Primitive Reflex Integration Case Studies

Neurodevelopmental movements transform child's ability to bond with parents.

This mother cried tears of joy when she was first able to truly hug and be hugged back by her 4-year-old daughter—outstanding outcomes in one month.

Submitted by Sarah Glantz, Occupational Therapist

Iris Claire is a 4.2 yr old girl who lives with her father, her mother Tania, and two siblings.

Iris was born during the COVID pandemic in 2020. Due to Covid, Iris was discharged from the hospital 24 hours after birth. She later contracted Covid following exposure at the pediatrician’s office during her well check-up, at four weeks old. She was consequently sent to the hospital to receive a spinal tap to rule out meningitis.

Iris had RH incompatibility due to a difference between her and her mother’s blood type, which required her mother to receive anti-rejection injections during the pregnancy. Tania, her mother, later learned that the RH factor was the cause of severe anemia, resulting in Iris being a “sleepy“ baby. Iris was unable to receive in-person Early Intervention despite delays in reaching milestones due to Covid restrictions, and her overall medical condition was compromised due to the many medical restrictions at the time.

When she was awake, Iris would smile in response to her parents’ efforts to engage her, but it was a constant effort to extend these interactions for longer periods of time. When moving through gravity, Iris always held her body in a stiff position, with her arms in high guard, mouth squeezed shut and her hands clenched and tightly fisted. This resulted in difficulty hugging and cuddling Iris, as she was unable to meld her body to a hug. It was actually painful for caregivers to hold Iris for more than a few moments due to the resistance felt on one’s body.

Iris was able to move her body against gravity on the floor but often only in total body movement patterns.

Iris with stiff posture and clenched fists, unable to lean into hug with parent.Iris had delayed speech and at age 3 was diagnosed with tongue tie, but the pediatrician did not recommend surgery. Iris received speech therapy which resulted in gradually improved speech but difficulty in expressing her thoughts and feelings was still noted. With lots of love and care, Iris developed into a fun-loving, happy, playful child but always with an aloofness to hugs and cuddles. As Iris got older, she would reach out and hug her parents occasionally, but she would often arch and throw herself away when attempts to hug or be cuddled were offered to her. This behavior was perceived as a sort of bossiness in her personality as she attempted to control her environment.

When her new baby sister was born, Iris was 4 yrs old. Iris would play near her mother and the baby and smile, but usually rejected overtures of physical engagement. As Tania began to hug and cuddle the new baby, it brought to her consciousness how very distancing it is to receive physical rejection from Iris when attempting to hug and cuddle her.

Tania realized that as Iris’s mother, she was experiencing a process called “blocked care”, a term coined by Dr. Dan Hughes to describe a block in care between parent and child which could cause a distance to occur in the relationship. Blocked care can hypothetically occur on the part of the parent or on the part of the child. If a parent is going through an issue and is unable to respond to the needs of a child, e.g. medical, financial, emotional issues, etc, it causes a reduction in outreach attempts and eventual shut down. Conversely, when a parent reaches out to a child who is suffering and the child rejects the attempts, e.g. colic, medical issues, sensory defensiveness, feeding issues, etc., it places a strain and can gradually erode the relationship as well.

Iris continued to show guarded arm positon and fisted hands Iris’s mother, Tania, approached this therapist for intervention with the hopes of increasing bonding and decreasing the distance that she was feeling.

Initially, Babkin/ Palmar input [from the Brain and Sensory Foundations course] was provided to address fisted hands.

Iris appeared delighted with this tactile input and reached her other hand out to receive input to her other palm. Iris was happy to have input to her feet as well, as Babinski reflex integration was applied. Iris continued sticking out her hands and feet while begging for more of this targeted input. At the end of the session, this therapist demonstrated the process for Tania to try and Iris happily requested more and more. When the session was over, Iris happily jumped onto her mother’s lap and gave her mother a huge bear hug — full arms wrapped around, heart to heart, with a joyous giggle and smile.

Tania had tears of joy in her eyes as she hugged Iris back, the first time experiencing such a physically bonding moment.

Iris began to request her “sevens” every evening, (in reference to the holding to count of seven of each input) This has become a consistent bedtime routine, which Tania feels has significantly increased bonding between them.

Tania cradling Iris in her lap.The next reflex chosen to be addressed was the Moro reflex, as Iris was a stiff baby and currently refused hugs and cuddles. The first time Iris received Moro reflex integration [from the Brain and Sensory Foundations course], she became very quiet while positioned in supine flexion and suddenly said “I am a newborn baby."

Tania adoringly cradled Iris in her lap while Iris willingly remained in the supine flexion position, allowing herself to be rocked, kissed and cuddled while restating that she was a little newborn baby. Tania was once again in tears, stating that Iris never allowed this type of interaction. They rocked and cuddled for a long time.

Iris now requests “Sevens” and “newborn baby” treatment on a regular basis, and even goes over to her baby sister and gently applies input to the baby’s palms and feet, re-enacting reflex integration experiences. She also is agreeable to rhythmic movement, which provides vestibular input. Iris becomes extremely relaxed when her mother provides oral facial input, usually then falling asleep, a big improvement since falling asleep had previously been a challenge.

Tania feels that the rhythmic and reflex integration exercises from the Brain and Sensory Foundations course have promoted bonding and a means to a healthier relationship. In addition, Iris demonstrates more verbal expressiveness and more free flowing movement.Iris demonstrating open arms and hands and free-flowing movement. What a change!

Iris's mother Tania emphasizes that she is eternally grateful for this intervention. I have learned the effectiveness of integration of these reflexes to release hand and facial gripping and tension and for mother child bonding and relationship repair.

I am planning to work on the FPR with Iris next and see how she responds to this stimulus and integration. I look forward to seeing the results!

Duration: Four sessions, over one month