Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Fifty-three kindergarten and first-grade students were screened to examine the relationship between primitive reflexes and scholastic performance. Overall, 100% of participants had retention of at least one reflex. Results indicated statistically significant relationships between reflexes and areas of academic performance. Further research is warranted to understand why reflexes are not being integrated and how school-based OTs ought to use these findings.
Primary Author and Speaker: Diana Feldhacker
Additional Authors and Speakers: Reilly Cosgrove, Benjamin Feiten, Kayleigh Schmidt, and Marissa Stewart
PURPOSE: Primitive reflexes have become an increasingly popular topic among occupational therapy practitioners. Though evidence related to this topic is growing, there continues to be a lack of explained impact on and relationship to occupational performance. Enhancing the knowledge of how primitive reflex retention relates to everyday occupations, such as scholastic performance, will help future therapists better structure intervention and maximize participation in valued roles. The purpose of this study was to examine the prevalence of primitive reflex activity and the relationship between primitive reflexes and scholastic performance among kindergarten and first grade students.
DESIGN: The study used a quantitative correlational design and involved a convenience sample of 53 typically developing, early elementary students, recruited from a single elementary school (24 kindergartners and 29 first graders, 31 males and 22 females, ages 5-7 years).
METHODS: Students were screened for seven primitive reflexes (spinal galant, palmar, rooting, asymmetrical tonic neck (ATNR), tonic labyrinthine (TLR), symmetrical tonic neck (STNR), and moro), using methods approved by the Institute for Neuro-Physiological Psychology. These were rated on a 3-point scale from absent to significantly active. The Woodcock-Johnson Test of Cognitive Abilities was administered by school staff, per regular scholastic testing procedures. Subtests included reading, math, written language, applied problem solving, spelling, reading comprehension, and overall academic achievement and skills. Descriptive statistics were used to explore primitive reflex retention prevalence as well as averages for scholastic subtests. Differences between ages and gender were explored. In addition, correlational analyses were used to determine the relationship between primitive reflex retention and areas of scholastic performance.
RESULTS: Results found that 100% of students had at least one active primitive reflex. The most common retained reflexes among students were STNR (83% retention), ATNR R (85% retention), and ATNR L (74% retention). Males demonstrated higher rates of retention for all reflexes except spinal galant. Among males, statistically significant relationships existed between retention of ATNR R, tonic labyrinthine prone (TLP), and tonic labyrinthine supine (TLS) and decreased scholastic performance in several subtests including reading, reading comprehension, written language, math, and spelling. Females demonstrated statistically significant relationships between retention of palmar R, Rooting L, and Moro with poorer scores in reading and math subtests.
CONCLUSIONS: High rates of retention and reflex activity were found among students. In addition, significant relationships were indicated between reflex retention and poorer scholastic performance. For occupational therapy practitioners serving pediatric clients, this new research points to a potential client factor affecting education and learning. Thus, screening for primitive reflexes as part of evaluation procedures could be indicated in holistically addressing client care. Ongoing research is warranted to thoroughly investigate why primitive reflexes are retained, how the context of early development is affecting integration, and how occupational therapy practitioners can and should intervene.
References
Konicarova, J., & Bob, P. (2013). Asymmetric tonic neck reflex and symptoms of attention deficit and hyperactivity disorder in children. International Journal of Neuroscience, 123(11), 766-769. https://doi.org/10.3109/00207454.2013.801471
Chinello, A., Di Gangi, V., & Valenza, E. (2016). Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder. Research in Developmental Disabilities. https://doi.org/10.1016/j.ridd.2016.07.010
Gieysztor, E. Z., Choińska, A. M., & Paprocka-Borowicz, M. (2018). Persistence of primitive reflexes and associated motor problems in healthy preschool children. Archives of Medical Science, 1, 167–173. https://doi.org/10.5114/aoms.2016.60503
Goddard, S. (2005). Reflexes, learning and behavior: A window into the child’s mind. Eugene, Oregon: Fern Ridge Press.
