#250 - A Primitive Reflex Brainstorming Session with Rachel and Jessica

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Sale ends April 30, 2023

Today we are answering a question from inside our Primitive Reflex Digital Course. The question is about the exercises for the Moro Reflex as well as the sensory  input that is provided during the exercises. We discuss all of this plus we dive into some research (which you can find in the links below)!

Jump into our Primitive Reflex Digital Course to learn all about retained primitive reflexes and how you can help integrate them!

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Links
All Things Sensory Podcast Instagram
Harkla YouTube Channel
Harkla Website - Shop Sensory Products!
Harkla Instagram
Research: Vestibular Stimulation and Primitive Reflex Integration'
Research: Effects of Primitive Reflex Integration Exercises on Forward Head Posture
Research: The Influences of a Primitive Reflex Integration Programme within the Classroom

Transcript

Rachel: 0:00

We have a little case study podcast episode for you as it relates to primitive reflexes. We were asked a question inside of our primitive reflex digital course, about a specific reflex exercise, and we decided to take this opportunity to bring you in so you could hear Jess and I really brainstorm and collaborate going through this question together. And hopefully you can learn something new and take this opportunity to really understand primitive reflex integration on a little bit of a deeper level. I'm Rachel.

Jessica: 0:44

And I'm Jessica. And this is All Things Sensory by Harkla.

Rachel: 0:47

We are both certified occupational therapy assistants and together with Harkla. We are on a mission to empower parents, therapists, and educators to help raise confident and strong children of all abilities.

Jessica: 0:58

On this podcast, we chat about all things sensory diving into special needs, occupational therapy, parenting, self care, overall health and wellness, and so much more.

Rachel: 1:09

We're here to provide raw, honest and fun strategies, ideas and information for parents, therapists and educators as well as other professionals to implement into daily life.

Jessica: 1:20

Thank you so much for joining us. We have something really cool to offer you today. It is April, and April is OT month. And in celebration of OT month, we're bundling some of our favorite digital products together and giving them to you for a discount. We're gonna call this the OT digital bundle because the digital courses that we've bundled together for April, will just help you become a better therapist.

Rachel: 1:56

They're not only beneficial for therapists, but because we are celebrating OT month, which is occupational therapy, we are giving our primitive reflex course our sensory diet course as well as our three skills courses, which include gross motor skills, fine motor skills, and visual motor skills. And so you're going to get all five of those courses, which is a $220 value for only$149, which is basically 50% off,

Jessica: 2:29

Almost a 50% off discount for five courses. Just kind of a quick rundown if you're not familiar with our digital products. Our primitive reflex course, we teach you how to identify retained primitive reflexes, as well as provide you the specific exercises to help integrate primitive reflexes. So it's great for therapists or parents who are learning more about primitive reflexes. Our sensory diet digital course teaches you how to identify sensory preferences, how to meet the sensory threshold, and how to put different sensory strategies together in order to help your child feel regulated in order to get through their day. So another great one for therapists to help them better understand how to help their clients. And then like Rachel said, our three skills courses, the three skills courses are very activity based. So our fine motor skills course gives you a ton of new therapeutic activities to work on fine motor skills. Same with the gross motor and the visual motor courses. So those three are really awesome if you are looking for more treatment ideas,

Rachel: 3:37

You can take advantage of this sale, this bundle, this fabulous discount we are sharing through the end of the month. So if you're listening to this after April, I'm so sorry, you know, but you missed out, maybe next year, I just want you to know that we appreciate you listening to our podcast, we appreciate the consistent support. And you know, this is just a little way of saying thank you and GO OT! Woohoo!

Jessica: 4:06

Yes, exactly. The link to take advantage of this bundle is going to be in the show notes but the link is harkla.co/otmonth.

Rachel: 4:19

Again that's Harkla h a r k l a.co/otmonth

Jessica: 4:26

Okay, now we can jump into the episode.

Rachel: 4:28

Hey there, welcome back to another episode of All Things Sensory by Harkla. We have a unique episode for you today. We're kind of like shaking things up and changing it up. But we're here for it.

Jessica: 4:39

We just want to talk about all the things and so anytime we find something new or different to talk about, we get really excited about it.

Rachel: 4:46

And today's topic is primitive reflexes.

Jessica: 4:49

So that's not new.

