Persistence of primitive reflexes and associated motor problems in healthy preschool children

Persistence and activity levels of primitive reflexes in young high-level football players

Introduction

Primitive reflexes (PR) induce involuntary automatic movements in response to specific stimuli. This study aimed to determine the prevalence of active PR in young high-level football players.

Methodology

Sixty-nine national-level football players from a French academy were tested (17.0 ± 1.4 years; 69.6 ± 8.0 kg; 178.9 ± 6.9 cm) to evaluate the persistence of PR, following the methodology of the Institute for Neuro-Physiological Psychology (INPP) and the classification by a global score (GS). Based on the sum of seven tests, each was rated between 0 = null and 4 = max. The GS is classified into five categories from no activity to maximal (0-1 = no activity, 2-7 = low, 8-13 = medium, 14-21 = high, and 22-28 = maximal).

Result

Around two-thirds (68.1%) of players presented active PR at different activity levels. Among them, a small proportion (7.2%) had medium GS, while 60.9% had a low GS. The GS was not dependent on field position or the age of the players (p > 0.05). However, playing football in an age category higher than their own was associated with significantly more active primitive reflexes (PR) compared to being in their age category (p < 0.01). The results showed that 72.7% of "upgraded" football players had low GS and 18.2% had medium GS, compared to 55.3% and 2.1% in the non-upgraded group.

Discussion

The findings of the current study demonstrate that PR could still be active in a healthy population of high-level football players. Practicing a single sport for years and upgrading players could create a negative environment that can ultimately lead to the activation of otherwise integrated PR.

The association between learning disorders, motor function, and primitive reflexes in pre-school children: A systematic review

This study aimed to systematically review evidence of the association between learning disorders, motor function, and primitive reflexes in preschool children. Seven databases were systematically searched (EMBASE, CINAHL, Academic Search Complete, Medline, PsycINFO, ScienceDirect, and Cochrane) with no restrictions. Inclusion criteria were full text peer-reviewed articles reporting new empirical data, assessing any two of three phenomena in preschool children: learning disorders, motor function, or primitive reflexes. Intervention studies or studies examining congenital, chromosomal or acquired neurological, or pathological conditions and prematurity were excluded. Included papers (n = 27) were assessed for methodological quality by the Hoy et al. Risk of bias tool. Learning and motor function were assessed in all except two articles and motor deficits found to be associated with speech/language and executive function as well as several areas of academic performance. Three studies included primitive reflexes, with high levels of the asymmetrical tonic neck reflex positively correlated with fine motor skills, "school readiness" and "impulsivity, hyperactivity and inattention." Caution must be used when interpreting the review results due to significant study heterogeneity. Further research is needed to further understand common underlying mechanisms that may inform earlier diagnostic methods for these three phenomena. PROSPERO: CRD42021265793.

Jumping Motor Skills in Typically Developing Preschool Children Assessed Using a Battery of Tests

The preschool period is characterised by the improvement in motor skills. One of the developmental tasks in children is the ability to jump. Jumping plays an important role in the development of leg strength and balance. It is the gateway to more complex movements. In the physiotherapy clinic, we see a lot of difficulties in jumping performance in 5-7-year-old children. The aim of this study is to present the jumping ability, assessed by the Motor Proficiency Test (MOT) and the G-sensor examination of the vertical countermovement jump (CMJ) and countermovement jump with arms thrust (CMJAT) parameters. A total of 47 children (14 boys and 33 girls) were randomly recruited. The mean age was 5.5 years. The mean height was 113 cm and the mean weight was 19.7 kg. The children were divided into two groups according to their results. Children with low basic motor skills have the greatest difficulty with jumping tasks. In the CMJ jump, the take-off force was lower than in the CMJAT (p = 0.04). Most CMJAT parameters correlate with age, weight, and height. Height correlates most with children's jumping performance. This study may be useful for sport educators and developmental researchers. The topic should be further explored and the CMJ and CMJAT parameters may be established as a basis.

