Integration refers to the inhibition by higher centers
of neurological control (cortex of the brain versus brain stem) which modify the reflex in such a way that the pattern of
response is no longer stereotypical. The reflex does not disappear; it may reactivate under stress, such as injury, severe
sickness, concussion or more severe brain injury, toxicity or intense emotional situations. If these primitive reflexes continue
to be displayed beyond the expected or typical developmental time period, their presence has traditionally been considered
an indication that underlying developmental or neurological issues may exist. As a result of better understanding of the human
neurological system today we also know that interruption of traditional infant movements, illnesses and stresses while young
prevent the reflexes from being integrated and then create additional challenges for a child or adult. Those who have integrated
their reflexes may find they resurface after the types of trauma noted above. Lack of integration of the primitive reflexes
then prevents the full development of more mature reflexes such as the postural reflexes which allow us to most fully engage
with our surroundings, sit up with ease, and maintain our balance in more challenging surroundings.
The next
logical question is what happens when the reflexes remain active beyond the infant’s 6-12 month age? When they remain
present or reappear due to trauma they indicate a remaining immaturity or weakness (Goddard, 2005) of the nervous system.
For example when a book falls to a hard floor, making a loud noise a young baby should go into the Moro reflex, straightening
out their arms and legs, then pulling them back in toward their body and end it with a hearty cry and need to be cuddled.
In contrast, those who have integrated Moro will startle, turn to assess the danger and then move on as normal when they see
the flight or fight system does not need to activate because of a book falling. For those individuals who
have not integrated their primitive reflexes, the intense response of the Moro reflex will continue to occur with the need
for more comforting and generally being quicker to be overwhelmed by their surroundings. While we won’t often see the
individual display the arms and legs extending out, as they may have enough control over their muscles to suppress this movement,
the emotional and adrenal responses are beyond their control and their environment can feel very overwhelming. Other reflexes
remaining active may interfere with a child’s visual focus, ability to read and write, make sitting in a chair difficult,
cause a child to be fidgety, affect balance skills and make it difficult for them organize their body movements; being prone
to falls, afraid to attempt playground equipment, refuse to ride a bike, hate having their feet off the ground, or toe walk
to name a few symptoms.
Over time the child and/or adult learns to put extra energy into managing their body and
pushing past these automatic directions from the brain stem. The energy to regularly push past or suppress the brain stem
commands of the reflex requires more energy and focus, taking away from a child’s ability to attend in the class room
and navigate the demands of their surroundings. When their brain and brain stem are sending contradictory messages it makes
it very difficult for a child to learn how to move their body to accomplish more advanced skills such as those needed to skip,
gallop, perform jumping jacks, play games such as tag and engage with the equipment and other children on the playground.
Older children and adults are walking around with a much more mature body that still contains elements of a baby’s conformation
within them. For those who have lost integration they suddenly find it harder to perform movements that once were easy, sitting
without a chair back may be tiring, standing is much harder and they may look for objects to lean against when standing in
line or fidget. Skiing, soccer, and bicycle riding may all become harder as limbs of the body need to perform independently
and the retained reflex is asking them to all do the same thing. It plain and simply requires more energy to overcome the
reflex and perform the voluntary movement that is desired.
The good news is that with therapy, a child and their
family can learn integration strategies and movements that are playful, more repetitive movements can be used with older children
and adults if preferred, that will integrate or reintegrate the reflex. These exercises allow the primitive reflexes to integrate
and more mature reflexes, such as the postural reflexes to be expressed. Working with the appropriate reflexes expressing
makes for easier, more skilled and efficient movement and more mature processing of the sensory stimuli around them. The world
becomes a gentler place in which to function.
For those with conditions that effect their movement patterns such as Cerebral Palsy, Down
Syndrome or in the case of Autism which can profoundly affect one’s sensory processing, reflex integration allows one’s
muscle tone to be better moderated, ability to lay on muscle mass improves, and the intensity of sensory stimuli is reduced.
While integrating reflexes will not undo these conditions, it does allow the individual to more fully access their maximum
potential.
The above information is primarily gleaned from:
Goddard, S. (2005). Reflexes, learning and
behavior: a window into the child’s mind. Eugene, OR: Fern Ridge Press.
Story, Sonia, and Steven Kane, OTR/L. Brain and Sensory Foundations - Neurodevelopmental
Movement for Physical, Emotional, Social
and Learning Skills. Vol. 1, 2017, MovePlayThrive.com.
