Different Theories and Practices behind Primary Reflex Inhibition and Integration

Primary or primitive reflexes are involuntary movements activated by a sensory trigger typically seen in infants or others with atypical neurology. Typically these primary, infant reflexes have a protective and developmental effect for the very young child. As the sensory-motor cortex of the brain matures, typically the primary reflexes are inhibited. Later, as the voluntary motor system develops, reflexive motor patterns may be used for strength and stability, as well as emotional expression. As the result of trauma before, during or after birth, the primary reflexes may come out of integration or may have never become integrated. It is not generally known what role genetics plays in reflex retention.

There are three basic types of reflex integration: isometric, passive/active positions and activity based. The isometric based approach has been developed by Svetlana Masgutova and others. The practice includes activating the particular muscles used in a reflexive response and holding them voluntarily so the motor cortex can gain control and develop an inhibiting ability over them.

The passive/active positions are simple sustaining the position of the reflex posture and moving from the contraction to the extension position. These postures also allow the motor cortex to differentiate these patterns and integrate the patterns.

The activity based programs, included in the work of INPP and many other groups, use games and higher level activities that include some or all of the motor patterns of one or more reflexes.

All the types of reflex integration help the motor cortex to differentiate and inhibit primary reflex patterns. Other techniques may be included to augment the integration work. Massages, with specific sensory or motor goals, are often necessary to gain symmetry and relaxation for some muscle groups. Sensory work is also often needed to regulate and organize the body senses to complete the integration of the sensory-motor systems.

Relationship of Hand and Mouth in Development

Movement in the hand and mouth are connected developmentally.
Below are just a couple of the ways:

Many primitive reflexes help a baby use hands to
feed and later learn to talk. One of these early reflexes is Babkin Palmomental where when the babies palm is touched or stretched and the baby’s mouth opens. You will see this in elementary
classes when children are raising an open hand and some mouths are usually hanging open. Hand to Mouth is another developmental reflex related to the one above. If something is pressed into the palm of a toddler, it is raised to the opened mouth.

In our course you may remember that the motor
areas of the mouth and hand are very close together in the Upper Brain. Some people have trouble speaking if they can’t move their hands. Also movement of the hands activates the speech centers of the brain in the parietal lobes. Research that uncovered this relationship was explored by Shigeru Obayashi and his team in 2001.
If anyone doubts the above have them open their mouths and
hands widely and after 5 seconds tightly fist the hands and tightly purse the mouth for 5 seconds. Repeat 3 or 4 times. Now have them reverse the action. Open the mouth and clench the fist and open the hand and purse the mouth. This second pattern goes against the pattern and is usually harder to accomplish.
Of course later in life, most people can use the upper brain
of the cortex to override the lower automatic systems used in development. One
will still see the hand mouth relationship when showing an emotional reaction,
such as, surprise where both hands and mouth are open and anger where hands and mouths are clenched.
The relationship between the mouth and hand is very important in early development. So in atypical development the motor relationship between hand and mouth can be used to restore disrupted or traumatized development.

The HANDLE Approach & Reflex Integration

Development of how we intake, process and react to our world depends on the sensory-motor feedback system. Before we are born, our senses trigger motor reflexes, which then help regulate and use the senses. This feedback growth continues after we are born through the seminal (seed) senses and the infant (primitive) motor reflexes. This feedback system develops our processing modalities of the Upper Brain (cortex). As you can see, infant reflexes play a role in development.


The HANDLE Approach looks at the entirety of the sensory-motor development. As a metaphor let’s consider HANDLE a basket. The basket’s handle includes the incredibly important principles that lift and guide the HANDLE approach. The basket’s bowl gathers holistically many pieces of the whole system: the sensory, motor, reflex, nutrition, genetics, environment, and much more. No other approach that I have found comprehensively deals with so many parts of an individual’s system.

Dealing with one facet of the neuro system, such as, nutrition, reflexes, motor, etc, can be helpful at times. That is why many HANDLE practitioners are themselves or may suggest complementary therapies to focus in on a particular area. Although HANDLE works holistically and developmentally to integrate infant reflexes, there may be reasons to deal one or more individually with other techniques. However, these may or may not stay integrated if the underlying body senses are not well enough developed.

