Our Central Nervous System is our Control Centre for living. It is essential for perceiving the world around us, for moving around and doing things in it, for thinking, feeling, learning, communicating, working, playing, loving, surviving.
Anatomically, the central nervous system is composed of the brain and spinal cord. The brain may be divided into a hierarchy of centres:
1) The most evolved thinking and integrating part, the cerebral cortex at the top
2) The older brain of instinct and housekeeping in the middle
3) The oldest, the brainstem, just above the spinal cord
Of course these "centres" are not isolated, they are quite complexly interlinked, but separating them helps to understand brain processes.
"Primitive" means "earliest of its kind" and the nerve centres controlling primitive reflexes are in the oldest (most primitive) part of the brain, the brainstem.
In the womb and in early months of life the higher centres of our central nervous system are not fully developed. During this time we are protected and assisted by reflexes, controlled by lower centres of our brain. A reflex does not involve thinking; it is an involuntary response. That is: given an external stimulus (e.g. touch, noise, heat) or internal stimulus (e.g. hunger) there is an automatic, involuntary reaction if the relevant reflex is active. Reflex response varies from simple muscular movement (e.g. moving a body part away from pain) to quite complex reflexes involving body movements, breathing, perceptual and hormonal changes.
Primitive reflexes are needed for survival and development in the womb and in early months of life. As higher centres begin to mature enough for conscious control of activity, the involuntary, uncontrollable reflex responses are a nuisance except in special circumstances (e.g. quickly moving a body part away from excessive heat). The reflexes anatomically and neurologically stay for the remainder of our life, but, if all is well, they are integrated into higher centre control.
Primitive reflexes ideally begin to function in a particular order and are integrated in a specific sequence. If they are retained out of sequence, they disturb the development and integration of subsequent reflexes. If they are retained beyond their normal age of integration they can disturb some or all of the functions of higher centres, which includes behaviour, learning, the integration of gross or fine movements and more. Basically, the perception of our inner and outer environment and our response to it may be disturbed; that is, conscious life may be disturbed.
What causes reflexes to be inappropriately retained? Like all questions on the nature of life and health there are no absolute answers. From research and experience it appears that trauma of some kind is involved somewhere between conception and early months of life. The trauma can be physical, chemical, hormonal or other forms not yet researched. In utero (in the womb during pregnancy) many chemicals and hormones can pass through the umbilical cord; all manner of traumatic events can occur in the delicate early months of life; but the two big ones appears to be Vanishing Twin Syndrome at around 2-3 months in utero and birth trauma. (I include caesarian section as trauma). Statistics and clinical observation show that there may be genetic factors. These appear to be predispositions, which raise the probability of problems arising from trauma.
FEAR PARALYSIS REFLEX (FPR)
The Fear Paralysis Reflex begins to function very early after conception and should normally be integrated before birth. It can be seen in utero as movement of the head, neck and body in response to threat. It is sometimes classified as a Withdrawal reflex rather than a Primitive reflex.
If this reflex is retained after birth, it can be characterised by withdrawal, reticence at being involved in anything new, fear of different circumstances, the " 'fraidy cat " child who bears the brunt of teasing by normally adventurous children.
"Withdrawal" does not necessarily mean quiet withdrawal. The child may scream loud and long when faced with a new situation or perceived threat. A colleague reported one child who stood and screamed until he paled and passed out simply because he was transferred to an unfamiliar schoolroom. This behaviour appears to be due to the reflex's involvement with the parasympathetic nervous system. Most of us are familiar with the "fight or flight" adrenalin rush of the sympathetic nervous system; fear paralysis reflex involves the opposite "eat and stay" parasympathetic nervous system. The parasympathetic nervous system is intimately involved with the vagus nerve. This nerve may be mechanically trapped in the chest, abdomen or neck. Release of the vagus nerve entrapment corrects one physical factor, which contributes to retained fear paralysis reflex.
