Retained Primal Reflexes and Learning challenges

[Night Sky]

Hi everyone. If someone can provide me with a bit of clarity on all these confusing and seemingly intertwined issues, I'd be really grateful.

My son is 10 years old and has symptoms of retained primal reflexes and learning challenges.

I hope it is OK if I try to organize this in number form, as it seems to be the only way to make it more legible:

1.
Symptoms: anxiety, bed wetting, fidgeting, dysgraphia (no dyslexia - his reading is, according to 2 tests we did, between 2 and 6 years above the grade level), emotional immaturity, occasional rigid thinking patterns, is a bit of a control freak (which I suspect comes from the attempt to control his own anxiety), can't focus very well on academics although he is very bright (assessed as very bright not only by me, but by the occupational therapist as well), was somewhat uncoordinated as a toddler (couldn't toss or catch the ball but that  seemingly resolved on it's own), poor memory for math facts and spelling facts, insomnia unless extremely tired, difficulty handling transitions (when younger, but this improved a lot, thankfully).

(He is taking several dietary supplements that definitely help the issues to an extent - iron, fish oil, magnesium, zinc, L Theanine.)

2.
After talking with OT about the symptoms, she decided to test him for Spinal galant  and it came positive. He started doing snow angels (5 reps)and bear walk (7 steps)daily, on most days, on average 5 days a week. He would not agree to do more than that. He did this for about 7 weeks, was re-tested and it was determined that Galant is still present.

At the same appointment, I wanted him tested also for: 1) Moro, 2) Asymmetrical tonic neck, 3) Symmetrical tonic neck and 4) Tonic Labyrinthine reflexes. Of these, OT determined he has retained: Moro,  Asymmetrical, and Labyrinthine. Apparently he doesn't have the STNR retained.

OT suggested he continues to do Galant exercises and add the 4 Moro exercises: Star (10 reps), Tuck and Extend (10 reps), Bridge (5 reps) and Prayer Pose (10 reps), 3 to 5 days per week.

(As a side note: since he finds all the exercises boring, I allow him to listen to children's audio books while doing them; I don't know if this impedes his progress as his mind isn't solely focused on the movements he makes, but it is impossible to get him to do these exercises without this type of a trade-off).

He was retested for Galant and Moro after about 10 weeks and both were still present. We (OT and I) agreed that we will temporarily drop Gallant exercises and focus on Moro. He was  retested for Moro after about 9 weeks and it is still present.
We are continuing to do Moro exercises, but I admit being discouraged by no progress, and  seemingly no improvement for either Moro (doing exercises for 5 months as of now) or Galant (did exercises for 4 months). But, there is no point in moving onto exercising for the next retained primal reflex on the list until Moro is integrated, right?

3.
I was researching dysgraphia resources and found Dianne Craft's program - Brain Integration Therapy - mid-line crossing exercises. I got her book and we started doing some of her exercises as well, as encouraged by OT: Writing 8s, Cross leg toe touch, Cross Crawl.

I find it stressful and time consuming to be doing both OT and BIT. What is more important to be doing now: OT exercises  for retained reflexes or Dianne crafts exercises for integration of left and right brain hemispheres and for dysgraphia?

4.
I would prefer to focus only on either integrating Moro, and doing academics of course, or Diane Craft's program (and academics) because to fit both Retained reflex exercises and Dianne Craft's program as well is very difficult for us: he needs to be constantly supervised while doing anything, is somewhat dragging his feet/is hard to persuade to start, finds it boring, so to struggle with either exercises for one retained primal reflex plus with academics OR Craft program plus academics is more than enough to fill my day. Having to do both makes me very anxious and depressed, as I seem to constantly be failing at fulfilling the plan and program for the day.

Yet, I also fear that day by day he is getting older and the window of opportunity to deal successfully with both retained reflexes and brain integration is getting smaller, so I am scared of even temporarily dropping the few Dianne Craft exercises that we do manage to do somewhat regularly. However I am also afraid that we are doing everything we are currently doing in a superficial and ineffective way because we have too much on our plate.

