Primitive Reflexes (Part IV)

In my clinical practice, I will initially meet with a child and his or her parent or guardian to complete intake paperwork and consent for treatment.  It is during this session that I will obtain some background information about the child and what issues he or she is currently experiencing.  Additionally, it is during this session that I will assess which of the child’s primitive reflexes are active and which reflexes have been integrated.

The next couple of session, I will teach the parent or guardian and the child the various exercises of Rhythmic Movement Training.  The next couple of sessions will be used to ensure that the exercises are being done correctly and to monitor the child’s progress.  Rhythmic Movement Training only requires a couple of sessions with a counselor, as most of the “work” takes place at home.  This “work” takes about five to ten minutes a day, once or twice a day.

Primitive Reflexes (Part III)

In my own clinical practice, most children with developmental trauma, or reactive attachment disorder, have many retained primitive reflexes.  Children with developmental trauma or attachment issues, generally come from home environments that are usually neglectful and abusive—a less than ideal environment for a developing child.

This less than ideal environment, with its lack of stimulation, contributes to primitive reflexes remaining unintegrated.  Consequently, since the foundation of the child’s development is not sound, the rest of the child’s development is disrupted—our tower of blocks may topple over.

As mentioned previously, most children with developmental trauma or reactive attachment disorder that I have worked with have many retained or unintegrated primitive reflexes.  In almost all of these children, the Moro Reflex has been retained.  As noted previously, the Moro Reflex is the infant’s primitive “fight or flight” response; and, along with the other primitive reflexes, assist in brain growth and maturation.

The “fight or flight” response is essential for our survival.  It allows us to act when confronted with a threat without having to consciously think about what to do.  The problem is not the “fight or flight” response.  The problem is when this response is activated at the child’s misperception of a threat or when no apparent danger is present.

Many children with developmental trauma or reactive attachment disorder are stuck in a “fight or flight” response—partly due to an unintegrated Moro Reflex.  This “fight or flight” response has become the norm for many of these children.  This almost constant state of arousal can have serious medical and mental health consequences for the child.

As the child continually uses this type of response to stresses in his/her environment, the “fight or flight” response becomes more “hardwired” in the child’s brain.  This is the reason why when many children with developmental trauma or reactive attachment disorder are removed from their neglectful and abusive environments, they still continue to act aggressively (a fight response) or they continue to act withdrawn and quiet (a flight response).

Primitive Reflexes (Part II)

The Moro Reflex

The Moro Reflex first develops in utero and generally is integrated by four months.  It is the infant’s primitive “fight or flight” response.

The Moro Reflex is associated with the following sensory systems:  vestibular, proprioceptive, auditory, tactile, and visual.  Children with an unintegrated Moro Reflex may be hyper reactive, be hyper sensitive, have balance issues, have a dislike of change, be easily distracted, have poor impulse control, and vestibular related problems.

The Palmer Reflex

The Palmer Reflex develops in utero and is generally integrated at two to three months.  It is this reflex that makes the infant grab when something is placed in his or her hand.

The Palmer Reflex is associated with the following sensory systems:  tactile and proprioceptive.  Children with an unintegrated Palmer Reflex may have poor fine motor skills, have poor manual dexterity, and have poor handwriting.

The Tonic Labyrinthine Reflex (TLR)

The TLR develops in utero and is generally integrated at three to four months.  This reflex helps the infant with holding his or her head up and developing a sense of balance.

The TLR is associated with the following sensory systems:  vestibular, proprioceptive, auditory, and visual.  Children with an unintegrated TLR may have poor posture, have poor muscle tone, walk on their toes, have poor sequencing abilities, have poor balance, have spatial orientation issues, and have poor organizational skills.

The Asymmetrical Tonic Neck Reflex (ATNR)

The ATNR develops in utero and is integrated between three and six months.  This is one of the reflexes that assists the infant through the birth canal.

The ATNR is associated with the following sensory systems”  vestibular, proprioceptive, auditory, and tactile.  Children with an unintegrated ATNR may have difficulty with hand-eye coordination, have issues with visual tracking, and have difficulty crossing the vertical midline.

The Spinal Gallant 

The Spinal Gallant develops at birth and is integrated at three to nine months.  This reflex also assist the infant in the birthing process and assists in the development of the vestibular system.

The Spinal Gallant is associated with the following sensory systems:  proprioceptive, auditory, and tactile.  Children with an unintegrated Spinal Gallant may have difficulties with fidgeting, experience bed wetting, have poor concentration, have short-term memory issues, and have postural issues.

The Rooting Reflex

The Rooting Reflex first develops at birth and is usually integrated at six to ten months.  The purpose of this reflex is to assist the infant with feeding.