Identification and reduction of retained primitive reflexes by sensory stimulation in autism spectrum disorder: effects on qEEG networks and cognitive functions

Several authors have reported finding retained primitive reflexes (RPRs) in individuals with autism spectrum disorders (ASD). This case report describes the reduction of RPRs and changes in cognitive function after transcutaneous electrical nerve stimulation (TENS) of muscle. Three individuals were examined in a study at the Institute for Neurology and Neurosurgery in Havana, Cuba. Two child neurologists, not involved in the study, conducted clinical examinations on each participant and diagnosed each with ASD based on DSM-V criteria and the Autism Diagnostic Interview-Revised (an autism evaluation tool). Each child with ASD possessed a triad of impairments in three domains: social interaction, communication, and repetitive behaviour. Individuals were evaluated by quantitative electroencephalographic measures and tested by standardised cognitive function tests before and after 12 weeks of intervention. These interventions were associated with reduced ASD symptoms in the three domains, significant changes in qEEG network connectivity and significantly improved performance on standardised cognitive tests.

Reliable change in developmental outcomes of Brain Balance® participants stratified by baseline severity

The effects of comprehensive multimodal programs on developmental outcomes have not been well-studied. Emerging evidence suggests a possible role for the Brain Balance® (BB) program, a multimodal training program, in serving as a nonpharmacologic approach to addressing cognitive, attentional, and emotional issues in youth. In this analysis, we examined the effects of 3 months of participation in the BB program on the outcomes of children and adolescents with developmental difficulties (N = 4,041; aged 4-18 years; 69.7% male). Parent-rated scores on the Brain Balance-Multidomain Developmental Survey (BB-MDS) were used to assess six areas at baseline and post-program: (1) negative emotionality; (2) reading/writing difficulties; (3) hyperactive/disruptive behavior; (4) academic disengagement; (5) motor/coordination problems; and (6) social communication problems. To estimate change from pre- to post-program, we calculated effect size (Cohen's d) and the Reliable Change Index (RCI) for groups stratified by baseline severity. There was a very large effect size for the moderate/high severity (d = 1.63) and extreme severity (d = 2.08) groups, and a large effect size for the mild severity group (d = 0.87). The average percentage of participants who observed reliable change over all BB-MDS domains was 60.1% (RCICTT) for extreme severity, 46.6% (RCICTT) for moderate/high severity, and 21.1% (RCICTT) for baseline mild severity. In additional assessments of primitive reflexes and sensory motor activity, students demonstrated significantly diminished primitive reflexes from pre- to post-participation and significant improvements in sensory motor skills including fine motor skills, gait and aerobic ability, proprioception, rhythm and timing, and eye-gaze stability. Overall, these results demonstrate improvements in primitive reflex integration and sensory motor skills, as well as statistically significant reliable change in emotionality, reading/writing, behavior, academic engagement, motor skills, and social communication in BB participants from pre- to post-program, with the probability and degree of change increasing as the participants' baseline severity increases. These results contribute to the growing literature on the need for evidence-based nonpharmacologic approaches to addressing developmental issues. Future research with well-controlled designs, longitudinal follow-up, implementation across settings, and participant groups in which diagnoses are known, will help to more fully characterize the effects of the BB program.

Prevalence of Active Primitive Reflexes and Craniosacral Blocks in Apparently Healthy Children and Relationships with Neurodevelopment Disturbances

BACKGROUND

In healthy children, the frequency of the anomalous persistence of primitive reflexes (PRs) and craniosacral blocks (CBs) is unknown, as well as their impact on neurodevelopment, behaviour disorders and related consequences. We aim to know the prevalence of anomalous PRs and CBs in apparently healthy children and their relationships with behavior and neurodevelopment anomalies.

METHODS

Participants (n = 120) were evaluated via a physical examination to detect PRs and CBs and an ad hoc parent survey to collect perinatal events, and children's behavioral assessments were conducted by teachers using the Battelle score.

RESULTS

PRs were present in 89.5%. Moro (70.8%), cervical asymmetric (78.3%) and cervical symmetric PRs (67.5%) were the most frequently observed PRs. CBs were found in 83.2%, and the most frequent CBs were dura mater (77.5%) and sphenoid bone (70%) blocks. Moro, cervical asymmetric and cervical symmetric active primitive reflexes were significantly associated with cranial blocks of dura mater, parietal zones and sphenoid bone sway. Gestational disorders or perinatal complications were associated with a higher frequency of PRs and CBs. The presence of PRs and CBs was associated with abnormal Battelle scores and neurobehavioral problems.