5.
So my questions are, if anyone has any suggestions:

   1) How long does it take to integrate Moro (if any estimation can be made)?
   2) Should we do both OT exercises for retained reflexes and Dianne Craft Brain Integration Program (mid-line crossing exercises)?
   3) If not both at the same time, which one to do first - OT for retained reflexes or BIT?
   4) Is there anything else that can help any of his symptoms that I listed above? Supplements help noticeably, but not fully; I also want to believe that the exercises that he has been doing for the last 6 months are helping some too. He is definitely calmer, more relaxed, less rigid in his thinking, more cooperative and more academically successful than before, all of which I am very happy about. However, the issues persist. The lack of focus, memory lapses and hyperkinesia...and everything else...albeit in lesser intensity, thankfully.

Any advice would be welcome and thanks to anyone who got through this amount of text!

[Rosie_0801]

1. You can't really estimate. I'm 43 and my Moro unintegrated itself recently, so I had to do a bit of work to reintegrate it.

2. You should be able to work on both the Moro and crossing midline, but if your kid is melting down because of overstimulation, cut them a break. You can reduce the other reflexes by working on them, but they won't fully integrate unless the Moro is. 

3. I'd prioritise the Moro over the midline work, but you should be able to do both,

4. Bed wetting can be a chiropractic issue. Reflexes that don't want to integrate are common with autism. 

 

Others on here know more about it than I do, so they should pop up with further information, or maybe even contradictions. It's been a while since I've needed to read up, and for reasons we didn't get to the end of this journey.

You might read up Sally Goddard's work, and show your son. Getting buy in is usually easier if the kids understand the problem, and that while their brain quirks are a hassle, they are common enough and are not character flaws.

[SKL]

I'm not an expert, but one of my kids had most of the issues you describe.  She was doing therapy for several infantile reflexes in 1st grade.  Things were going fine, but we discontinued because we were just too busy.  I reasoned that her gymnastics classes were giving her enough movement etc. at that point.

It's hard to say how much the therapies helped.  We can't know what the results of doing more or less therapy would have been.  My kid still has math difficulties despite lots of home help, tutoring, and hard work.  Impossible to say, but maybe she just wasn't born for a mathy career.

I wanted to mention that my kid ended up with an OCD diagnosis at age 13.  She shared many of your son's issues:  anxiety, tics, rigid thinking patterns, control freak, impaired focus on schoolwork despite good work ethic,  somewhat uncoordinated as a toddler, poor memory for math facts and spelling (and grammar), insomnia, difficulty handling transitions and surprises.  After my kid was diagnosed, we did some reading on the topic and realized a lot of her academics (and life skills) were affected by OCD.  The need to do certain things over and over despite that not being helpful in completing the work; avoiding certain things we're taught to do.  There are strange issues with numbers that mess with math.  Again, I really don't know how much of her academic situation results from OCD vs. other things.  She is on a medication now that does help.

[kbutton]

I agree with the others and have a few things to add.

If your child is hypermobile, fully integrating might not be quite possible, but integrating as much as possible and tweaking things later (at growth spurts, etc.) can make a world of difference anyway.

Not every therapist uses the same techniques to evaluation and treat retained reflexes--it's okay to try multiple things (but I wouldn't do it all at once). For instances, NONE of the exercises you described for Moro sound like what my child did, but I know other kids who did them. My child did duck and pigeon walking (with a whole series of tiny modifications in steps), bear walk, and maybe something else that I can't remember. I'll see if I can find videos.

Doing exercises with a distractor is usually the last step when something is almost integrated. Before that, doing them slowly and with concentration, then they get easier and more controlled, and then you might add a metronome to that exercise while started the next in the series. 

Learning and behavior issues will get better if the issue is strongly tied to the reflex in some way--for instance, if the Moro is causing developmental vision issues, and fixing the Moro improves the vision, then academics related to that will get better.

I have not found retained reflexes to completely fix learning issues or ADHD, but they help bring a happier, calmer, and more focused child to the table. Fixing reflexes DOES make a huge difference in sensory issues. The psychologist who tested my kids said sensory issues "mature" into anxiety, so it's worth working on them. 

Moro takes a lot of patience and steady work. It's not an overnight fix.

12 hours ago, Night Sky said:

Yet, I also fear that day by day he is getting older and the window of opportunity to deal successfully with both retained reflexes and brain integration is getting smaller,

I wouldn't worry about that. Brains are more flexible than we think.

I would strongly advise you to get a visual development exam by a developmental optometrist. They can potentially pinpoint and maximize therapy if the Moro or other reflexes are causing vision issues (and by extension, some of the memory and concentration issues, etc.). A good one will know what they can and can't do, and they might advise certain things before working with them or after working with them. They will do a lot of bodywork if they are good at what they do.