Rachel: 4:50

No, but we do get very excited when we have new revelations, new conversations, new epiphanies, new challenges to work through. And that is what we're going to discuss today.

Jessica: 5:04

So our topic comes from inside of our primitive reflex digital course which if you're unfamiliar, we have a digital course that teaches you all about primitive reflexes and how to test for them and integrate them. If you want to learn more than that will be linked in the show notes. Within our course, I guess our students in the course, they can comment on each section within the course. And then we will receive a notification and we can comment back and other people can comment and have all these discussions. So, we got a question from one of our students in our course, and I'm going to read it, it's kind of long, so stay with us. After I read the question, we will discuss and do some brainstorming."I'm currently working with a kiddo who I've suspected has a retained Moro (reflex). I've been able to get her to work on a few modified activities, such as supine on a scooter for a very short duration, or upside down over a large therapy ball. It takes work to encourage her into these positions, both due to motor planning and what appears to be heightened anxiety with moving into supine. After the activity she has seemed more calm. A couple of times, she attempted to lounge on the floor in sidelying and took a lot more encouragement to stand up and move to another activity. Once she laid in prone after and really wanted to stay put and seemed happy when I transitioned to activities in that position. And we did putty in prone, propped on forearms. Once she was happy to transition to a desk, and actually did quite a bit better for a few minutes. So what I guess what I am curious about is do you tend to see some kind of immediate effect when completing activities or exercises targeting a retained reflex? Is there a typical response?

Rachel: 6:53

Okay, so I think we should just kind of hash out our initial thoughts with this question. So my first thought knowing that she did the supine position upside down over therapy ball, it was a lot of alerting input, my first thought is, with her not getting up wanting to stay in the prone position, laying down, is she trying to ground herself if she tried to, you know, calm her nervous system, is she trying to really feel where she's at, because when you're laying on your tummy and prone, you're getting a lot of full body proprioceptive input, a lot of full body tactile input. And it's really helpful to like reset and reorganize your nervous system, especially after that intense vestibular input from going upside down over the therapy ball, going upside down or laying supine, or on your back on the scooter board. So that's my first thought.

Jessica: 7:50

And going along with that, if she seems happy afterwards, it almost sounds like she's getting into a more regulated state. So she's getting some really great vestibular input, followed by some really great proprioceptive input, and those two help her to feel more calm and regulated, which is what we want is for our kids to feel more calm and regulated for certain situations. But it seems like this combination is helping her so I mean, I don't think there's a typical response. You know, all kids are so different, all humans in general are so different. Our sensory systems are all very unique. But those are kind of our initial observations. And I think this therapist who asked this question, I think that she's doing an awesome job. She is working on the Moro reflex in a very functional way. And then she's, you know, helping her client with regulation afterwards, even though she didn't know it, you know, she's asking these questions. But, in turn, what's happening is she is helping this client feel more calm and regulated, which is awesome.

Rachel: 9:05

As far as immediate effects with primitive reflex integration, I wouldn't say necessarily this reflex is immediately integrated, we can move on. I don't think we're necessarily seeing immediate effects from the reflex integration. I think we're seeing the effects from the sensory stimulation that's being provided. But I think if she continues doing this and continues to have the family do this, like upside down over the therapy ball and then laying prone to do a fine motor task, I think that can be really beneficial. And I'm hoping that she will see benefits after you know, incorporating that every day for you know, a designated amount of time. But I'm thinking that it's a result of the sensory input and you know that I mean, what came first the chicken or the egg, the two are directly connected. So, yes, there are immediate effects. It's definitely I think, from the sensory input that's happening rather than the reflex. Because usually we see things get worse before they get better in the reflex department. So if you're starting a reflex integration plan, we generally like to caveat and say, hey, expect things to be to be a little harder initially, you know, it'll get better, stick it out. But the brain is going through a lot when you are integrating these reflexes, and you're really pushing on a lot of those brain stem skills to start developing, the wiring to start happening, and firing. And when you see that happening, it can look like the kids melting down more, or they're really struggling with anxiety or tactile processing. But really, it's a good thing.

Jessica: 10:51

Yeah, I have two thoughts, exactly what you said, you know, the challenge comes because the brain is creating new neural pathways, and that can be hard and difficult for many children. And so you do have to kind of take it as it comes and determine, can we push through this, which is ideal, you want to be able to push through it. But there is also a chance that maybe you need to take a break for a minute, maybe, you know, take a couple of days off. So if your child is having such a hard time, that's always an option, because you don't want it to become such a negative experience.

