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Tag: occupational therapy

What are primitive reflexes?

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A reflex is an automatic and instantaneous response to a sensory stimulus. Remember when you were a child at the doctor’s office and they tapped your knee with a small mallet to check if your leg kicked upwards? You didn’t decide to kick your leg, it just kicked. From infancy, reflexes are vitally important for proper development of the brain, nervous system, body and sensory systems. Some reflexes are meant to stay with us our whole lives. Others are designed to be dormant after their function is fulfilled – also called integration. Check out this awesome resource from Tools to Grow to learn more about specific reflexes and how they impact a child’s function during their daily life. Primitive reflexes are adaptive responses that develop before birth and typically integrate as the brain matures. Primitive reflexes are important for survival and development early in life; however, it is also important that they become integrated as the child grows. Retained reflexes can cause sensory issues, postural disorders, decreased motor skills, and attention/behavioral issues.

What causes retention of primitive reflexes?

Some potential causes of retention of primitive reflexes include c-sections, trauma during birth, exposure to toxins, decreased tummy time during infancy, decreased time crawling, chronic ear infections, or head injuries during infancy among many other unknown causes.

Five Commonly Retained Primitive Reflexes and their Impact on Occupations

1. Moro Reflex

The Moro Reflex is known as the “startle” reflex. This reflects is a fight or flight reaction. It is present at birth and should be integrated by four months. Common effects of retention include emotional outburst, motion sickness, and difficulties with vision, reading, and writing.

2. Asymmetric Tonic Neck Reflex (ATNR) 

The Asymmetric Tonic Neck Reflex (ATNR) is known as the “Fencer’s pose”. It assists in the birthing process. It appears at birth and should be integrated by nine months. Common effects of retention include decreased eye-hand coordination, poor handwriting, poor balance, difficulty with reading and math, and difficulty focusing.

3. Symmetric Tonic Neck Reflex (STNR) 

The Symmetric Tonic Neck Reflex (STNR) is an essential foundation for crawling. It appears at six to eight months and should be integrated by nine to eleven months. Common effects of retention include poor posture, W sitting position, poor eye-hand coordination, messy eater, and low muscle tone.

4. Tonic Labyrinthine Reflex (TLR) 

The Tonic Labyrinthine Reflex (TLR) is commonly seen in children with ADHD diagnoses. It appears before birth and should be integrated by three and a half years of age. Common effects of retention include decreased balance, poor spatial awareness, toe walking, weak muscles, poor posture, and difficulty with climbing.

5. Spinal Galant 

The Spinal Galant Reflex also assists in the birthing process. It appears at birth and should be integrated by three to nine months. Common effects of retention include bed wetting after potty training, hyperactivity, postural issues including scoliosis, attention issues, and decreased endurance.

What are integrated reflexes?

Integrated reflexes are important for developing motor control. A child needs motor control to maintain proper posture at a desk in school, ride a bike, read a book, cross midline, write, and get dressed. A child with integrated reflexes has normal movement patterns to complete these functional tasks at home and at school. A child with unintegrated reflexes could benefit from skilled reflex integration therapy which will essentially train a child’s brain by establishing an efficient movement pattern that supports higher level motor skills or cognitive tasks.

How do you know whether or not your child has integrated these reflexes?

There are many common areas of difficulty that may suggest a retained reflex including the following:

  • “Bouncing” Child: Constantly moving, can’t sit still on a chair, hyperactive
  • “Noodle” Child: Leans on everything, rests head on table
  • “Shirt Chewers”: Constantly chewing on shirts or pencils, and touches everything
  • “Emotional Child”: Challenges with regulating emotions, easily frustrated or upset, difficulty with utilizing age appropriate coping strategies to calm body
  • School Performance Challenges: difficulty with reading, handwriting, language/speech, poor sitting balance and immature grasp on writing utensils
  • Coordination Challenges: Chronic body aches, poor endurance, fatigue, muscle weakness, poor concentration, fidgeting, disorganization

How do I know If My Child Has Retained Primitive Reflexes and What Can I Do?

Once your Occupational Therapist suspects a retained reflex, he/she will educate the caregiver on the importance of carryover for treatment recommendations. Caregivers play an important role in seeing progression in their child’s everyday activities. It is typically recommended that the child completes a set of tailored exercises to meet your child’s needs, 5-10 minutes per day, for 30 consecutive days in order to see any progress. Your therapist may recommended a reward or sticker chart in order to keep your child motivated towards an end goal. Progress can be noted short term and over 9-12 months. In addition to exercises, your Occupational Therapist will make recommendations for modifications in the school and home environments which may include changing positioning during school work, movement breaks, sensory techniques, relaxation techniques, decreasing auditory and visual stimulation, and organizational skills, just to name a few!