[kbutton]

https://www.google.com/search?q=duck+and+pigeon+walk+moro&rlz=1C1GCEA_enUS944US944&oq=duck+and+pigeon+walk+moro&aqs=chrome..69i57j69i64.5593j0j7&sourceid=chrome&ie=UTF-8

https://www.google.com/search?q=bear+walk+moro&rlz=1C1GCEA_enUS944US944&oq=bear+walk+moro&aqs=chrome..69i57j0i546l2.4472j1j9&sourceid=chrome&ie=UTF-8

So, once Moro is improved, they still might want to do some of the other reflex exercises--I think that sometimes with Moro out of whack, the other exercises are still beneficial because Moro is kind of considered the lynchpin of them all, and it kind of finishes off the Moro to do the other ones too, even if it's just a quick trip through the series. I could be wrong on that, but that's the sense I get of it.

[Night Sky]

 Rosie_0801, SKL, kbutton:

Thanks very much for your input and suggestions, I appreciate it.

Rosie_0801: I never thought that bed-wetting might be an issue that chiropractor would deal with, so I'll definitely look into it. He never, either as very young, nor now, displayed the bulk of typical autistic traits, so I don't think there is ASD at play here. To me things look more like ADHD.

kbutton:

In all fairness, he is not hyperkinetic all the time, just sometimes, a few spells during the day, but I always notice it.

I find it interesting that your child did duck and pigeon walk as an exercise to correct retained Moro - our OT uses duck and pigeon walk to test and re-test my son, and so far every time his pigeon walk has been fairly twisted, arms are very much affected by the position and movement of the feet. I would like to do some pigeon walking with him at home, but I fear that the next time he is tested by OT for Moro, he will perform well on test due to practice and not due to true integration of Moro, so that would be misleading and deceptive in our situation, possibly. Would that be the case, in your opinion?

Metronome: we tried just clapping with metronome at 54 bpm for 2minutes daily, but he is frustrated and bored with it. Would just listening to metronome while doing Moro exercises without trying to follow the beat still be beneficial?

I never noticed that he has any vision problems but I think I will actually look into developmental optometrists for him. What I forgot to mention in my OP is that he hardly  checks any boxes for Visual Processing disorder according to Dianne Craft's book, but definitely checks a lot of boxes for Auditory processing disorder. But I sadly still haven't reached that spot - where I can start working on his auditory processing problems with her exercises.  

It is also interesting (to me, as I still don't really know a whole lot about retained reflexes, even though I am trying to get myself up to speed) that your child did bear walk for retained Moro. My son did bear walk for retained Spinal galant (as advised by OT). Would it be correct to say that an exercise can be beneficial for more than one retained reflex? I thought they are very rigidly assigned to very specific retained reflex.

Would you maybe say that varying Moro exercises might be a good idea? As in introducing different ones not on OT's list for us? Or would that be counterproductive as he would not be focused on those four,  specifically recommended by OT to do?

And thanks for the links, I will definitely check them out.

[kbutton]

9 minutes ago, Night Sky said:

I would like to do some pigeon walking with him at home, but I fear that the next time he is tested by OT for Moro, he will perform well on test due to practice and not due to true integration of Moro, so that would be misleading and deceptive in our situation, possibly. Would that be the case, in your opinion?

Duck and pigeon is really difficult with retained Moro, and if it improves, it's because Moro is improving. Our vision therapist used it for both detection and as therapy.

11 minutes ago, Night Sky said:

Would just listening to metronome while doing Moro exercises without trying to follow the beat still be beneficial?

I don't know. And some exercises work better with a beat than others. Is he clapping accurately? If not, he needs more work on it. 

Our vision therapist said that we should aim for 2-3 exercises 5-7 days per week that take a total of 15 minutes. That's it. It's hard work.

13 minutes ago, Night Sky said:

What I forgot to mention in my OP is that he hardly  checks any boxes for Visual Processing disorder according to Dianne Craft's book, but definitely checks a lot of boxes for Auditory processing disorder. But I sadly still haven't reached that spot - where I can start working on his auditory processing problems with her exercises.  

I don't know a lot about Dianne Craft or her credentials, so I would look at what is listed on covd.org about developmental vision issues. My younger son had APD, and parts of his auditory processing improved dramatically after doing vision therapy, specifically his issues with hearing in the presence of background noise. He ultimately had APD therapy a number of years later that was really good at fixing the rest of his issues (igaps.org). It was unexpected for him to have such a huge improvement in APD with vision therapy to say the least! 

