So a few weeks ago I posted a revelation we had about Lincoln (7) and his “hyperactivity.” And my friend Lucy (not her name) messages me and says:
“After doing my own research after your post, I am beginning to think my son may not have ADHD. He has good grades and no trouble learning, he’s just disagreeable and disruptive in class… we have been so lost on this and you are the only person I know who has been going down this road too…”
And I’m thinking, yeah, I’ve got to tell more people what we found out. Because never in my life have I heard of the concepts I’ve learned about in the last few weeks, and I’m a well-researched, smart, educated gal. So it stands to reason that most of my momma peers don’t have a clue either.
First, let’s not discount the fact that gifted children are often misdiagnosed with ADHD rather than recognized as under-challenged in their learning environment. They could also be dual diagnosis, also known as 2e or twice-exceptional. These are certainly worth looking into, and I recommend Misdiagnosis and Dual Diagnoses of Gifted Children and Adults by Dr. James Webb if this is an avenue you want to explore.
That said, we discovered that our gifted Lincoln doesn’t have ADHD, but that there’s an underlying issue causing his inability to sit still, among other things that led to a diagnosis of Sensory Processing Disorder.
Two words: Primitive Reflexes.
Basically, these are reflexes from infancy and, in most cases, they “integrate” within the first year of life. But sometimes, they don’t shut off. And when they don’t, it causes all sorts of issues, specifically impeding the development of postural reflexes and hindering brain development. And these primitive reflexes could be the root cause of what doctors diagnose as ADHD/ADD and sensory disorder. Addressing them could be a significant help to your child.
There are at-home techniques for testing for these reflexes and addressing them. However, my personal recommendation is to get your child evaluated by an occupational therapist and ask him/her to specifically test for the reflexes you’re concerned may be a problem, giving you exercises to address them. This is one of those times when a trained professional is going to be your best option, so you don’t accidentally do something wrong and make the struggle harder.
There are eight primitive reflexes according to Brain Balance Centers (another evaluation and treatment option available – and the founder wrote a book that goes more in depth about all this, including home assessment techniques and exercises) and a variety of occupational therapy resources:
Grasp (Palmer) Reflex
In Infancy, when something touches the infant’s palm, it automatically grasps, holding tighter when the object is pulled away. This should “shut off” around 6 months of age. When retained past infancy, it shows itself as moving hands when talking, poor grip/fine motor skills and poor handwriting.
Startle (Moro) Reflex
When an infant is touched unexpectedly, hears a loud noise, sees a bright light, etc., he thrusts his arms outward and then draw them in like a self embrace. This is basically the early showing of fight or flight response and should shut off around 4 months old. If retained past infancy, it often shows as a child becoming easily overstimulated (sensory issues with textures, tickling, sounds, etc.), possibly showing aggression (fight) or anxiety (flight). The child may also be easily distracted and have poor impulse control.
Rooting (Sucking) Reflex
Stroking a baby’s cheek will cause it to turn toward your hand, impulsively looking for food. After 4 months old, those with an “on” rooting reflex may be messy eaters, have difficulty articulating speech, be sensitive to facial touches and have poor manual dexterity. They may also be long-term thumb-suckers or have oral sensory concerns (i.e. chewing on clothes, toys, etc.).
Spinal Galant Reflex
This reflex is thought to be utilized for an infant coming through the birth canal, as stimulation around the lower back causes the hips to move. It should shut off between 4-9 months of age. This is actually one of the most common active primitive reflexes in children diagnosed with ADHD, as those who Spinal Galant is still on are often unable to sit still (what is also known as “seeker sensory”). They may also exhibit poor posture, have chronic digestive issues, and may wet the bed (or have daytime accidents) after age five.
Asymmetrical Tonic Neck Reflex (Fencer Position – ATNR)
When a baby is laying on her back and turns her head one direction, ATNR means that the opposite arm and leg will bend, while the arm and leg in the direction she’s looking will straighten. This should turn off by 6 months. In older children and adults, when this reflex has not shut off, they have trouble crossing the midline of the body (such as touching the right knee with the left hand). This can result in poor hand-eye coordination and difficulty in reading/writing because of visual tracking issues. W-sitting is another sign. When driving, if an individual with a retained ATNR looks away from the road, the opposite hand will follow, causing the car to turn.
Symmetrical Tonic Neck Reflex (Crawling Reflex – STNR)
In infants, this reflex helps the baby to learn to get on hands and knees and crawl. When the head is lowered, the arms bend and legs extend — when the head is raised, the arms extend and legs bend. This should shut off by around 11-12 months. Retained, this reflex also results in poor posture, clumsiness and a disconnect when changing focus from one thing to the another (such as copying something from the blackboard on to a piece of paper on the desk). It also means a possible inability to register things in the peripheral field without turning the head or problems visually track objects across the midline of the body.
Tonic Labyrinthine Reflex (TLR)
As an infant prepares to roll and move on her own, this reflex activates. When a baby is laying on her back and her head tilts backward, the legs straighten and toes point. This reflex takes a bit longer to shut off, usually by 3.5 years old. When it does not, the most obvious presentation are toe-walkers with poor balance/posture. These children often deal with motion sickness, a poor sense of rhythm and difficulties with orientation and spatial processing (i.e. they can be clingy because they do not understand personal space).
This reflex presents from about 3 months to one year and is most commonly present during “tummy time” — when the baby lifts his head up, the entire trunk of his body flexes (like the superman pose). If this reflex remains active, a child may have stiff movement — a hard time skipping or hopping — as well as poor balance and muscle tone.
I want to again emphasize the importance of having your child evaluated by a professional to see if these primitive reflexes are active. At-home evaluations tend to only be effective if the reflex is extremely obvious. There are subtleties that I even missed when the Occupational Therapist was evaluating Lincoln. She has been able to hone in on which reflexes are the most problematic for him and we’re doing a combination of in-therapy and at-home exercises to address them.
Six weeks of therapy has already resulted in improvement for him, and I know for a fact I never could have Googled and found the right treatments he would need because there are too many resources with differing opinions. I’m a “research it and figure it out” type of girl, but not with his therapy. I’ll research it to understand it, and hopefully help guide someone else to the right answers, but I’ll leave treatment to the professionals.