Neurodevelopmental Disorders & Retained Reflexes in Children and Adults

Baby's right hand grasping his father's finger (0 years and 2 months, boy, Japanese).jpg

What are Neurodevelopmental Disorders (NDs): "Neurodevelopmental Disorders" is the official term for a broad range of conditions that influence how the brain functions and alters neurological development causing difficulties in motor, social, cognitive, and emotional functioning.

Onset of NDs often occur during stages of early development which makes them present in toddlers, children, and adolescents but they often can also persist into adulthood. In some cases children can outgrow symptoms associated with NDs but in many cases untreated underlying problems can lead to compensatory and dysfunctional patterns in behavior and movement that make life more challenging.

There are many types of conditions but more common ones include motor disorders, autism spectrum disorder, communication disorders, developmental coordination disorder, attention deficit/hyperactivity disorder (ADHD), dyslexia, cerebral palsy, learning disorders, intellectual disorders, among may others.

Symptoms associated with NDs are dependent on the ND itself but some of the more common problems affects areas of:

Movement problems, missed milestones, and delays
Memory
Language and communication
Behavior
Learning
Speech and articulation
Social skills
Emotions

Early identification as well as proper nutrition, physical exercise, mind/body practices, and appropriate integration of retained reflexes all play a role in helping manage neurodevelopmental symptoms when they are present.

What are Primitive & Retained Reflexes? Primitive reflexes are involuntary movement responses that originate in the brainstem and are present in utero and after birth. These reflexes allow the baby to survive and play a role in neurological development during the first months of life. In may cases after the first year, these reflexes are no longer observed are are typically integrated into higher order voluntary movement patters as the child's neurological system and brain matures.

Primitive reflexes are considered some of the first foundational movement building blocks that a baby uses to help in development and create strong neurological connections between the brain and body. When these reflexes get "stuck" and/or do not integrate during a typical growth period or remerge later during development or adulthood, this can cause problems not only in movement, but also in cognition and behavior to occur.

When reflexes do not properly mature for a child who has neurodevelopmental disorder or reappear in an teenage/adulthood after an injury, trauma, or stress, these reflexes, which are referred to as retained reflexes, interfere directly with the child's brain and body and can create many challenges and problems.

Retained reflexes can interfere with proper neurological connections and can create difficulties in social and educational children's life. They can disrupt not only the natural process of physical and movement maturity, but also the cognitive and emotional development as well. As a result, these disruptions or disconnections in neuro-development impacts not only the individuals but also the family relationships as well.

Misdiagnosis of Movement and Behavioral Conditions: In some cases the reemergence's of reflexes may or may not look like how they initially presented in utero and early development as a baby. Especially the older and more conditioned a child or adult becomes to working with their environment, the harder these reflexes are to observe. As a result, reflexes may demonstrate themselves in more subtle ways such as physical, mental, or sensory symptoms such as autonomic changes, pain, confusion, hypersensitivity, muscle stiffness, weakness, coordination problems, ambulation problems, energy fatigue, eye strain, or other movement or learning type imbalances.

When retained reflexes are present in a child or adult, cognitive processing and/or other behavioral problems are often also associated as well. Research now strongly supports associative conditions such as anxiety, OCD, ADHD, autism, anxiety, autonomic nervous system disorders, depression, etc. with individuals who have retained reflexes present.

For this reason, early identification and a thorough examination of the nervous system beyond that of just the general check of meeting gross milestones and ankle and knee reflexes is necessary for children.

What Causes Retained Reflexes in Young Children & Adults: Retained Reflexes can occur in both children and adults. Brain injury, missed milestones, disease, trauma, illness (including Long Haul Covid), excessive overtraining, ongoing chronic stress, or other taxing and unexpected events placed on nervous system can all cause the reactivation of primitive reflexes or parts of primitive reflexes to emerge again.

Primitive reflexes serve as the foundation blocks to all voluntary movement. So in a sense, our primitive reflexes can stay with us and are part of our larger voluntary movement patterns throughout life. The difference being they are in the background and do not disrupt voluntary movement. We can even call on them subconsciously to help us lift heavy things, regain balance when we lose it, or respond to situations that are dangerous without needing to think. It is only when the body suffers in some neurological way that these reflexes again become overactive and require integration.