16 minutes ago, Night Sky said:

It is also interesting (to me, as I still don't really know a whole lot about retained reflexes, even though I am trying to get myself up to speed) that your child did bear walk for retained Moro. My son did bear walk for retained Spinal galant (as advised by OT). Would it be correct to say that an exercise can be beneficial for more than one retained reflex? I thought they are very rigidly assigned to very specific retained reflex.

I think he did Bear walk more to integrate some of the reflexes downstream from Moro, but it's been a while. There were other exercises he did too, but I know that only some were things he worked on after working on duck and pigeon. 

There is a lot of overlap in what works to integrate reflexes if you compare exercises from a variety of sources. Same for the tests to demonstrate a particular reflex. My personal theory from things specialists mentioned plus what I saw with my son is that Moro kind of underlies all of them to some extent. If it's not improved greatly or fully integrated, the others aren't going to work as well. I think that's maybe why other than Moro, a lot of the exercises get pretty mushy on which thing they improve.

20 minutes ago, Night Sky said:

As in introducing different ones not on OT's list for us? Or would that be counterproductive as he would not be focused on those four,  specifically recommended by OT to do?

If he is making progress with the OT, then I would do those, but if not, or if he's super frustrated, I don't think it would hurt to do the duck and pigeon or some of the stuff that came up on the search. It's worth asking the OT.

OTs all have their own specialty things they like to do, and sometimes they are still learning. Our OTs didn't do a lot with reflexes--we found it was the vision therapy people that did. That's probably a local difference, but the vision therapy people were very, very skilled. The OT people were too, but they had a different approach. 

[Storygirl]

I don't have advice about the primitive reflexes. But your list of symptoms suggests things that occupational therapy alone will not address. You are working so hard to help him. I think it would be beneficial for you to seek additional evaluations from a neuropsychologist or educational psychologist. They would do a full IQ assessment, as well as explore what might be causing the learning issues. The report will give you a list of accommodations to provide for his schoolwork and other ideas for what therapies might help.

In the United States, you can request for your local public school to do educational evaluations when a disability is suspected, and they are required by federal law to do testing. School testing would be free though not usually as thorough as private testing. I would also explore the possibility of autism.

[Night Sky]

kbutton: I am just now in the process of getting in touch with a developmental optometrist in our area. They do Retained reflexes testing as well, and I am thinking that retesting him by a different facility might be a good idea.

As for APD, I had looked into an Audiologist in our area as well, and still have her on my list of things. I think we'll start with the Optometrist and go from there.

Many thanks for your detailed responses, I really appreciate it!

[Night Sky]

Storygirl: Yes, I will definitelly look into educational testing as well

[PeterPan]

There are a variety of systems for working integrating retained reflexes. If you've worked on them for 30-40 days consistently, every day, and seen no progress, I would be looking for a new OT/new system. Hopefully what the optometrist is trained on will work better. Pyramid of Potential and MNRI were  both good in our house.

And yes I agree that you will need to get full psychological and psychiatric evals done to learn the remainder of what is going on. If you can find a psychiatrist (ie. MD) who does genetics and more detailed testing for mitochondrial disorders, etc. you may turn up something. 

[Night Sky]

Petar Pan: thanks for your input! Yes, I too am hoping that the developmental optometrist and their Retained reflexes testing will bring some answers, and I will be soon starting the long process of getting us to a neuropsychologist as well, however long it takes

[Night Sky]

PeterPan: "If you can find a psychiatrist (ie. MD) who does genetics and more detailed testing for mitochondrial disorders, etc. you may turn up something." Could you elaborate a bit on "mitochondrial disorders"? A bit of search I did on it didn't point to anything I see in my son. Is there a link you can share? Thanks!

[PeterPan]

9 hours ago, Night Sky said:

"mitochondrial disorders"

It's a pretty big umbrella and I don't really know much about it yet. I can tell you it has been suggested for both my kids now with symptoms much like what you're listing. The testing has improved over the last 10 years, so we may finally make a move on it. I'm just suggesting that occasionally you'll find a pdoc who does more than just hand out ssris and actually runs labs to dig in. Kids with complex presentations usually have a range of things going on. 

Edited February 20, 2023 by PeterPan