The Rooting Reflex is associated with the following sensory systems:  tactile and proprioceptive.  A child with an unintegrated Rooting Reflex may be a picky eater, engage in thumb sucking, and have speech problems.

The Symmetrical Tonic Neck Reflex (STNR)

The STNR develops at six to nine months and is integrated by nine to eleven months.  This reflex prepares the infant for crawling and is important for proper body posture.

The STNR is associated with the following sensory systems:  vestibular, proprioceptive, and visual.  Children with an unintegrated Spinal Gallant may slump while sitting or W sitting, have poor muscle tone, and have poor hand-eye coordination.

 

Primitive Reflexes (Part I)

Primitive reflexes are automatic, stereotypical movements that are controlled by the brainstem and sometimes by the midbrain.  These reflexes are an involuntary response to some type of stimulus and require no thought.  The primitive reflexes are the first foundations of the nervous system and assist in brain growth.  They are like the base blocks in a block tower.

Primitive reflexes begin to develop in utero.  They serve two purposes.  First, primitive reflexes help in the survival of the infant when his/her nervous system is not fully functional (meaning the infant does not have a lot of voluntary control over his/her movements).  Second, they help the infant with moving.  As primitive reflexes are integrated, voluntary movements will take place; which in turn, assist in the development of balance, vision, hearing, speaking, communicating, and learning.

There are many reasons why primitive reflexes could be retained.  Some of these reasons include:  a cesarean section birth, trauma, environmental toxins, not enough “tummy time,” delayed or skipped creeping or crawling, an excessive amount of falls, and chronic ear infections.  It should be noted that the birth process is important to the development and inhibition of some primitive reflexes.  A child born by cesarean section or who experienced birth trauma may be at an increased risk of having retained reflexes.

Children with retained primitive reflexes may have social, academic, and motor learning difficulties.  There is a relationship between neurodevelopmental disorders such as ADD/ADHD, Sensory Processing Disorder, and Autism and retained primitive reflexes.  Each reflex has its own symptomatology if unintegrated and will be discussed in greater length in future blogs.

Considerations When Choosing A Counselor Who Works With Attachment Issues

There are two main considerations when choosing a counselor who works with attachment issues—the type of mental health professional and the training of the mental health professional.  There are many different types of professionals who provide mental health services.  First, let’s start with counselors.  A counselor has completed either a Master’s level program (M.A. or M. S.) or a doctoral level program (Ph.D. or Ed.D.).  In addition, a counselor also possess a license (LPC).  Counselors are trained in a variety of counseling theories and techniques.

Another type of mental health professional is a social worker.  Like a counselor, a social worker has completed a Master’s level program (MSW) or a doctoral level program (DSW).  These individuals are licensed (LCSW).  Similar to counselors, social workers are trained in a variety of theories and techniques.

Another common mental health profession is a Marriage and Family Therapist.  Like counselors and social workers, these individuals have completed a Master’s level program (M.A. or M.S.) or a doctoral level program (Ph.D.).  In addition, this individuals are licensed (LMFT).

A clinical psychologist is another type of professional that provides mental health services.  These individuals have completed a doctoral program (Ph.D. or Psy.D.) and are licensed (L.P.),  Psychologist provide testing and counseling services.

Finally, a psychiatrist is another type of mental health professional.  These individuals are medical doctors with specialized training in mental health issues.  Psychiatrist are designated by the initials “M.D.” or “D.O.” and are able to prescribe medications.  Most psychiatrist provide limited, if any, counseling services and mainly manage medications.

Children with Reactive Attachment Disorder have complex issues.  For that reason, I would recommend, at a minimum, that the counselor be licensed.  It takes a minimum of two years for a counselor, social worker, or marriage and family therapist to obtain licensure after graduating college.  This two-year period gives the counselor time to gain experience and additional training to work with children who have Reactive Attachment Disorder or attachment issues.  I would be extremely skeptical of a counselor who is provisionally licensed or is working under the license of an agency to provide counseling services to children with Reactive Attachment Disorder.

The other consideration when choosing a counselor who works with children with Reactive Attachment Disorder is the training of the counselor.  Does the counselor have training in attachment issues?  Such training would include Dyadic Developmental Psychotherapy, Attachment-Focused EMDR, Somatic Experiencing, and Neurofeedback.  Additionally, does the counselor provide psychoeducation regarding Reactive Attachment Disorder and parenting?

As most children with attachment issues also have trauma, the counselor needs to have advanced training in this area.  Such training would include EMDR, Somatic Experiencing, and certain types of play therapy.

There are many considerations in choosing a counselor who works with attachment issues.  I hope these suggestions can offer guidance to families seeking attachment-focused therapy.