Rachel: 11:31

Yeah, you don't want them to have negative connotations towards these exercises.

Jessica: 11:35

Yes. So I feel like that could be a whole other podcast episode of talking about the regression. That often happens with primitive reflex integration, maybe we should do an episode on that. The other thought I had was talking to this client about how these activities makes her feel. We always like to incorporate emotions and feelings into any sensory activity, which primitive reflex integration is going to incorporate sensory input so we want to talk about how does this activity make your body feel? Does it make you feel nervous or anxious? Does it make you feel silly? Does it make you feel calm and happy? And really identify those emotions that go along with the activities so that this client can start to better understand their own body and their own emotions and in turn become a better advocate for their own sensory needs because that's one of our goals with therapy and with working with our kids is to help them become more independent, and be able to advocate for what their body needs in different situations. So you kind of get a lot going on with this situation of working on primitive reflexes, working on sensory integration, add the emotional component in, so many different things that are happening here.

Rachel: 12:59

So, I think what would be helpful to talk about to is if you are a therapist, or a parent working on reflex integration, and maybe your child or a client that you're working with is struggling to get into these positions. Let's give some strategies. If we were working with the kiddos, what we would do. So the first thing that comes to mind, with the supine position is just starting on the floor, you know, just starting by laying down on the floor, getting the child comfortable in that position first. Even if it's you know, laying supine on a wedge so that way, they're not totally flat.

Jessica: 13:38

That's a great thing that you just brought up because I do remember working with some clients that even laying on their back on the floor was scary for them. And so yeah, getting a wedge or a cushion. So they're more inclined versus fully supine on their back. That is a great strategy that and laying on their back over the therapy ball. I think using the wedge again to get into that prone,

Rachel: 14:03

So yeah, so before you even put them on the therapy ball, start on the floor, on the wedge, maybe on the bosu ball, and then work up to the therapy ball. And you know, if it's a younger child, their feet aren't going to be touching the floor. So make sure that you provide them some stability, whether it's on your legs, or on a structure like a stool or something, give them give them some support for their feet. And then I would use as many preferred items as possible behind them kind of above them if they have a favorite toy, you know, dangling above them when they are laying down so that way they can reach and grab it with their hands and then help facilitate them sitting up and doing that like crunch position back up to sitting. But what about the prone position? using that wedge is such a great strategy, but ultimately just getting your kiddo was laying on their stomach on the floor, propped up on their forearms is something that all kiddos need I'm thinking about the kiddos who even just that was so to be able to do. exhausting and so challenging, we would put the wedge on the on the floor, and they'd have their arms on the floor, their upper body kind of off the wedge, but more supported but supported. But you know, we were playing a game and they were in that position. Even just like on hands and knees would be a good modification. Using a visual using a timer for motivation, you know, asking them, how long do you think you can lay on your tummy? You know, while we play this game? And if they say, five minutes or five seconds, be like okay, let's try it, set the timer for it, set the timer and let them see I had one kid who held a Superman for like five minutes, because he like had a goal. He was like, I can do this for five minutes. And the kid did it. So anyways, I just I think it's it's fun for them to learn that goal setting.

Jessica: 15:59

And you doing it with them? Right? So absolutely. When they're prone on the floor, laying on their stomach on the floor for an activity, make sure you're down there with them. So that they're not just doing it by themselves. It's not as motivating.

Rachel: 16:11

No fun. Lay across from them, you know, get on their level, talk about other things, you know, just it just be aware of those compensatory strategies to are they laying their head down? Are they propping their head on their elbow? Are they laying their head to down on the side of their arm? Are they you know, do they have any scapular winging? Are they just really struggling in that position, just bring that awareness to them in a kind, kind way.

Jessica: 16:42

We're going to link a couple of research articles in the show notes that we encourage you to read and learn from because they're very interesting. I think I just wanted to kind of circle back to the initial question and make sure we've answered it. You know, there's a client that has a potentially routine Moro reflex, they are modifying activities to get this client into supine for short durations of time, and then also seeing some positive side effects of the sensory component of these activities. And I think, to this therapist, I would say keep doing what you're doing, keep doing these treatment activities with this client and work up to longer periods of time in these positions. Incorporate the emotional component to it so that the client can identify how it makes them feel and what they enjoy and what they don't like. And then make sure you're talking about the proprioception afterwards, and how beneficial that is.

