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Reflex Integration

6 Key Reflexes According to Location

1. Phasic - Spinal Reflexes:

These reflexes help you interact with and interpret your environment.

Examples: fear paralysis, moro, gallant

 2. Tonic - Brain Stem Reflexes: 

These reflexes control muscle tone.

Examples: Atonic Tension Neck Reflex (ATNR),

Symmetrical Tonic Neck Reflex (STNR), Tonic Labyrinthine Reflex (TLR)      

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3. Righting reactions - Midbrain reflexes: 

head righting, postural and protective reactions (concentric, isometric, eccentric)


The Main Reflexes of Focus                        


1. Moro (startle) Reflex :
The Moro reflex serves as a baby’s primitive fight or flight reaction. It is usually inhibited by around 4 months of post-natal life and replaced by an adult “startle” reflex. When the moro reflex is retained in an older child it becomes an automatic uncontrollable overreaction to any type of stimulus, therefore overriding the higher decision making center of the brain. Retention of the moro reflex can present the following challenges: hyperactivity, extreme sensitive to sudden movement, noise or light, sleeping problems, impulsive behaviors, inappropriate behavioral responses, food sensitivities, emotional and social immaturity, poor adaptation skills      


2. Gallant Reflex :
The spinal gallant reflex exists to help babies move their hips as they move through the birth canal and is elicited when the side of the lower spine is stroked gently. If not fully integrated, it can result in difficulties with potty training, concentration, posture, and digestion and can cause excessive fidgeting and hip movement while seated in a chair.      


3. Atonic Tension Neck Reflex (ATNR)
Activated by turning the head to the left or right side. As the head is turned, the arm and leg on the same side will extend while the opposite limbs bend. If not fully integrated, the ATNR reflex can cause difficulties with: hand-eye coordination, written expression, crossing midline, visual tracking, and bilateral integration (use of both sides of the body simultaneously), and hand-dominance.           


4. Symmetrical Tonic Neck Reflex (STNR)
Causes the arms to bend and the legs to extend when the head is bent down and causes the opposite - legs bent, arms straight - when the head is bent backwards. If the STNR reflex remains present in an older child, it can cause difficulty with: integration of upper and lower portions of the body, sitting posture, typical muscle tone development, and poor hand-eye coordination          


5. Tonic Labyrinthine Reflex (TLR):
The TLR is associated with balance and coordination of the extremities. This reflex is activated by bending the head forward or backwards (head forward - the body and limbs curls inwards, head backwards - the body and torso straighten and extend). If not fully integrated the alignment of the head with the rest of the body will be uncoordinated. Proper head and neck alignment is necessary for balance, visual tracking, auditory processing and organized muscle tone, which are all vital to the ability to focus and pay attention          



Reflex Integration


It is necessary to go through reflexes but in order to increase an individual’s function you must integrate the reflexes. Reflex integration is an important part of developmental delay therapy. Integration of reflexes will determine the individual ability to learn and progress in developmental milestones.        


Reflex integration is the mechanism by which less mature responses are incorporated into voluntary movement. This is done through first going further into the primitive reflex pattern and then countering the reflex – putting the client in a position opposite to the reflex presentation. Slow repetition is key to integration. Successful integration ensures the reflex will remain functional.           


Considering motor milestones there is an association with the even months of age beginning at 4 months old. At 4 months old the infant should have head control, support on arms and hands and midline orientation of the head. This is an important time for motor development in that the movement changes from asymmetric to symmetric. Integration of ATNR. At 6 months old there is symmetric extension and abduction of the extremities against gravity, segmental rolling and trunk extension against gravity. At 8 months there is more controlled rotation of the trunk, independent sitting, reciprocal creeping and more rhythmic movements of the limbs. At 10 months there is biped balance and cruising. At 12 months is an important milestone due to the transition from infant to toddler and the milestone at 12 months is independent walking.        


With the progression of walking it is important to consider the natural progression of walking which entails equilibrium reactions of the feet. As the knee position changes between flexion and extension the foot alternates between toes ‘clawing’ the floor and ‘flaring’ upward. These are innate balance assistance techniques that may resurface post neurological injury due to a lack of trunk stability during gait.            


Keep in mind that the stages are guidelines of trends seen within the typical developing infant but also reinforce the natural integration of reflexes. The timeline on integration naturally occurs within the first year of life for all the primitive reflexes.

Why Is Reflex Integration Important?   


We believe reflex integration should be the cornerstone to any program catered specifically to neuro developmental delays. Currently many caregivers turn to bracing, surgery or medications to correct muscle imbalances, gait and learning abilities. However, it has been shown to only temporarily solve the situation but only for it to re-surface in a few weeks or months. The reflex integration approach seeks to get to the bottom of the condition which ultimately starts in the brain – not at the leg or arm – getting to the route of the imbalances instead of putting a band- aid on the symptom. Thus, most medical approaches tackle only the symptoms and do not address the cause of the problem; the brain injury. Reflex integration tackles the brain which ultimately will affect many of the symptoms related to neuro developmental delays.

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