Primitive Reflex Integration Case Studies

5-year-old gets help for sensory issues, motor deficits, and emotional regulation

This young boy with ASD-like characteristics was very hyper, had frequent meltdowns and tantrums, exhibited gross and fine motor deficits, and had sensory sensitivities. After 8 weeks of rhythmic movements and reflex integration from the Brain and Sensory Foundations course, he is much calmer, can sit still, isn’t bothered by sounds, has better motor skills, and is no longer experiencing meltdowns.

Submitted by Caroline Szewc, Occupational Therapist

Nathan is a 5-year-old boy with no known diagnosis, but presents with many classic traits of ASD and ADHD. He is in a self-contained kindergarten through second grade classroom. Some of his challenges include fine motor skills, sensory processing skills, behavior, and hyperactivity/impulsivity. He would always hold his pencil with a fisted grasp, and never allow an adult to correct him. He is very sensitive to loud noises and touch, but also seeks deep pressure and movement. He struggles with sitting still in class, and has frequent meltdowns if there’s a change in routine. 

I chose to implement the rhythmic movements [from the Brain and Sensory Foundations course] to start because I knew that we needed to work on regulating his nervous system, and this would help set up a foundation for integrating reflexes. After testing for reflexes, I decided to focus on ATNR [Asymmetrical Tonic Neck Reflex], Moro, and hand reflexes because of his difficulty with fine motor skills, poor balance, bilateral coordination, focus, hyperactivity and difficulty with adapting to change. 

To start the sessions, we would start with rhythmic movements. We trialed movements 1-4, but he really liked 1A/B the most. This was the thing he looked forward to the most during our sessions and immediately I noticed he seemed so calm and regulated afterwards. I then gradually introduced integration activities and play into our sessions. It was really difficult at first to even get him to follow directions and even engage him in the activities. Over time, I noticed a gradual improvement in his ability to focus and I noticed improvements in his overall coordination. Initially he was unable to cross midline, but after some time he was able to demonstrate cross crawls! He has also made so much progress with his grasp and handwriting. After about 4 weeks he went from using a fisted grasp to a tripod grasp and has become more consistent ever since. He doesn’t complain about writing and now he even looks forward to it! 

Sessions were approximately 15-20 minutes long, 1-2x a week for about 8 weeks. I also sent home exercises and demonstrated how to do the rhythmic movements so that there would be more carryover at home. Even after just 8 weeks Nathan has made so much progress! His teacher reported that he is noticeably calmer and more regulated in the classroom. Before, he was only able to sit for 1-2 minutes at a time before moving around and now he is able to sit for at least 15 minutes. He doesn’t seem to be bothered by unexpected noises. When there is a change in his routine, he does not throw tantrums like he used to. These movements have significantly helped this student be able to become calmer and more regulated, and he really seems to now enjoy school. 

I’ve learned so much working with this Nathan. I had to learn to adapt my approach to where he could be successful and work from there. He showed me that you can make significant progress without everything going perfectly, which just proves that these movements can really work if you are consistent with it.

(Edited, emphasis added)