# Primitive Reflex Integration Case Studies

##  Reflex Integration Increases Girl’s Accuracy with Scissors

   October 31, 2025

## Neurodevelopmental movements support focus and fine motor skills in 7-year-old with ADHD

This young girl often fidgeted, and had fine motor challenges along with poor eye-hand coordination. Her occupational therapist used neurodevelopmental movements from the [Brain and Sensory Foundations course](https://moveplaythrive.com/index.php?Itemid=362 "Help for attention challenges")—including rhythmic movements and reflex integration—and saw notable changes. After doing a 5-Step Balance during one of the sessions, her client’s accuracy with scissors doubled!

Submitted by Christian Baker, OT

![Before and after graphic of two paper cut-outs, showing 3/8 inch deviation from lines in the first image and 3/16 inch deviation in the second image.](https://moveplaythrive.com/images/2023_Misc_Images/Before_And_After_Gallery/BandA_GALL_ChrisBaker.webp)

 | Before | After |
|---|---|
| Inability to focus | Improved focus |
| Challenges using scissors; choppy, inaccurate cutting, deviating up to 3/8 inch all around the triangle | Improved cutting/visual motor ability; more accurate cutting, only deviating up to 3/16 inch and only on one of the corners of the triangle |

Jill, age 7, has been diagnosed with ADHD, mild intellectual disability, and autism, though—recognizing I am not qualified to diagnose—I do have my personal doubts about her autism diagnosis. She is incredibly verbal and imaginative (LOVES to talk and is very friendly/social). Her OT goals with me include using an appropriate scissors grasp to cut out simple shapes containing straight and curved lines within 3/8 inch of the cutting lines (with standard or adaptive scissors).

I used Rhythmic movements, Heart Connection, Brain Tune-Up, 5-Step Balance, and Asymmetrical Tonic Neck Reflex (ATNR) activities \[from the [Brain and Sensory Foundations course](https://moveplaythrive.com/index.php?Itemid=362 "Reflex integration course")\], with intention to go forward next with Symmetrical Tonic Neck Reflex (STNR) and Hand Reflexes, then the other reflexes as they seem beneficial. I feel like this tool sequence best addresses Jill’s need for improved focus, calming, ability to cross the midline, and to address difficulties with both gross and fine motor skills (she also receives PT services), visual tasks, poor/tense pencil grasp and other challenges with handwriting/cutting, poor hand-eye coordination, squirming/fidgeting, and some oral involvement when she rocks her head back and forth. I’m not sure if this oral involvement (opening her mouth in an “O” shape when her head turns side to side) could be an indication that she would benefit from integration of her hand reflexes, but it seems to be yet another reason why checking the hand reflexes could be important.

After doing the above mentioned movements for 6 sessions (total time 2 hours, 55 minutes), **Jill’s ability to focus without being distracted by things in the environment, or by her own thoughts, has improved.** She still talks almost non-stop, but she doesn’t jump to random topics as often. **She focuses now more easily on the task at hand.** The 5-Step Balance \[from the [Brain and Sensory Foundations course](https://moveplaythrive.com/index.php?Itemid=362 "Help for fine-motor skills")\] worked very well in the session when that was applied to improve her cutting/visual motor ability!

Goal for the 5-Step Balance: Jill will use an appropriate scissors grasp to cut out simple shapes containing straight and curved lines within 3/8 inch of the cutting lines using standard or adaptive scissors. **The results \[of using the 5-Step Balance\] were impressive!** Before when cutting the triangle she deviated up to 3/8 inch, with corners somewhat rounded. Cutting was choppy. **After the balance when she cut out the triangle she only deviated up to 3/16 inch—half the distance as did previously—and only on one of the corners** (as opposed to a whole side as she did initially). **The corners were not rounded this time.**

(Edited, emphasis added)

- [ From Occupational Therapy Professionals: ](https://moveplaythrive.com/component/tags/tag/case-studies-from-ots)
- [ ADHD & ADD ](https://moveplaythrive.com/case-studies-conditions/adhd-and-add)
- [ Fine Motor Skills ](https://moveplaythrive.com/case-studies-conditions/fine-motor-skills)
- [ 5-Step Balance ](https://moveplaythrive.com/component/tags/tag/5-step-balance-case-studies)