What Do Retained Reflexes Look and Feel Like? In many cases retained reflexes can be hard to diagnose or may go undetected in general wellness checks and physicals. Some research suggests that >65% of preschool children demonstrate signs of some retained reflex. For both adults and children, these present in different ways that include missed milestones, movement dysfunctions, speech problems, learning problems, and disruptive behaviors that can affect children and adults differently.

Some examples of associated symptoms are: poor coordination, balance, sensory perceptions, fine motor skills, sleep, immunity, energy levels, impulse control, concentration and all levels of social, emotional, and academic learning can be impacted.

If retained reflexes are not well managed as a child and/or continue to disrupt into adulthood, you may see larger imbalances that relate to social, behavioral, and relationship problems. In addition you may also see compensatory strategies that over time can lead to more severe physical symptoms such as chronic muscle tightness that do not change with stretching, chronic pain, repetitive musculoskeletal problems/injuries, neurological symptoms, or/or other systemic conditions that involve disruption to the nervous system and/or require surgical interventions.

How We Test for Reflexes: We test retained reflexes by carefully watching how you or your child interacting with different forms of movement patterns, tactile, and/or sensory experiences. This assessment process helps us to understand what specific retained reflexes, or parts of reflexes, may still be active and disrupting the brain and body connections.

In many cases, there can be multiple reflexes present affecting the nervous system so we check everything from the eyes and nose all the way to the toes. We include screening for retained reflex as part of all of our physical therapy evaluations regardless of the condition for adults and children.

How We Treat Retained Reflexes: As long as reflexes remain unintegrated, one's body will stay in a state of disharmony in efforts to try and find a balance. Once we understand what particular reflexes may be interfering you or your child, we help with this process by developing a rich self-care, movement, and multi sensory-based program to directly manage and integration these reflexes.

We use sensorimotor and neuroplasticity based techniques that are rich with proprioceptive and tactile feedback that rebalance nervous system and ultimately allow these reflexes to move into the background. Often this process helps makes voluntary control feel easier, improves energy levels, and brings more ease and balance to both the sensory, movement, and nervous system.

Addressing the body in this more holistic manner allows for truer integration and mind body balance. As this occurs, interventions such as movement training or exercise to be much more tolerable and yield more results.

How Neurogenic Tremoring Can Help Manage Retained Reflexes in Children, Teenagers in Adults: We are able to teach you or your child a technique called neurogenic tremoring to help with the treatment, management and integration of retained reflex when they are present.

Neurogenic tremoring engages directly with autonomic nervous system (ANS) through an easy to learn exercise that allows you or your child the ability to self-integrate retained reflexes. We use this technique therapeutically to help assist with sometimes harder to see underlying retained reflexes.

This technique works exceptionally well with history of neurodevelopmental problems, chronic pain and muscular stiffness/tone imbalances associated with retained reflexes and allows individuals the ability to use safely on their own as a self-care technique once learned.

We are a certified provider for neurogenic tremoring. More information can be found out here regarding the benefits of neurogenic tremoring.

Unitegrated Reflexes We Look For in Children and Adults:

It is suggested that over 50-60% of the population has retained reflexes present and one out of six children may be affected. Recent studies also suggest motor problems related to retained reflexes and sensory motor problems DO NOT disappear with age and those that do show movement pattern problems during puberty continue to go unintegrated into adulthood leading to further complications in the nervous system. Knowing this we take seriously early child identification for sensorimotor problems and retained reflexes and test for these disruptions in similar ways for both children and adults.

There are over 82 different reflexes known that currently can be tested in children and adults to see they are still active.

Below are a few of the common reflexes we see retained in children and adults along with their associated physical, cognitive, and behavior problems that may also present with each reflex.

Please note it is unadvisable to assess primitive reflexes unless you have been trained by a professional and doing so can cause further stress to an individuals nervous system. If you suspect possible retained reflex based on associated symptoms, please contact us and we can look closer together.

