Primitive Reflexes and Their Impact on Development

In our recent Airway Circle webinar, Dr. Josh Madsen shared invaluable insights into primitive reflexes and their profound impact on development. These reflexes, which originate in the brainstem, play a critical role in laying the foundation for brain development and function. Here’s a breakdown of the key points from the webinar.

What Are Primitive Reflexes?

Primitive reflexes are automatic, involuntary movements present at birth that support the development of the nervous system and motor skills. They act as building blocks for the rest of the brain and body. Ideally, these reflexes should integrate or inhibit as the brain matures. When they don’t, retained reflexes can create challenges in learning, behavior, motor skills, and more.

Key Primitive Reflexes and Their Integration Timelines

1. Asymmetrical Tonic Neck Reflex (ATNR):
• Helps develop hand-eye coordination.
• Should integrate by 6 months.
2. Symmetrical Tonic Neck Reflex (STNR):
• Supports crawling and body coordination.
• Should integrate by 9-11 months.
3. Moro/Startle Reflex:
• Prepares the body for the fight-or-flight response.
• Should integrate by 2-4 months.

The Impact of Retained Reflexes

When primitive reflexes remain active beyond their typical timelines, they can interfere with development in various ways:

• Motor Skills: Difficulty with gross and fine motor tasks.
• Eye Tracking & Visual Processing: Impaired ability to follow objects or process visual information.
• Muscle Tone & Posture: Issues with core stability and alignment.
• Behavior & Attention: Struggles with focus, hyperactivity, or inattentiveness.
• Speech & Oral Motor Function: Delays or difficulties with articulation and feeding.
• Balance & Coordination: Clumsiness and difficulty with activities like riding a bike.
• Emotional Regulation: Increased anxiety and sensory processing challenges.

Assessing Primitive Reflexes

Testing for retained reflexes involves observing specific physical responses:

• ATNR: Assess arm and head movement alignment on hands and knees or while standing.
• STNR: Evaluate head flexion/extension on hands and knees.
• Moro: Look for exaggerated startle during a quick backward movement.
• Gait Analysis: Check for toe-walking and upper body movement patterns.

Treatment Approaches

Dr. Madsen recommends a multifaceted treatment model:

1. Reflex Integration: Start with intensive reflex-focused exercises for 2-4 hours daily over 1-4 weeks.
2. Oxygen and Energy Support: Techniques like laser therapy to enhance energy flow.
3. Vestibular and Visual Integration: Incorporate activities targeting balance and eye coordination.
4. Home Program: Follow-up exercises to reinforce progress.

Collaboration with Other Specialties

A successful treatment plan often involves a multidisciplinary approach:

• Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy: For motor and oral function improvements.
• Airway and Breathing Assessments: Identify and address underlying issues.
• Metabolic Factors: Review nutrition and energy levels.
• Cranial Nerve Function: Ensure proper nerve coordination.

The Big Picture

Addressing retained primitive reflexes early can significantly improve a child’s developmental trajectory. By integrating targeted therapies and a collaborative care model, we can set the stage for better motor skills, emotional health, and overall quality of life.

Want to learn more? Catch the full webinar recording with Dr. Josh Madsen on Airway Circle!