Primitive Reflex Integration Case Studies

Rhythmic Movements and Reflex Integration Help 9-Year-Old Boy

Despite receiving numerous therapies, this 4th grader continued to stutter and had nearly illegible handwriting. This occupational therapist used rhythmic movements and primitive reflex integration from the Brain and Sensory Foundations First Level course, to greatly improve his handwriting and address his stutter. He also initiated more conversations!

Submitted by Tina Palanchar, OTR/L

Larry is a 9-year-old 4th grade student. He is diagnosed with a Specific Learning Disability. He receives occupational therapy, speech therapy, social work and academic support in math and reading. He has a mild-moderate stutter when speaking. He often has a difficult time with reciprocal conversations. I started working with this student when he was in 2nd grade. His handwriting was a huge concern at that time—almost illegible. When having a conversation with Larry, he would often stutter 4-5 times per half-hour session. I started using primitive reflex exercises and rhythmic movements with him when he was in 3rd grade. I work with him once per week. He was not seen over winter break (December 22, 2023—January 17, 2024) or summer break (June-mid August). He was seen roughly one time per week over an 8-month period last school year and one time per week over 1.5 months this current school year.

I chose to do rhythmic movements, grasp reflex and palmar/babkin reflex exercises with this student. I chose the rhythmic movements because the cerebellum has direct links to the speech centers of the cortex. Doing rhythmic movements helps develop the pathway through the cortex. I also chose the hand reflexes because when unintegrated, the movements of the mouth and hands are often connected which can have a connection to stuttering. I have done some other reflex exercises with him, but the hand reflexes and rhythmic movements are the ones I have done the most with him.

I typically start my sessions with most of my students with the rhythmic movements [from the Brain and Sensory Foundations course], then move on to one or two other exercises, then to a tabletop activity. Larry had reported in 3rd grade that he enjoyed the rhythmic movements. During one of his sessions in 4th grade, I did not start with the rhythmic movements because I didn’t think he really liked doing them anymore. We jumped right into some midline crossing exercises and a tabletop activity. At the end of the session, he was given free choice in which he got to choose an activity to do. He asked if he could do the rhythmic movements. I was initially shocked, but also so happy at the same time. I said “Of course!” He reported that he still likes the rhythmic movements. That they make him feel calm.

He participates in the hand reflex exercises also. Initially he did not like them. He said they were too hard. We have been continuing with them and they have definitely gotten easier for him. He is demonstrating better handwriting skills. His handwriting is much more legible than in the last couple years. He still needs some work on it, but it is significantly better. The speech pathologist recently commented that she hasn’t heard him stutter this year. The student initiates conversations and takes part in reciprocal conversations much more than last year. I am so happy I took this course. I have learned so much! Taking this course makes me want to help everyone—not just students, but staff, family and friends as well. Thank you!

(Edited, emphasis added)