hot day. He expressed excitement about and happily played in the swimming pool on 2 different occasions which is an activity he had difficulty engaging in last summer. He moved to a new classroom at church (from the PreK to K-5th class) and did a great job introducing himself and participating with the other children. He had a dentist appointment (his first x-rays, exam, and cleaning) and had a positive experience (appeared confident before the appointment, listened well to the dental staff, and handled every part of the appointment well).

He often surprised me by wanting to do additional movements, asking for a new activity, or letting me know when he was and wasn’t feeling ready for movements.

Doing movements together fostered a greater connection between the parent and child and the child found ways to help the parent such as reminding them of movement ideas and coming up with play ideas to help both of them.

Length of time: 6 sessions, over 2 weeks, ranging from 15-25 minutes each (sessions in order were approx. 15, 20, 25, 25, 20, 20 minutes long; 125 minutes total)

Case Study 2

The client is a 37-year-old woman who is a parent to the 5-year-old in the case study above. She reports sensory sensitivity to noise, light (such as fluorescent or bright lights), and visual stimulation, especially when multiple senses are activated at the same time and she is feeling tired (such as when she hears her kids making loud noises while trying to cook dinner after work or in a large family gathering with many people talking and moving around). She reports feeling anxious such as when unexpected transitions occur. Her goals are to have reduced sensory sensitivity and to be able to connect more with the people around her in larger group settings.

I tested the client’s reflexes and she showed signs of a retained TLR, ATNR, Palmar and Babkin reflex (both hands), and Babinski reflex (both feet). She also showed signs of a retained FPR and Moro reflex.

She engaged in a movement program with her son and had several reflexes that overlapped with his retained reflexes. We therefore started with the same activities for her and her son to support modeling and connection. I used heart connection, rhythmic movements, and reflex integration [from the Brain and Sensory Foundations course].

The client had a positive response to the rhythmic movements, reflex stimulation, and integration activities. Overall, she felt more relaxed after the sessions and felt an increased connection with her son while doing the movements together and after engaging in the sessions together. She noticed several times when multi-sensory environments felt easier and less overwhelming for her, such as feeling less overwhelmed at a large, noisy family gathering and during a social time after church. She felt like she was able to engage in more conversation with those around her than she typically does. She was noticed a time when she able to stay calm and grounded when her son was upset and yelling while she was trying to make dinner.

She said: “Doing this with my son was special and helped me feel more connected to him and more playful with him.” I also noticed that doing the reflex integration movements personally also allowed me to teach and adapt the movements better while helping my son with his movement program.

Length of time: 6 sessions, over 2 weeks, ranging from 15-20 minutes each (sessions in order were approx. 15, 15, 20, 20, 20, 20 minutes long; 110 minutes total)

[Edited for length and clarity, emphasis added]