Primitive Reflex Integration Case Studies

Neurodevelopmental movements help with regulation and compulsive chewing

This 5-year-old boy frequently sought oral proprioceptive input, using a chew necklace on a daily basis. He exhibited heightened sensory sensitivity, and had difficulty with self-regulation and sleep. Using rhythmic movements and reflex integration from the Brain and Sensory Foundations course, his therapist greatly decreased his compulsive chewing and improved his quality of sleep; resulting in greater calm and better moods.

Submitted by S.N., M.S., OTR/L

C is a 5.5 year-old boy with hypersensitivity to auditory, vestibular and proprioceptive input. He attempts to calm through oral proprioception (sucking, chewing). He can be clumsy and have poor balance and coordination. He tends to be rigid, has difficulties calming down and sleeping and often appears “unsettled” in own body. Goals are to help C decrease his sensitivity in order to sustain engagement in class and with peers, improve balance and coordination, and create a sense of calm and confidence internally.

Based on the above challenges I decided to focus on rhythmic movements [from the Brain and Sensory Foundations First Level course], Moro reflex, and the Hand reflexes. I chose the rhythmic movements, because personally I felt they worked so well to calm and ground me. I was hoping they would have a similar effect on C. and thought that if I could encourage a consistent regulated state for him, that there would be a softening of his sensory sensitivities. C presents as rather anxious and stuck in thought so I figured Moro would maybe align. I selected hand reflexes for C since I saw so much oral seeking and some difficulty with handwriting that made me think there may be a connection there.

I felt that I noticed a shift immediately after doing the rhythmic movements. Not only did C seem calmer and approach the rest of the session more regulated, I felt more calm and relaxed in how I administered the rest of our session. It seemed really grounding for us both. His parents were open to learning the exercises and reported that they continued practicing them 3-5x a week since then. They reported increased relaxation at bedtime, falling asleep faster, and waking up in a better mood. I haven’t specifically noticed changes in his movement patterns as of yet, but this is all still very new for him. During the hand reflexes I noticed only slight flinching of his fingers. During a writing sample he had a good grasp, however, over a longer drawing session he began to tighten his grip and seemed to fatigue with an increase in coloring demand. While coloring his tongue was out most of the time, licking his lips and mouth. While we are still building upon all of this, I have noticed a decrease in his chewing during our sessions, almost never requiring a chew necklace (which he was previously using each session). His parents still report that he chews at times at home, but notice it most when getting silly with siblings and toward the end of the day.

C has taught me the power of rhythmic movements. I of course felt the impact myself, but what I don’t think I realized was just how regulating they could be and how crucial that is to set the stage for all other success.

I have been working with C on RMs and reflexes for about 2 months (8 sessions).

(Edited, emphasis added)