CONCLUSION

The presence of PRs and CBs in children without diagnosed diseases is frequent and related to disturbances in childhood neurodevelopment.

Prefrontal Functional Connectivities in Autism Spectrum Disorders: A Connectopathic Disorder Affecting Movement, Interoception, and Cognition

The prefrontal cortex is included in a neuronal system that includes the basal ganglia, the thalamus, and the cerebellum. Most of the higher and more complex motor, cognitive, and emotional behavioral functions are thought to be found primarily in the frontal lobes. Insufficient connectivity between the medial prefrontal cortex (mPFC) and other regions of the brain that are distant from each other involved in top-down information processing rely on the global integration of data from multiple input sources and enhance low level perception processes (bottom-up information processing). The reduced deactivation in mPFC and in the rest of the Default Network during global task processing is consistent with the integrative modulatory role served by the mPFC. We stress the importance of understanding the degree to which sensory and movement anomalies in individuals with autism spectrum disorder (ASD) can contribute to social impairment. Further investigation on the neurobiological basis of sensory symptoms and its relationship to other clinical features found in ASD is required Treatment perhaps should not be first behaviorally based but rather based on facilitating sensory motor development.

The Correlation between Residual Primitive Reflexes and Clock Reading Difficulties in School-Aged Children-A Pilot Study

The aim of the pilot project was to research relationships between the occurrence and level of intensity of primitive reflexes in primary school children, the ability to read an analogue clock and to tell the time. A group of 28 children (14 girls and 14 boys) who attended Montessori Primary School was examined. In the first stage, participants were assessed for the presence of five primitive reflexes (PR): the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), spinal Galant reflex, tonic labyrinthine reflex (TLR) and Palmar grasp reflex. Romberg's test was employed to identify signs of difficulties with control of balance and/or proprioception. In the second stage, pupils underwent tests that challenged their ability to read a clock and calculate passing time. After summing up points obtained for all tests, a correlation coefficient was made from which the results were derived. There is a negative correlation between the ability to read an analogue clock and the continued presence of some primitive reflexes. Lower neuromotor maturity (higher points of PR) correlates with lower ability to read a clock. The highest correlations between difficulty with telling the time were found with persistence of the STNR, ATNR and Romberg's test.

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders

We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.

Primitive Reflex Factors Influence Walking Gait in Young Children: An Observational Study

Background: Primitive reflexes (PRs) are observed as an automatic response to a specific stimulus. They are vivid from intrauterine life to 6 months postnatal. The reactions are inhibited with the growing maturation of the central nervous system (CNS). In some cases, when the natural process of development is incorrect, PRs manifest later. The analysis of differentiation in gait parameters in children with persistent PRs is important for better understanding their specific behaviour and movement. This study’s aim was to investigate the influence of active PRs on the gait parameters of preschool children. Methods: There were 50 children examined, 30 girls and 20 boys. They were 3.5−6 years old. The children had persistent PRs in the trace form. Each child was examined by S. Goddard’s Battery Test. The acquisition of the spatial-temporal gait parameters was performed using a BTS G-SENSOR measurement instrument. Participants walked barefoot, in the most natural way for them, at a self-selected speed on a 5 m walkway, then turned around and went back. They performed this twice. Results: The reflex activity influences gait cycle duration (p = 0.0099), the left step length (p = 0.0002), the left double support phase (p = 0.0024), the right double support phase (p = 0.0258) and the right single phase. Difficulties in recreating the crawling pattern and GRASP reflex influence gait cadence (p < 0.05). The left GRASP reflex corresponds to step length (p < 0.05). The activeness of the symmetrical tonic neck reflex correlates with the right single support (p < 0.05). Conclusion: The presence of PRs affect walking gait in preschool children.

Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children

Psychomotor development in the first year of life is possible due to activity and then integration of primitive (neonatal) reflexes. The presence of active primitive reflexes (APRs) in preschool and school-aged children indicates neuromotor immaturity. Studies show dependencies between the preserved activity of primary reflexes and developmental problems such as learning difficulties (problems with reading, writing, reduced mathematics skills, and dyslexia), difficulties with coordination, and attention deficit. The primary purpose of this study is to present the activity of three tonic reflexes in a sample of 112 Polish children aged 4–6 in relation to their motor skills. The children were examined for the presence of the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR). Motor performance was examined with the MOT 4–6. Statistical analysis shows an inverse correlation between the score in the test of reflexes and motor efficiency (MOT 4–6) at p < 0.05 (−0.33). Children with increased reflex activity presented a lower level of motor efficiency. The multiple regression model showed that with the older age of the child and the decrease in the level of reflex activity, the motor skills of children improve. Thus, there is a need for early screening of primitive reflexes in children. Properly selected exercises and therapeutic activities aimed at integrating APRs in children with developmental difficulties can improve their motor skills, perceptual abilities, and emotional behavior.

Chiropractic management of toe-walking in an eight-year-old male diagnosed with autism spectrum disorder utilizing a functional approach: A case study

OBJECTIVE

The objective of this paper is to discuss the treatment of idiopathic toe-walking utilizing cognitive-motor dual-tasking and primitive reflex integration exercises.

METHODS

An eight-year-old child with the previous diagnosis of autism spectrum disorder and idiopathic toe-walking presents for chiropractic care. The patient had previously received eight months of physical therapy in which his results plateaued after three months of care.

RESULTS

On the initial visit, the child was evaluated for primitive reflexes. The patient retained the asymmetrical tonic neck reflex and palmer grasp. He was prescribed exercises to integrate these reflexes. In the second visit and onwards, the patient was tasked with walking while performing a cognitive or motor task. The patient's performance of primitive reflex attenuation exercises significantly improved in form and timing, and the patient achieved proper gait mechanics with most interventions used.

CONCLUSION

Due to the limited number of visits, the patient was prescribed a cognitive task to help facilitate the retention of proper gait mechanics; however, these findings suggest that chiropractic management may prove useful in children who toe walk and that further investigation into treatment utilizing primitive reflex integration exercises for children with psychomotor delays is warranted. We suggest that the integration of primitive reflex testing for the chiropractor can yield many answers and serve as a valuable rehabilitation approach.

Developmental Language Disorder and Uninhibited Primitive Reflexes in Young Children

Purpose Developmental language disorder (DLD) is a developmental disorder where children fail to acquire language in the absence of a clear cause. Many studies have reported general motor deficits in children with DLD, but no studies have uncovered a cure. The purpose of our study is to better understand the underlying motor deficits in DLD, starting from uninhibited primary reflexes-which are the most basic stage of motor development. Knowledge of this motor-language relationship should lead to earlier and more targeted interventions in young children with DLD. Method Children with DLD (n = 75, age range: 4-10 years) and 99 age-matched typically developing (TD) children completed a nonword repetition test to assess DLD and six other tests to assess primitive reflexes. Results Children with DLD demonstrated higher levels of persistent primitive reflexes compared to TD children. As the scores for neuromotor immaturity increased, nonword repetition test scores decreased (r = -.44, p < .01). Results indicated that TD children exhibited lower neuromotor immaturity (M = 7.63, SD = 3.75) compared to children with DLD (M = 13.51, SD = 4.47). All primitive reflexes (the Moro reflex, the symmetrical tonic neck reflex in flexion and in extension, the asymmetrical tonic neck reflex, the tonic labyrinthine reflex, and the Galant reflex) turned out to be statistically significantly different for the TD and DLD groups (p < .001). We also observed some differences between sexes. Conclusions Children with impaired language development underwent slower neuromotor development. However, further research is needed to determine whether motor intervention programs that inhibit primitive reflexes are helpful for children with DLD.