Inappropriate retention of the fear paralysis reflex can contribute to such conditions as Sudden Infant Death Syndrome, elective mutism, hypersensitivity to sensory information and may result in physical and psychological conditions such as Panic Disorders. As it begins first and is normally integrated first, retained fear paralysis reflex may effect the integration of any other primitive reflex.
The Moro reflex begins to function 9-12 weeks after conception and is normally fully developed at birth. It is the baby's alarm reflex.
The newborn's higher centres have not yet developed enough to make a rational decision about whether a circumstance is threatening or not. This involuntary reflex, which is a “one reflex for all occasions, protects it", so this one set of physical and hormonal events covers for most eventualities.
The reflex is set off by excessive information in any of the baby's senses. For example, a loud noise, bright light, sudden rough touch, sudden stimulation of the balance mechanism such as dropping or tilting, turns on this "one reflex suits all" reflex. The newborn arches its head back, lifts its arms up and back, spreads it hands and takes a gasp of air, then curls forwards, pulls its legs up, folds its arms across its chest and breathes out as in a cry for help. The first phase would help if the child were falling; the second seems to be a grasping to cling to mother or to protect the more vulnerable front of the body. The reflex has to cover all eventualities so the child's "fight or flight" "adrenalin rush" hormonal and neurological response is turned on, preparing the child's body for whatever turned on its alarm system.
If the Moro reflex persists beyond three to six months of age it becomes an automatic therefore uncontrollable overreaction, overriding the newly acquired higher centre decision making. The child (or adult) may be hypersensitive to any of the senses which turn the reflex on (e.g. light, sound, touch or any stress) and so may withdraw from situations. There may be difficulty with new or stimulating experiences (which the normal child would find exciting), so would have difficulty in socialising, accepting or giving affection.
Because the reflex stimulates fight or flight responses, these responses may happen inappropriately from anything in the person's environment. Fight or flight responses prepare or stimulate the body ready for fighting or for running so the child (or adult) may be an aggressive, overreactive, highly excitable person, unable to turn off and relax. These responses are for pure survival, for very focused fighting or running, not for being perceptive, sensitive or noting the subtleties of circumstances, thus the person may have difficulty functioning socially (which includes the schoolroom, playground, workplace etc.). The child (or adult) may be very difficult to understand, they may be loving, perceptive and imaginative but at the same time immature, overreactive and aggressive.
As the fight or flight adrenalin response may be inappropriately turned on many times a day and is on standby most of the time, there is a constant demand on the adrenal glands which may become fatigued. These glands are very important for the immune system, and if they are fatigued, allergy and chronic illness may be experienced.
When an inappropriate Moro reflex begins to integrate after therapy, there may be changes in emotional state or behaviour. This is common and is a good sign that the Moro is integrating. Emotional ups and downs are common as the nervous system and hormonal system readjust. With a retained Moro, the child may never have fully experienced the discovery phase of development (the "terrible twos"). As the Moro integrates, the child (or teenager or adult) has the opportunity to pass through this important developmental phase. "Terrible twos" may not appear appropriate in later years, but it is important that this phase of development runs its course.
One unusual but not uncommon occurrence is that the child's mother may also experience a period of emotional sensitivity when the child's Moro is integrating.
ATNR (Asymmetrical Tonic Neck Reflex)
The ATNR begins about eighteen weeks after conception. It should be fully present at birth and appears to assist the baby's active participation in the birthing process.
If a newborn's head is turned to one side, the arm and leg on the side to which the head is turned will straighten outward while the opposite arm and leg pull in. The reflex continues after birth and plays an important part in the development of hand eye coordination, object and distance perception.
While the ATNR is operating, the hand moves in conjunction with the head. This connection between touch and vision helps to establish distance perception and hand eye co-ordination. By the middle of the first year of life this is normally accomplished and the ATNR, being no longer required, should be integrated. If the reflex persists, the hand-eye connection makes coordinated crawling difficult. When walking, turning the head results in the straightening of the arm and leg on the same side, upsetting balance and normal walking pattern.