Fear Paralysis

Moro Reflex

Babkin Reflex

Oral and Grasping Reflexes

TLR: Tonic Labyrinthine

Spinal Galant Reflex

ATNR: Asymmetrical Tonic Neck Reflex

Hands-Pulling Reflex

Crossed Extensors Reflex

Babinski Reflex

Amphibian Reflex

STNR: Symmetric Tonic Neck Reflex

Startle Reflex

Fear Paralysis Reflex (FPR):

This reflex emerges at five to seven weeks in utero and is integrated ideally before birth (preferably before 12th week). It plays a role in protection of both unborn baby and mother. It also protects the fetus from mother's excessiv cortisol or adrenaine or other toxins by slowing or shutting down its systems. The protective response is often an abrupt motor paralysis, unresponsiveness, and an abnormal slowing of heartrate and respiration to allow all the motor's physiological resources to be available for her. When this reflex is unintegrated it can cause life-long challenges related to fear to the baby or individual. Manifestations of retained reflex can be far reaching and highly varied.

Risk Factors for retained FPR reflex:

Heavy smoking, alcohol consumption, drug addition, and medication during pregnancy
C-section delivery, highly stressful pregnancy's, premature birth, small birth weight
Sudden infant death syndrome (SIDS) in siblings
Panic Disorders, agoraphobia, or emotional distress in parents

Associated conditions when retained: ADHD, autism, central auditory processing disorder, dyspraxia, obsessive-compulsive disorder, and selective mutism.

Possible Physical and Cognitive Problems:

Increased cortisol
Hypersensitivity to touch, sound, light, smell, and/or taste
High blood sugar
Breath holding
Low digestive enzyme
Rapid drops in blood pressure
Inability to speak at times or in classroom discussion
Defiant behaviors at home/temper tantrums
Gut brain dysregulation
Panic
Sweating or Nausea
Cytokine activation of brain microglia
Hyperactive Immune system
Low Ph balance (yeast, candida, parasites due to reduced blood flow to digestive tract)
Muscular freezing following startle
Shallow, difficult breathing
Underlying anxiety or negativity
Insecure, low self-esteem
Depression/isolation/withdrawal
Constant feelings of overwhelm
Extreme shyness, fear in groups
Excessive fear of embarrassment
Isolation and depression
Inability to create eye contact
Reluctance to try new things
Staring intensely without blinking
Fear of separation from a loved one, clinging
Sleep & eating disorders
Feeling stuck
Elective mutism
Low tolerance to stress
Withdrawal from touch
Avoidance of clothes or getting dressed
Aggressive or controlling behavior, craves attention
Extreme fear of failure, perfectionism
Phobias
Low muscle tone/Hypermobility Syndrome

Moro Reflex:

The Moro reflex appears in utero (after fear paralysis reflex) after nine to twelve weeks and often integrates three to four months after birth. It is considered the "gateway" reflex and paves the way for successful emergence and integration of all the subsequent reflexes. This reflex helps with the development of breathing mechanism and birthing process. It protects the infant from excessive or sudden stimuli, and prepares the baby for maintaining vertical and horizontal head position.

Moro reflex also offers a two stage protection causing the baby to arch the head back, lift the arms up and back, spread fingers and take a gasp of air and hold it. The second stage, cases the child to curl forward, pull legs, up, fold the arms and ross the chest, clench the fists, and breath to ad cry for help. This involves a grasping response to the mother as well as protection of vulnerable body parts.

Test for retained Moro Reflex: First phase involves a quick head back movement of the baby/child done by you or by the child. This may cause a response of lifting arms up and back, spreading of fingers, and tasking a grasp of air and holding; the second phase, is then head forward motion either by you or the child with a automatic response of the legs pulling towards the chest and crossing, folding of the arms, and breathing out with cry.