Primitive Reflex Activity in Relation to the Sensory Profile in Healthy Preschool Children

The presence of active primitive reflexes (APRs) in healthy preschool children can be an expression of immaturity in the functioning of the nervous system. Their trace presence may not significantly affect the quality of child functioning. They may also undergo spontaneous and complete integration within the stages of child development. However, a higher level of active reflexes and their significant number can disturb sensory-motor development and lead to additional problems in a child’s motor activities, social life, and education. The main purpose of this study was to examine the types of sensory disorders noticed by parents of children, if any, that accompany the presence of active primitive reflexes. The study was conducted in a group of 44 preschool children (aged 4–6 years). The sensory profile of children was determined using Child Sensory Profile Cards, and Sally Goddard-Blythe tests were used to measure their primitive reflexes. The coefficient of determination (R-squared) indicated that the level of reflex activity was most strongly associated with sensory disorders such as dyspraxia, sensory-vestibular disorders, and postural disorders, at a level of p < 0.005. The obtained research results show that the examination of non-integrated reflexes might be a screening tool for children of preschool age. Knowledge of the subject of reflexes and their impact on sensory-motor functions may contribute to more accurate diagnoses of the causes of problems and higher effectiveness of possible therapy.

The effects of prenatal cigarette and e-cigarette exposure on infant neurobehaviour: A comparison to a control group

BACKGROUND

Infant neurobehaviour provides an insight into the development of the central nervous system during infancy, with behavioural abnormalities highlighting a cause for concern. Research has demonstrated that prenatal exposure to cigarettes leads to deficits within neurobehavioural development, along with negative birth outcomes detrimental to subsequent development. With the growing use of e-cigarettes amongst pregnant women, this study explores how prenatal e-cigarette exposure compares to prenatal cigarette exposure.

METHODS

Eighty-three infants were involved in the study, either exposed prenatally to cigarettes or e-cigarettes or not exposed to either. Differences were assessed between these three groups for birth outcomes and scores on the Neonatal Behavioural Assessment Scale (NBAS) at one month of age.

FINDINGS

Both cigarette and e-cigarette exposed infants had a significantly greater number of abnormal reflexes (p = ·001; p  =  ·002). For both self-regulation and motor maturity, cigarette exposed infants performed significantly worse (p = ·010; p = ·002), with e-cigarette exposed infants having decreased motor maturity (p = ·036) abilities and marginally decreased for self-regulation (p = ·057). Birth outcomes, namely birthweight, gestation and head circumference, did not differ for e-cigarette exposed infants compared with infants who were not prenatally exposed to nicotine. Cigarette exposed infants had a significantly lower birthweight (p = ·021) and reduced head circumference (p = ·008) in comparison to non-exposed infants.

INTERPRETATION

To our knowledge, this is the first research study assessing a neurological outcome as a result of e-cigarette exposure. Findings of this have potentially important implications for public health policies regarding the safety and use of e-cigarettes throughout pregnancy.

FUNDING

This research was funded by a doctoral training partnership scholarship via the ESRC, ES/P000762/1.

Pelvic Symmetry Is Influenced by Asymmetrical Tonic Neck Reflex during Young Children's Gait

Gait is one of the examined functions in child development. It should be economical and symmetrical. One test increasingly used by physiotherapists and pediatricians is asymmetrical tonic neck reflex (ATNR). Physiologically, it is observed from in utero up to six postnatal months. This reaction is inhibited with the growing maturation of the central nervous system (CNS). In some children, when the natural process of development is incorrect, ATNR manifests later in life, when it is observed as an automatic response of muscle tension to head rotation. Analysis of pelvis symmetry in the gait of children with active ATNR is important for better understanding their specific movements. In the gait of children with persistent ATNR, some variations are observed. The aim of the study was to investigate the gait symmetry of preschool children and the influence of persistent ATNR. Fifty preschool children with a trace form of ATNR were examined. The distribution of the gait parameters was determined using a BTS G-SENSOR measurement instrument. ATNR negatively influences pelvic obliquity and pelvic rotation (p < 0.01). Younger children have a statistically higher symmetry index of pelvis obliquity in the examined group (p = 0.015). Boys obtain a higher result of symmetry in pelvic tilt than girls in the group (p = 0.027). ATNR affects walking symmetry in preschool children, thus evaluation of the reflex activity and then proper therapy is required to support proper development.