Rachel: 17:49

Yeah, I'm already on these research articles, because I think they're so interesting. And I just want to point out a couple of things from one of them. It's called effects of primitive reflex integration exercises on forward head posture balance and concentration in children with neurodevelopmental disabilities, and it's a pilot study. So it's a small study, but there were 10 children with a neurodevelopmental disability. And the primitive reflex integration exercises were performed for 40 minutes, twice a week for eight weeks. I'm curious, like what they were doing for 40 minutes, twice a week for eight sessions. Like normally, that's not what we read. That's a

Jessica: 18:27

long time. I wonder what exercise Yeah, for 40 minutes?

Rachel: 18:31

Yes, but they only did it twice a week, instead of every day. Like we recommend. What were the results? So the results were there were significant improvements in forward head posture after the intervention, the exercises significantly improved balance ability of children with neurodevelopmental disability, and there were significant improvements in changeless, sitting and looking at the teacher putting children's hands on their knees and looking at the immovable and movable objects. So says it was a successful intervention.

Jessica: 19:04

I think that's an interesting point that we will chat about just really quickly here is that, you know, in the therapy setting, in the clinic setting, we would work on primitive reflexes. Once or twice a week with our clients, we would try to give the home exercise programs to do at home. But that is a challenging thing for many families to add a challenging exercise to the daily routine. So oftentimes, we wouldn't see consistent carryover, but we would still see positive results from what we would do in the clinic. From a primitive reflex integration standpoint, maybe not fully integrating the reflex because they're only doing it once or twice a week. But we would still see improvements in other areas, kind of like what that study is talking about of like posture and balance control and ocular motor skills.

Rachel: 19:58

So anyways, with that being said, this was a kind of an interesting episode. Well, honestly, I think it's collaboration. I think that if you're a therapist looking for some collaboration, this is an episode for you. Maybe we need to do these more often. But it's, it's honestly fun. Like I missed that part of being in the clinic right now is like collaborating. I mean, Jesse and I get to collaborate all the time on this stuff. But it's, it's really fun to just kind of brainstorm some strategies. And hopefully, it was helpful. If you want to hop in on our course and take it and learn it's available. We are rebranding it. And it's, like, literally amazing. So good.

Jessica: 20:38

Also, if you're struggling with any of your clients that you work with, you can sign up for our two on one mentoring program that we do. It's a 45 minute brainstorm session. And you can tell us about some challenges you're having with some clients and you know, looking for new ideas, and we can brainstorm with you so the link for that will be in the show notes as well.

Rachel: 21:00

Okay, that is it for our episode today. Short and Sweet. Thanks for being here. If you want to take a screenshot and share it on Instagram, you can tag us at all things sensory podcast, and we would love to see that you're listening. And don't forget to leave a review on iTunes and Spotify. We love reading your thoughts about this podcast.

Jessica: 21:20

All right. That's it. We'll talk to you next time. Okay, bye.

Rachel: 21:23

Bye. Thank you so much for listening to all things sensory by Harkla.

Jessica: 21:28

If you want more information on anything mentioned in the show, head over to harkla.co/podcast to get the show notes.

Rachel: 21:36

If you have any follow up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at Harkla underscore family or at all things sensory podcast. If you just search Harkla, you'll find us there.

Jessica: 21:52

Like we mentioned before our podcast listeners get 10% off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory will get you 10% off. That's s e n s o r y.

Rachel: 22:11

Head to harkla.co/sensory to use that discount code right now.

Jessica: 22:16

We are so excited to work together to help create competent kids all over the world. While we make every effort to share correct information we're still learning.

Rachel: 22:26

We will double check all of our facts but realize that medicine is a constantly changing science and art.

Jessica: 22:31

One doctor or therapist may have a different way of doing things from another.

Rachel: 22:35

We are simply presenting our views and opinions on how to address common sensory challenges health related difficulties, and what we've found to be beneficial that will be as evidence based as possible.

Jessica: 22:47

By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your child.

Rachel: 22:55

Consult your child's pediatrician or therapist for any medical issues that he or she

Jessica: 22:59

This entire disclaimer also applies to any guests or contributors to the podcast.

Rachel: 23:06

Thanks so much for listening