Infant reflexes are within us to support development and safety. Sometimes they become atypical due to trauma. Other times they are atypical due to developmental factors that take a more holistic approach to remediate.

Needs of the Lower Brain Must be Met for the Upper Brain to be Fulfilled

Our Lower Brain holds our developmental and survival resources. Sometimes these resources are called “primitive” because they are with us from the beginning and are foundational for our growth and survival. However, if the Lower Brain ain’t happy, the rest of the person usually can’t be fully happy either. The Lower Brain can feel unsafe because of issues dealing with gravity, body in space sense, efficient energy use, inconsistent sensory input or conflicting signals.Let’s look at these issues more closely:

Gravity: From the moment of conception our developing body-brain system must do a dance with gravity. To live, cells, organs and tissues must push against gravity. Our first developing sense deals with measuring and reacting to gravity. Most developmental issues have their genesis with issues around gravity regulation of muscles and tissues. Autism, dyslexia, low tone, ADHD and other concerns have challenges with gravity.

Body in Space: All of our senses constellate to let us know where we are in relationship to other people and things in the environment. It is the basis of our sense of boundaries. If this body map isn’t well established, the body-brain system sends out an unconscious alarm. This alarm is often picked up by the Upper Brain as generalized anxiety. Although anxiety is usually associated with emotions, a physical feeling of lacking safety will trigger negative emotions. People on the autism spectrum, those with OCD, ADHD and other neurodevelopmental issues can have issues sensing their body in space.

Efficient energy use: Development is all about learning how to conserve and use limited neural energy wisely. When unnecessary energy is being eaten up by overworking Lower Brain functioning, the result is often a burst of energy and then exhaustion. This pattern is often seen in ADHD, autism, bipolar disorder and other syndromes.

Inconsistent sensory input: The body-brain system does not like to receive conflicting sensory signals. It would be like someone seeing a barking cat. The alarm signals go off. The brain wants agreement among the differing senses. If one sense is consistently giving unreliable information, the body-brain system will block or transform that information to improve agreement. This is a very inefficient use of neural energy and can interfere with day-to-day functioning.

Conflicting signals: The sensory system is not the only system that dislikes conflict. If a person has retained infant reflexes in the Lower Brain and the Upper Brain wants to move in a way counter to the reflex pattern, tension arises. It is as if one horse is pulling one way and the other another. Both horses do not get where they are going and use a great deal of energy trying. Most people with neurodevelopmental or learning disabilities have retained or atypical infant reflexes that interfere with planned motor activities.

Trunk Extension Reflex

As I was doing research into the Trunk Extension Reflex, I came upon this study that links the ability for volitional Trunk Extension and hip stability.

Dynamic iso-resistive trunk extension simulation: Contributions of the intrinsic and reflexive mechanisms to spinal stability
Journal
Technology and Health Care
Publisher IOS Press ISSN 0928-7329 (Print) 1878-7401 (Online) Issue
Volume 15, Number 6 / 2007 Pages 415-431
Subject Group
Rehabilitation & Assistive Technology

As I am always looking for ways to stabilize the hips to improve vestibular functioning and balance, this information intrigued me. Extending the heels and crown and sustaining for a 7 seconds stretch, appears to be one of the most powerful integration tools in postural reflexes, especially for adults. Those with retained ATNR, Moro, Spinal Galant, Perez or a number of other reflexes find that the Trunk Extension stretch is an important addition to their program.

HANDLE Principles 2: There is no silver bullet

As the year mark of the passing of Judith Bluestone comes around, I will continue the principles that she articulated and developed as a part of the HANDLE Approach.

There is no silver bullet. There is no "cure" for neurodevelopmental issues. Only through gentle challenges of weak systems can we harness the developmental power that each of us has within our body-brain system. This can move us forward in our functioning.

There are many snake oil salesmen offering the "answer" to autism, ADHD, dyslexia and so on, but although many approaches can help individual systems, no one approach can "fix" these issues. The truth is that we should reframe our search into helping people with their own personal goals that are evading them. A goal might be to talk, to walk or to play a musical instrument.

Nutrition, cranial sacral therapy, speech, OT, PT and many more approaches can give a piece. The HANDLE approach works on the sensory-motor and body senses better than any therapy that I have seen. When I added the reflex motor resources to the mix, I find a powerful tool to help most people make their goals. And this is powerful indeed. Thanks, Judith.