Primitive Reflex Integration Case Studies

Young toddler no longer bottle-dependent, can eat solid foods without gagging or throwing up

When this infant started therapy at the age of 11 months, she was completely reliant on bottles for all nourishment and hydration. She could not sip from a cup or use a straw, and any attempts to eat solid food resulted in gagging and vomiting. She also exhibited gross-motor delays. Her occupational therapist began applying rhythmic movements and reflex integration from the Brain and Sensory Foundations course, and after just two sessions she started drinking with a straw. Within four months—six sessions total—she was walking, bottle-free, and successfully eating a variety of solid foods!

Submitted by Elizabeth L. Comrie, MS, OTR/L

I saw Carrie through Early Intervention for concerns with motor and feeding skills, I began working with her when she was 11 months old. At that time, Carrie had not yet pulled-to-stand or walked, was drinking bottles but not holding them, and also she was gagging on or throwing up all solid foods that were attempted. Carrie’s goals were to be able to drink from a straw or open cup for all her liquid intake and to finger feed table foods with good chewing and safe swallowing.

The tools from this [Brain and Sensory Foundations] course I used in treating Carrie’s concerns included introducing rhythmic movements 1-4 after diaper changes. I also included some reflex integration with movement play activities that I shared with her mother and father, and a vestibular stimulation program. We also used the hand and foot reflex activities [from the Brain and Sensory Foundations course]. I introduced cross crawl in play and activities for visual tracking in all three planes (up/down, left/right, and near/far).

Carrie was very responsive to the tools that I used in sessions and taught her mother to carry over with daily. Her mother reported being very diligent with completing rhythmic movements, the vestibular program, and hand/foot reflex play each day, partially I think because Carrie seemed to enjoy them all so much! It was not long before Carrie was knee walking and pulling to stand through half kneeling (after 2 sessions). She was also drinking from a straw at that point and I began seeing more tongue movements side to side in oral sensory play. Her mother began introducing more solid foods for tactile play and exposure, and Carrie began bringing them to her mouth and started actually eating them! I used these tools with Carrie for 6 sessions over 4 months. By the end of our time working together, Carrie was walking, finger feeding a wide variety of food items for both taste and texture, and was no longer drinking any bottles, instead using a straw or open cup with some assistance. She’d made tremendous progress!

I appreciated so Carrie’s mother’s dedication to her daughter and willingness to use the tools I gave her. I think she was very encouraged by Carrie’s responses and that was a key factor in Carrie’s progress. It was really incredible to see a child respond to these types of interventions to address her feeding issues, I think that many people would not have understood these underlying pieces to the feeding concerns. I also realized that I was very specific with Carrie’s mother regarding the amount of time I wanted her to complete these tools each day and I know that I need to be more clear with my families about this. I feel like Carrie’s mother was able to utilize these tools well because the expectations were clear about what I wanted her to try to do for her child.

(Edited, emphasis added)