Developmental Practitioners' Association

FAQs

• Q: What causes neuro motor immaturity?

  A: There is no definitive answer – it is the debate about nature or nurture.
  Nurture: The development of primitive reflexes can be halted in their development possible because of the lack of stimulation so for instance the lack of stimulation to babies who remained in their cot in Soviet Romania often had serios developmental delay issues. The British Association of Behavioural Optometrist (babo.co.uk/retained-primitive-reflexes) say that retained primitive reflexes may be caused by ‘Traumatic birth experience ….. c-section … and falls, trauma, lack of tummy time, delayed or skipped creeping and crawling, chronic ear infections, head or emotional trauma etc.’
  Nature: Certainly, from my experience as a therapist and my own family history it would seem that neuro motor immaturity can be passed down through the generations.
  Pete Griffin Open Doors Therapy.

  A: I completely agree with Pete and would like to add that if babies are not given sufficient floor time, on both their back and front, then this may lead to problems. Overuse of equipment such as baby walkers and other ‘containers’ can also prevent babies from developing their movement patterns naturally.
  Janice Graham Move to Maximise

• Q: Should you work with someone with cerebral palsy?

  A: The general advice is that you should not work with someone with brain injury. The underlying cause is injury to the brain and this in itself may be the cause of unintegrated primitive reflexes. In my experience the benefit of therapy can be very varied. However, some clients have benefitted particularly physically in terms of balance and co-ordination. The support from occupational therapy and physiotherapy can be limited and patchy and even if not, it may be that neuro development therapy has something to add.

  Pete Griffin Open Doors Therapy.

  A; I have worked with clients with cerebral palsy who have benefitted in terms of balance and co-ordination. In the work I do, we are trained to use the ‘less is more’ approach and always be guided by our client, closely observing for the signs that indicate the client has done enough. Working with these principles enables us to work with a range of clients.
  Janice Graham Move to Maximise

• Q: An occupational therapist will sometimes suggest that a child uses a writing slope. How does this work?

  From a primitive reflex point of view moving the head up and down can trigger the symmetrical tonic neck reflex, or the tonic labyrinthine reflex or both. By having the more upright position the influences of these reflexes upon handwriting and posture may be reduced. Unfortunately for a child with a strong asymmetrical tonic neck reflex, the ability to adapt and lean to one side, look at their writing side one or angle their paper is harder and in reality for many their writing worsens. In practice I have found that standing to a high counter or desk is of more benefit to many children
  Pete Griffin Open Doors Therapy.

  A: I completely agree with Pete.
  Janice Graham Move to Maximise

• Q: How long does it take to integrate the primitive reflexes?

  A: In my experience this is a difficult question to answer, as it can vary between individuals, depending on the nature of their challenges. When working with children, I let parents know upfront that they need to commit to a programme of one year (and sometimes longer). Patience and persistence are needed, with parents required to commit to daily integration activities with their children. That said, I have had some children who make rapid progress, even within the space of a few sessions.
  We also need to remember that reflexes that are inhibited and integrated in infancy can later reactivate because of trauma, injury, toxins and stress.
  Janice Graham Move to Maximise

  A: I rarely work with a client for more than a year. Generally, I begin to doubt myself if I do not see some positive signs within three months, but that is just me. There may be some residually retained reflexes after twelve months but they usually have minimal effect upon the client. I usually say to the client lets leave it for eight to ten months and see if nature will continue the work we have started.
  Pete Griffin Open Doors Therapy.

• Q: Can adults benefit from reflex integration?

  A: If unintegrated reflexes are not addressed in childhood, then the individual can be affected by them throughout life. This can cause both postural and emotional challenges. In order to function when we have retained reflexes, we learn to compensate and our posture can become compromised. For example, we lock our spine to prevent wriggling if we have a Spinal Galant Reflex retained and then this can lead to discomfort and backache. I have worked with adults who have successfully improved their posture and quality of life through reflex integration.
  Janice Graham Move to Maximise

  A: I personally do not have the confidence to work with adults. I do know that reflex integration can be life changing for them, but I do not have the confidence to council them as they go through the changes. I always refer them to someone who has that confidence and experience.
  Pete Griffin Open Doors Therapy.

• Q: Can my child start a therapy for reflex integration at the same time as them having other therapies, for example physiotherapy and undertaking a sensory integration programme?

  A: It is important not to over stimulate the child’s system due to them having similar therapies at the same time. It is therefore advisable that the child stops any other physical sensory integration program whilst they are having therapy to integrate their reflexes. The child can however continue to have skills based therapies or nutritionally based therapies at the same time. If you are worried about potential overstimulation, through use of different therapies, you should speak to your therapist about this. Your therapist can monitor the potential of the child’s system being overwhelmed and should reduce stimulation and/or change exercises accordingly so that it is dosed at a level that the child can tolerate.
  Helen Maddix Open Doors Therapy.

  A: I once had an enquiry from a client and during the discussion found that they were having over three other different therapies and had been doing them for over two years. I talked about overload and the parent got quite upset, particularly when I said that I would not work with their child whilst they were doing the other three. If I was going to work with them they would have to take a break from the others for at least six months. They said that they would go away and think about it. I kept getting messages from them saying that the other organisations said that there would not be a problem but I stood my ground. In the end I said, “Look I think that you are doing too much and possibly overloading, but I could be wrong. If the other therapies are working you do not need me. Go away and think about it. But I do not work with children who are doing other similar things, I believe that we could overload the child and my first principle is to do no harm.’ I thought that I had lost them but after 6 weeks they contacted me and we have worked well together.

• Q: What is Neural Plasticity and how does it inform reflex integration programmes?

  A: Neural Plasticity is where the brain can reorganise itself and form new neural connections. This means that in spite of prior pruning, deprivation, injury, damage or disease; new experiences and stimulation (e.g. reflex integration) can bring about new learning and/or recovery to the functioning of the brain. This means that by repeating the same thing (e.g. the reflex stimulation/inhibition exercises) regularly (e.g. every day) over a duration (e.g. over approximately one year) it can change the pathways of the brain and maintain the positive results of therapy overtime.
  Helen Maddix Open Doors Therapy.

• Q: Is having a Moro Reflex always a terrible thing?

  A: When I was being trained I asked the trainer if I should undertake therapy to integrate my reflexes particularly my Moro. She replied, “No you’re a happy Moro”. Too a large extent I am, but typical of many Moro adults I have to be a control freak and have ‘imposter syndrome’. However, the upside is that my Moro is my driver to succeed. Just knowing that I have a Moro helps me to know myself better and live with the tangled emotions and reactions that I have sometimes. Understanding has also given me a better understanding of others who are living on a Moro. However, without my Moro I perhaps would not have been so outgoing, been able to successfully organise things, run a successful business, and been a port of call for friends when they need help and advice.
  Liz Brennan Open Doors Therapy

• Q: Is it possible to work with a group of children in schools that cannot commit to individual therapy for each child?

  A: There are a few school based programmes that can be used with groups of children. Ideally children should have a bespoke therapy but group based exercise programmes are very successful. The issues are to do with staffing, staff training, allocating time within an already overcrowded school day, finding space and deciding which children would most benefit. Most schools I have worked in target those children who are underachieving, but in my school at the time we found it easier to do whole year groups. We found it easier to deliver and all the children benefitted. Teachers noticed that the children were more attentive, less fidgety and that there was less disruptive behaviour. There are a number of programmes available. Many DPA members use the EASIE program (Exercise and Sound in Education) whilst others use the INPP programme (Assessing Neuromotor Readiness for Learning).

  Liz Brennan Open Doors Therapy