In early months, after hand-eye relationship is established, ATNR locks vision on to anything that catches the attention, further reinforcing object and background perception. If ATNR is inappropriately retained, the child (adult) is easily distracted by anything that attracts the attention.
With retained ATNR, difficulty may be experienced with tasks that involve both left and right sides of the body (including eyes, ears, limbs etc). Establishment of a dominant hand, leg or ear may be difficult. Turning the head may cause a visual image to momentarily disappear or parts of the visual field to be missed. Visual tracking and judgement of distance may be affected.
As each time the head is turned the arm wants to follow it and the fingers want to open, writing then becomes an enormous effort to hold the hand still or perform the subtle movements required while the head is looking up at a blackboard. To compensate for this, excessive writing pressure often occurs and/or a clenched fist pencil grip is used, both of which affect quality and quantity of writing. The act of writing requires intense concentration at the expense of thinking about what is being written; thus the child may be fluent of speech but unable to express ideas in written form.
It has been found clinically that, with retained ATNR, looking at a hand will cause neurological disorganisation and body weakness. That is, both body and mind become scrambled when the eyes are looking at a hand. This further affects writing, drawing, catching balls etc.
Adult sportspersons who suffer recurrent shoulder injury often have a retained ATNR. It appears that as their hand and eye are not functioning independently, there is a constant stress, interrupting the fine organisation required for smooth head, eye, arm, and hand coordination, which leads to structural problems, as well as affecting sports performance.
SPINAL GALANT REFLEX
This reflex is found about 18 weeks after conception and is normally integrated before the end of the first year of life. There are as many questions as answers about this reflex. It appears to take an active role in the birth process, with movements of the hip helping the baby to work its way down the birth canal.
In the newborn, stroking the low back to one side of the spine will result in side flexion of the lumbar (low back) spine away from that side, with raising of the hip on the same side. Stimulation down both sides of the spine simultaneously will activate a related reflex, which causes urination.
If the spinal galant is retained beyond normal time of integration it may be elicited at any time by light pressure in the low back region. In the classroom, the child's belt or waistband or leaning against the back of a chair may activate the reflex, creating the 'ants in the pants' child who wriggles, squirms and constantly changes body position. This constant irritant affects concentration and short-term memory (as well as getting them into trouble).
Due to the neurological association with a bladder-voiding reflex, children with retained spinal galant reflex may have poor bladder control. As the low back region is stimulated by bed sheets, the involuntary voiding reflex may be elicited so the child may continue to wet the bed despite all attempts to stop.
If the Galant Reflex remains present on one side only it may affect posture and walking gait, resulting in the illusion of a limp or contributing to spinal scoliosis.
With retained Spinal Galant the infant may not be able to maintain a sitting position. It may also interfere with the full development of the later occuring postural reflexes, affecting fluency and mobility in physical activities or sports.
Tonic Labyrinthine Reflex (TLR)
The TLR begins about 12 weeks after conception. It is elicited by bending the neck forwards (flexion) or tilting it backward (extension). It involves the vestibular system (sense of balance and position in space) and vestibular interaction with other senses. When the neck is tilted backward the limbs straighten, when the neck is bent forward the limbs bend. The reflex should be fully developed in both positions from birth, and has done its job by the end of the first year of life.
Retained flexion without extension TLR may produce the "floppy" child, while retained extension without flexion TLR may result in a rigid, awkward person with stiff or jerky movements.
If the TLR is not integrated at the correct time it will constantly disturb the balance sense in its actions, and in its interaction with other sensory systems. Head-Righting reflexes may not develop fully. If head control is lacking, eye functioning will also be impaired. The vestibular system and hearing are very closely related and many neurodevelopmental assessors now recommend that cranial faults related to this reflex be corrected before their clients participate in Sound Therapy. The child who still has a retained TLR when starting to walk cannot acquire true standing and walking security and may experience difficulty in judging space, distance, depth and speed.
