How ADHD can resemble 'retained primitive reflexes' in children

When Amanda Cassidy wrote an article about how she thought her son had ADHD (attention deficit hyperactivity disorder) and instead discovered he had what's called 'retained reflexes', it went viral. It also marked the start of her journey into the world of neurodevelopmental therapy that many parents are not aware of. 


The response to my article both took me by surprise and overwhelmed me. Like myself, most people had never heard of retained primitive reflexes.

Over 1.5 million people read the article I wrote about my son, and it was shared over 90 thousand times.

Teaching magazines in New Zealand asked my permission to republish so the thousands of primary school teachers could better identify it amongst the children they teach. I was interviewed on talk radio in New York and Canada and have replied to thousands of emails from concerned parents all over the world.

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I’m not an expert in this field, but I am also a concerned parent who was surprised to learn how often these behavioural traits are initially mistaken for ADHD. Of course, a diagnosis of ADHD is respected when diagnosed by medical professionals, but to know that there was another avenue that might explain some of the patterns in behaviour was eye-opening – especially when it can be treated easily and very effectively with simple exercises.

Impulsive

The reason we started down this path was because my son was squirmy in school, impulsive and found it hard to concentrate. Yes, they are also traits of a very typical five-year-old boy. He is my second child and not having experienced any of this with my eldest daughter, like every parent, I overreacted and I convinced my husband that we should get him tested for ADHD so we could manage it the correct way from the get-go.

Off we set to the therapist who put my happy little boy through a series of physical tests (skipping around the room, drawing, eye movement, crawling etc) He was in his element. Then we braced ourselves for her conclusion.

She explained that not only did my son not have ADHD but that he had retained some of his more primitive reflexes and this was the reason he was getting himself into trouble at school and at home.

She went on to explain that there can be as many as seven children in each class that have some form of reflexes that are retained. My immediate reaction was to tell everyone I knew. Why had nobody told me about this sooner?

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The science part

So what does this all mean? Well, reflexes are muscle movements that happen unconsciously to certain stimuli. For example, if you burn your hand on the radiator, you automatically pull your hand away. We are all born with a set of these reflexes and because they originate from the most primitive part of the brain they are known as ‘primitive reflexes’.

The reason we have them is because we are biologically hard-wired for safety. In other words, they are part of our protection system to keep us safe in infancy and to prepare us for later development changes like sitting and crawling.

That is why each milestone is so important for babies – especially crawling which strengthens certain brain connections (my son crawled briefly but was up running at 10 months old).

Most of these primitive reflexes should disappear within the first year of life and are replaced by higher-level conscious reflexes. The problem is that sometimes if they stick about for longer than they should (retained) these pathways in the brain can result in behavioural traits that are often linked to immaturities such as a lack of coordination, low concentration, fidgeting, over sensitivity and much more.

As the child grows, these primitive reflexes (that were once necessary) now become superfluous and can even hinder development. For instance, the grasping reflex which allows an infant’s little hands to grip thing, once her fingers mature, this reflex needs to disappear in order to allow the more sophisticated fine motor skills to develop. Those kids who retain this grasping reflex into toddlerhood then can’t develop the subsequent pincer grip and may struggle to hold a crayon or learn to feed themselves.

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Of course, there are different levels of severity depending on how much of a reflex is retained. My son had only retained two of his reflexes and they were very mild.

The Moro reflex

Often called the ‘startle reflex’ this develops in a baby while in the womb and is fully noticeable at birth. You will remember it well - It is the way your little one 'startles' suddenly in their sleep, their arms fly out like they are falling backwards. It is part of our very primitive fight or flight survival response. It is completely involuntary and is activated at the brainstem level.

If this reflex is retained, your child will have an exaggerated startle reaction - they will constantly be 'on alert', restless and ready to react very quickly to anything that can be perceived as 'danger' (including schoolyard fights!). The high cortisol levels released from the adrenals will also result in an inability to balance blood sugar levels and have negative implications on energy levels and mood throughout the day.

Spinal Galant reflex

The other reflex which is often closely linked with (and mistaken for) ADHD is called the Spinal Galant reflex. You can see this happen when you gently stroke a baby’s back. The baby will arch their back in response – a motion that researchers believe is designed to encourage the baby towards crawling. If this reflex is retained past the first year, it can result in bedwetting, short-term memory issues or a lack of concentration or the inability to ‘sit still’in later years.

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Involuntary movements

What struck me is that often, a child is labelled as having behavioural problems or being disruptive in school when in fact, it is often involuntary. It is not so much that these children have a problem of attention, it is that their attention is constantly being forced upon physical activities that is totally unconscious for the majority.

Our therapist explained that my son might (involuntary) kick his feet under the desk while sitting in school. This is because he’s retained a reflex called the Symmetrical tonic neck reflex (ATNR) where he is hugely uncomfortable in the crawl position (sideways when you are sitting at a desk with your knees bent and arms on the desk writing). It seems like he is being 'difficult' or 'disruptive,' but the reality is that the poor guy doesn't even realise what he's doing and the position he is expected to remain in for four hours a day is unbearable to him.

The more it was explained to me, the more I realised how this was impacting every part of my son's life.

And all this isn’t new. Research over the years has suggested a link to neurodevelopmental disorders like dyslexia and ADHD. In fact, several studies have found that children diagnosed with ADHD are more likely than their peers to have retained primitive reflexes. Often a diagnosis of ADHD is given without examining the why – which is a pity because some of the movements and exercises we were given have helped greatly.

So why do some children retain these reflexes? Some research links it with a traumatic birth, repeated ear infections early in the child’s life as well as skipping key development milestones – walking without crawling, not enough tummy time.  Before you beat yourself up about this, often there is no specific reason – this is just the way your child is wired. Luckily, there is nothing ‘wrong’ with them and intellect isn't at all impacted – they just need to replace lingering infantile reflexes with higher-level reflex. The answer is in repatterning.

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Repatterning

The brain is extremely plastic. By taking the body through the physical motions of the developmental stage which was skipped, the brain is encouraged to develop the connections, which should have been formed during infancy. For the Moro reflex, sit your child in a chair in the fetal position with fists closed and arms and legs crossed. Ask him to extend his limbs out like a starfish, opening his fists and leaning his head back. Hold for seven seconds and then have your child fold back into the fetal position and switching the direction of their crossed limbs. This should be done six times, twice a day.

For the Spinal Galant reflex, the child should lie on his back and move his arms and legs in a ‘snow angel’ shape until the hands meet at the top of his head and the feet come together. This can be done five times in a row, twice a day until the reflex can no longer be activated by stroking the back. Encourage your child to do it slowly and to move all the limbs at the same time.

The benefits of strengthening your child’s neural pathways are significant. We have similar exercises to do at home each evening with my son. The idea is that repetition should help the brain to reform these connections. Almost two years later, we have noticed a huge difference in his behaviour, he is calmer and less impulsive. He is still mischievous, but I’m blaming that on his dad! Of course, you can’t paint over some colourful personalities- the world would be a greyer place if we did. But it is useful to arm yourself with the information that I wish I'd had when I began on this journey with my son.

I’m not saying that you can blame every scrap of naughty or impulsive behaviour on primitive reflexes – that wouldn’t be doing my son any justice at all. But knowing that some of the things there were frustrating me weren’t his fault (he couldn’t sit at the table for more than a few minutes without getting up) has helped me to help him navigate the world a little more smoothly.

Here is more information on the different retained reflexes might affect your child and some Irish based therapists 


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