Risk Factors for retained Moro reflex:

Poor nutrition
Environmental contaminants like chemicals, toxins, and electromagnetic frequencies
Birth stresses including C-sections, forceps births, breach births, and premature births

Associated conditions when retained: ADHD, autism, central auditory processing disorder, cerebral palsy, dyspraxia, dyslexia, visual processing disorders, and other neurological conditions and pathologies

Possible Physical and Cognitive Problems:

Sleep disturbances, difficulty settling down to sleep
Easily triggered, reacts in anger or emotional outburst
Increased cortisol levels
High blood sugar
Low digestive enzyme
Hyperactive immune system
Gut/brain dysregulation and/or inflammation
Shyness
Frequent crying, clingy, or fussy as baby
Poor balance and coordination
Poor stamina
Nausea
Motion sickness
Dislikes playing, tumbling, or amusement type rides
Hard to manage rapidly approaching stimuli (ball catching)
Poor digestion, tendency towards hypoglycemia
Weak immune system, asthma, allergies and infections
Hypersensitivity to light, movement, sound, touch & smell
Vision/reading/writing difficulties
Difficulty adapting to change
Cycles of hyperactivity and extreme fatigue
Easily distracted, difficulty filtering out extraneous stimuli
Difficulty catching a ball
Difficulty with visual perception
Adrenal fatigue
Panic attacks
Mood swings
Anxiety and fear
Aggressive outbursts
Difficulty giving or accepting affections
Constantly picked on
Chronic colds and/or allergies
Difficulty finishing meals/snaking tendencies
Withdrawal from new situations
Tires easily or is irritable under fluorescent lighting

Babkin Reflex:

This reflex appears at nine weeks and persists until the fourth month of life. It helps develop skills for nursing. It stimulates had and mouth behaviors together including sucking, swallowing, biting, and chewing. It also supports speech development.

Test for Retained Babkin Reflex: Pressing on the space slightly below the thumb of the baby's hand will cause opening of the mouth and bending of head forward toward chest. Doing to only one side cause head turning to that side

Possible Physical and Cognitive Problems When Retained Babkin Reflex:

Difficulty with nursing
habitual hunger
Food allergies
Constant clenching of fists
Difficulty with fine motor skills such as buttoning of clothes and writing
Eating disorders
Messy Eating
Thumb sucking or nail biting habits
Involuntary movements of mouth and tongue while writing, reading, or other activities

Grasping and Oral Reflexes:

These reflexes emerge early in utero and infancy and are generally integrated in the first year. When they're active you may see children or adults moving their tongue or mouth while drawing, writing, or using their hands. Grasp reflexes form the basis of neurological loops between the palms of the movements of the mouth.

Test for Grasping Reflex (Hand): place finger in the palm of infants hand, this will prompt the baby to curl his fingers with thumb usually underneath the index finger. Two phases consist of first grasping motion then holding.

Possible Motor and Cognitive Problems:

Speech delay or difficulties
Swallowing problems
Difficulty in social situations
Drooling
Stuttering or poor articulation
Involuntary hand movements when speaking
Manual dexterity challenges
Hypersensitivity to palms with touch
Poor pencil grip
Handwriting difficulties
Tension with writing
Gross motor skills with crawling, swimming, ad throwing and catching a ball
TMJ syndrome
Loose, easily sprained ankles
Toe walking
Flatfooted or walking on sides of feet/hip rotation
Difficulty expressing written ideas
Addictions

TLR: Tonic Labyrinthine Reflex:

TLR "forward" emerges at three to four months in utero while TLR "backward" emerges at birth. TLR forward integrates three to four moths of life while TLR backward integates more gradually persisting until age three to four years.

These both helps the baby learn about gravity, separates the front and the back, and helps further master neck, head and limb control. This reflex helps the baby practice balance, increase muscle tone, and develop proprioceptive and vestibular senses to move from the floor to all fours. This reflex helps with the organization of postural control, overall balance with standing, visual tracking, and auditory processing.

Test for Retained TLR Forward: Raising head while on back or belly: On belly causes immediate bending of arms and legs (as fetal);

Test for Retained TLR Backwards: Lowering the head to cause immediate extension of the arms and legs and stiffening (even arching) of the back; toes may point and the hands may clench

Possible Physical and Cognitive Problems:

Not walking by age two
Balance and coordination problems
Tendency for cross-eyed
Problems with math
Emotional Problems
Shrunken posture
Fatigues easily
Muscle tone usually weak or too tight
Difficulty judging distance, depth, space and speed
May have a fear of heights
“W” leg position when floor sitting
Motion sickness
Visual, speech, auditory difficulties
Auditory confusion and overload during
Difficulty blocking out irrelevant stimuli
Tendency to be cross-eyed
Stiff jerky movement
Toe walking
Difficulty following directions
Difficulty judging direction, distance, velocity, and spatial orientation (where they are in relationship to objects or others)
Difficulty walking up and down stairs
Disorganized and forgetfulness
Difficulty following directional or movement instructions
ADHD
Difficulty learning from mistakes
Unable to determine cause and effect
Unable to notice spaces between paragraphs or words
Letters may appear revered
Poor comprehension

Spinal Galant:

This reflex emerges at twenty weeks in utero and remains active for the first three to six moths of life. This reflex aids with the helping the baby navigate the passage through the birth canal and helps with development of inner ear and balance nessary for crawling and creeping. Supports muscles of lower back, buttocks, pelvis, and back of legs.

Test for Retained Spinal Gallant Reflex: This reflex is tested by touching the sides of the back lightly and looking for a bending of the lower back muscles.

Possible Motor and Cognitive Problems:

Hypersensitivity to touch especially on the back
Bedwetting
Mental fatigue
Fatigue
Attention difficulties
Difficulty with leg control
Dislike for sports
Hip rotation to one side
Prefers laying down instead of sitting activities
Challenges with school performance
Poor concentration
Poor coordination
Poor short-term memory
Fidgeting
Poor fine motor notably hand writing
Hyperactivity
Difficulty sitting still
Irritable bowel syndrome (as adult)
Scoliosis or other spinal abnormalities

ATNR Asymmetrical Tonic Neck Reflex (ATNR):

This reflex emerges in utero at 13 weeks and simulates kicking as well as slight movements for comfort while in the womb. It helps early with the development of muscle tone and during labor to navigate the birth canal during delivery. After birth, it helps develop motor skills including turning over and crawling. It also helps with developing hand-eye coordination as well as the vestibular system. Integration of this reflex helps shoulders to work independently of the neck

Testing for retained ATNR reflex: With turning of head to a side, you will see an associated opposite arm bend and leg bend. Often referred to ass "fencers pose" and is one of more commonly retained reflexes seen in children and adults.

Possible Motor and Cognitive Problems:

Dyslexia
Difficulty crossing midline
Pain with driving
Joint and bone misalignment
Scoliosis
Subluxations or dislocations of hip
Reversal of letters and numbers
Reading, listening, hand writing and spelling difficulties
Difficulty with math
Difficulty in reading comprehension
Fighting against "unseen force" when engaging in arm activities
Difficulty running, bike riding, roller blading
Tight gripping/frequent shaking out of hands with activities
Twist body or turn page 90 degrees during writing for compensation
Poor sense of direction
Confused handedness
Poor focus
Balance difficulties
Selfishness ad egocentricity
Impatience

Hands -Pulling Reflex:

This reflex emerges about 28 weeks in utero and is integrated by two months. It works to help develop ability to grasp as well as gross and fine motor movements. This helps with the ability to perform mirroring movements such as clapping or jumping jacks together ad works closely with other reflexes

Test for retained Hands-Pulling Reflex: Place child or baby on back. Wrists should be grasped and child pulled into sitting position. Stimulation of the wrists promotes bending of the elbow, followed by bending of the head towards the chest and flexion of the core.

Possible Motor and Cognitive Problems:

Difficulty drawing
Problems performing fine motor tasks
Hypotonic muscles in arms, hands and upper body
Hypertonic muscles in arms, hands, and upper body
Difficulty in coordination of L and R working together
Decrease coordination
Difficulties reading or spelling

Crossed Extensor Reflex (CER)

This reflex shows up in utero and remains active for the first or second month of life. It influences both movement and cognition. This reflex is also known as the "withdrawal reflex" and can be helpful when the need to shift off of one foot and to another for protection. It allows the individual to develop strong connections between left and right brain and provides concept of two legs. It is a critical component in athletic training and performance and enables teamwork between the limbs

Test of retained CER: Firm pressure at the center of the sole of foot (K1 acupuncture point). This causes an reaction of the other leg to first bend, move outward to the side, then tense itself.