OTHER PRIMITIVE REFLEXES
PALMAR REFLEX is a reflex grasping of the hand when the palm is touched.
If retained beyond the first few months of life it can impede the development of independent finger movement and consequently writing and other fine motor skills.
INFANT PLANTAR REFLEX is a reflex grasping of the foot.
If retained, placing the foot on the ground causes a reflex curling under of the toes, which can affect balance and walking. It may also contribute to ingrown toenails, shin soreness and ankle twisting.
SUCKING and ROOTING REFLEXES
Touching the lip or face near the lip of a newborn elicits head turning and lip pursing which assists moving towards the mother's nipple and suckling.
If retained beyond the first few months of life it can cause problems in chewing, eating and vocalisation.
In most cases, these reflexes spontaneously integrate when the FPR, Moro, TLR, ATNR and Galant integrate. An exception is the Palmar Reflex, which will occasionally remain due to an elbow or wrist or hand problem, which is usually easy to correct.
STRUCTURAL CORRECTION RELATED TO RETAINED PRIMITIVE REFLEXES
The Central Nervous System is so important as a Control Centre that it is housed in a membrane, which isolates it from the rest of the body. Outside that membrane, blood supplies nutrition and lymph carries wastage. Inside the membrane, a special clear fluid called cerebrospinal fluid provides nutrition and protection.
The membrane surrounding the Central Nervous System is called the Dura Mater. It attaches at its uppermost end to the inside of our skull; it surrounds our brain, brainstem and spinal cord, and attaches at its lowermost end to our tailbone. Cerebrospinal fluid is circulated mainly by the rhythmic movement of our cranial (skull) bones at the top and the movement of our sacrum (in the middle rear of our pelvis) at the bottom, joined by the dura mater between. If this cranio-sacral system is not functioning correctly, many symptoms can occur. Basically, as the central nervous system is involved, almost anything can not function at its best. Headaches, muscular imbalance, hormonal dysfunction, developmental delay (including retained primitive reflexes) and learning disability are common problems.
Cranial or sacral correction is mostly gentle pressure on a particular place or places (on the skull or pelvis) in a specific direction, often on a specific phase of breathing. This helps to restore normal membrane - bone relationship and cranio-sacral movement. As it is the cranio-sacral movement, which circulates cerebrospinal fluid, its correction helps to normalise central nervous system function.
Recently it was discovered that some cranio-sacral faults might be found only in body postures related to primitive reflexes. Furthermore it appears that these cranio-sacral problems inhibit normal integration of the reflex. Correction of cranio-sacral faults while in those postures removes the inhibition to normal primitive reflex integration. Higher centres may then integrate the reflexes. These postural cranio-sacral faults usually stay corrected, needing no further structural intervention.
Clinical experience has demonstrated over and again that in any procedure related to primitive reflexes, the order of treatment best follows the natural sequence of their integration. A minimum of one week between treatments also ensures that the previous treatment and its effects has had time to be somewhat integrated.
Structural correction, especially correction of the cranio-sacral system, can be likened to fixing the "hardware" of a computer. It does not necessarily mean that the unit then functions perfectly, for there is also the "software" to consider.
Thus structural correction is only one of a team which includes Behavioural Optometrists, Neurodevelopmentalists, Reflex Therapists, Sound Therapists, Medical Practitioners, Nutritionists, Neurofeedback, Occupational Therapists, Psychologists, Speech Therapists, Educationalists etc.
KEITH KEEN DC.DO.
SYDNEY, AUSTRALIA 1997
This information sheet is an attempt by the author to present, in plain English, some aspects of primitive reflexes, the effects of their retention, and physical correction related to their integration. Although resourced from both literature and clinical experience, the paper remains the opinion of the author at time of writing.
Many thanks to Marianne and Ken Johnson for their valued input and proofing.
This document may be reproduced provided that author, date and title are credited.