In order to determine whether your child would benefit from direct treatment for Reflex Integration, it is recommended that your child be evaluated or screened by an Occupational Therapist at Carolina Therapy Connection. Give us a call at 252-341-9944 today to schedule your FREE occupational therapy screening with one of our experienced and knowledgable OT’s. 

Is My Child Ready For Potty Training?

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Is My Child Ready For Potty Training?

Many parents ask the question, “Is my child ready for potty training?” Making the transition out of diapers is an important developmental milestone but it can also be a topic that causes frustration and anxiety for both children and their caregivers. Questions about when to start and how to promote a child’s success with potty training can feel overwhelming. If you are a caregiver that can relate to any of those feelings, this blog post is for you!

When Should I Start Potty Training?

This is a question that many caregivers ask themselves. A variety of factors must be considered before initiating the toilet training process. A child must be physically, emotionally, cognitively, and physiologically ready prior to  starting the process. Here are some tips to identify whether your child may be ready:

Emotional readiness – Can your child tolerate sitting on the toilet or potty training seat? Are they excited about wearing “big kid” underwear?

Cognitive readiness: Can your child follow 1-2 step directions? Can they communicate their need to use the restroom?

Physiological readiness: Are they able to stay dry up to two hours at a time or wake up from a nap with a clean pull-up?

Physical readiness: Is your child able to sit on a toilet or potty training seat without assistance? Can they get on and off the toilet with little to no assistance? Can they assist with managing their clothing during toileting tasks?

potty training, occupational therapy, tips and tricks of potty training

If you have said yes to the majority of the above questions, then your child may be ready to begin potty training! 

At what age can I expect my child to start potty training?

 The following list includes general guidelines to help establish a baseline of where a child might be on their journey towards potty training. However, each child has a different timeline in which they are emotionally, physically, cognitively, and physiologically ready for potty training. It is vital that you never push a child towards progressing through the developmental sequence. If you see meltdowns or signs of regression, it may be best to take a break and try again at a later time.

 

Developmental Sequence for Toileting:

1 year – Children indicate that they are wet/soiled through non-verbal signs of distress

2 years – Child begins to tolerate sitting on the toilet

30 months – Child communicates that they need to use the bathroom and will likely require assistance with managing their clothing and wiping

3 years – Children will initiate using the toilet independently. They may attempt to wipe but continue to require assistance for thoroughness. 

4-4.5 years – Children may have a few accidents. They are able to manage their clothing independently. 

5 years – Child is able to complete a full toilet routine independently, including washing and drying their hands. 

5-7 years – Children are consistently able to stay dry throughout the night. 

 

Tips to Help Progress Through the Potty Training Process

  • Make potty training FUN!

Whether it is the sound of the toilet flushing or the new environment, some children may have a fear of sitting on the toilet. If a child is anxious, they may be hesitant to sit on the toilet or may not even tolerate sitting on it. One method to help ease this transition is to allow the child to play with their favorite toys while sitting fully clothed on the toilet. Another method to make potty training fun is to invite the child into the process. You can do this by allowing the child to pick out their underwear and ask them to choose their potty seat. This helps address their newfound need for autonomy and allows them to take pride in the potty training process. 

  • Consistency is key. 

Establishing a consistent routine will help minimize a child’s accidents and increase their likelihood of using the toilet successfully. A general guideline is to prompt the child to sit on the toilet as soon as they wake up, after naps, and in two hour intervals throughout the day. Encourage your child to sit on the toilet for a few minutes at a time. It can be helpful to read a story to them while on the toilet or provide them with a preferred toy to make this time fun and engaging.

  • Know the signs. 

If a child is squatting, holding their genital area, or fidgeting, they may need to use the bathroom. Prompt the child to sit on the toilet when these signs occur. This can help the child become familiar with these signals to increase their ability to identify these signs as well. 

  • Celebrate the small victories. 

It is important that parents and caregivers build up a child’s confidence and self-efficacy during the potty training process. Caregivers can do this by providing their child with positive praise and celebrating the small victories! Some examples of this include praising their child for sitting on the toilet, communicating that they need to use the bathroom, successfully using the toilet, and completing all other steps in the toileting sequence (ex. Pulling up their pants, flushing the toilet, washing their hands). Sticker charts can also help motivate children to use the bathroom by providing them with a tangible reward to work towards!

  • Know there will be accidents. 

In combination with Point 4 above, it is important to know that accidents will happen and how to respond when they do. Never punish a child for soiling their clothing. Instead, always be prepared with an extra set of underwear or clothing, especially when going out in the community. 

You can find more tips on the potty training process here!

 

How can Carolina Therapy Connection Help?

If your kiddo struggles with self-regulation, completing their daily activities, or meeting developmental milestones, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Blog By: Emily Britt, OT