Possible Motor and Cognitive Problems:

Poor left and right discrepancy
Poor concepts of legs
difficulty moving legs up and down or shifting body weight
Uneven walking or poor rhythm
Tripping
Poor lower extremity coordination or balance
Vision problems
Binocular vision
Difficulty with math
Poor handwriting or fine motor skills with dressing
Hypersensitivity, especially on the back
Reading difficulties
Black and white thinking
Decrease speed of perception and thinking
ADHD
Aggression
Other emotional challenges

Babinski Reflex:

This reflex appear about one week after birth and remains active in the first year of life. It helps in development of joint rotation, especially feet, ankles, knees, and hips. It also helps develop gross motor coordination allowing for crawling, standing, walking, and running. It has close ties with the vestibular system and plays a role in development of balance, coordination, speech development, and higher-level cognition skills.

Test for Retained Babinski Reflex: Pressing on the space slightly below the thumb of the baby's hand will cause opening of the mouth and bending of head forward toward chest. Doing to only one side cause head turning to that side

Possible Physical and Cognitive Problems When Retained Babinski Reflex:

Abnormal gait
Hip rotation
Shuffling during walking
Walking on inside or outside of feet
Odd wearing of running shoes
Curling of toes upward
Running or walking difficulty
Problems wearing shoes
Bunions
Balance and Stability problems
Speech problems
Poor abstract thinking
Can be present with Parkinson's, ALS, brain tumors, spinal cord injuries, spinal cord tumors, stroke, and spinal tuberculosis

STNR: Symmetrical Tonic Neck Reflex (STNR):

This reflex emerges at six to nine months and integrates between nine and eleven months it supports vision and binaural hearing. It helps the baby to begin crawling using bilateral movement, which in turns helps gross and fine motor skills. This reflex also helps develop intentional movement leading to the ability to get up on hands and knees and using the body's upper and lower halves independently.

Test for STNR: This reflex is tested by asking the child to lift their head in an all fours position or in standing. A response of arms extending and legs bending may occur. When asking the child to bend their head in all fours or standing, the arms may bend and legs straightening.

Possible Motor and Cognitive Problems:

Poor posturing - stooped shoulders, bent knees, bent hips
Head lowering at desk during work
Sitting with legs wrapped around chair
Prolonged W sitting
Challenges with farsightedness and vertical eye tracking
Squirming or fidgeting; poor posture, slouching
Difficulty crawling
Hypertonicity of muscles
Unsynchronized movements
Headaches from muscle tension
Difficulty writing and reading
Unable to catch ball
Difficulty sitting still
Difficulty copying from blackboard
Ape-like walking
Vision disorders
Short term memory issues
Lack of impulse control
Trouble staying on task
Clumsy, messy eater
ADHD
Autism

Amphibian Reflex:

This reflex is a life long postural reflex that emerges in a child between 4-6 months and develops after arms and legs are no longer dependent on position of the head. This reflex is responsible for helping develop the strength and coordination to move the arm, hip, and knee on the same side of the body to allow for crawling. This helps the baby to develop the strength and coordination for crawling.

Test for Retained Amphibian Reflex: Gently stroke the side of the abdominals to cause to see if a contraction of abdominals occurs

Possible Physical and Cognitive Problems:

Clumsiness
Excessive tension in lower legs
Difficulty Crawling
Poor hand eye coordination
Difficulty distinguishing left and right
Problems skipping
Problems walking
Problems running

Startle Reflex:

The startle reflex can appear similar to the moro reflex but can also take other form that involve different types of musculoskeletal contractions including eye blinking. This reflex is simulated by sudden or unexpected sounds, bright lights, or movements. A similar response can occurs with the head going backwards, arms and leg's extending.

Test for Retained Startle Reflex: Unexpected sounds or voices cause a startle like response or series of musculoskeletal contractions in body.

Possible Physical and Cognitive Problems:

muscular stiffness following startle
chronic uneasiness
chronic fascial tension
excessive blinking
increased heart rate
heat intolerance/sweating
Inability to tolerate crowded or noisy areas
Easily triggered, reacts in anger or emotional outburst
Shyness
Poor digestion
PTSD
Panic Disorders
General Anxiety Disorders