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We try to take a holistic approach to physical therapy and support the whole child and their family to meet them where they are at along their life journey.
Resources for Parents and Clinicians
The Connection Between ADHD and Primitive Reflexes: How We Use Trampoline and Gymnastics to Support Integration
Introduction: Primitive reflexes play a crucial role in early development, laying the foundation for more advanced motor skills and cognitive function. However, research shows that when these reflexes are not fully integrated, they can contribute to challenges such as ADHD. In this post, we’ll dive into a recent systematic review and meta-analysis exploring the relationship between ADHD and primitive reflexes. We’ll also share how Balanced Creations Therapy & Trampoline leverages trampoline and gymnastics activities to support reflex integration.
Summary of the Study: A systematic review and meta-analysis titled Attention Deficit Hyperactivity Disorder is Associated with (A)symmetric Tonic Neck Primitive Reflexes offers a comprehensive look at the link between ADHD and non-integrated primitive reflexes, specifically the asymmetric tonic neck reflex (ATNR) and symmetric tonic neck reflex (STNR). The study analyzed data from four articles, encompassing 229 samples, and found significant positive correlations between ADHD and these reflexes.
Key Findings:
The correlation between ADHD and ATNR was moderate, with a summary r value of 0.48.
Similarly, the correlation between ADHD and STNR was also moderate, with a summary r value of 0.39.
Factors such as behavioral assessment tools, sex, and specific primitive reflex tests influenced the strength of these correlations.
The authors concluded that ADHD symptoms are closely linked to the non-integration of ATNR and STNR, suggesting a need for further research to explore the causality of this relationship.
Connecting the Research to Practice: At Balanced Creations Therapy & Trampoline, we see firsthand how the integration of primitive reflexes is crucial for children’s physical and cognitive development. Trampoline and gymnastics offer unique opportunities to address these reflexes in a dynamic, playful environment.
How We Use Trampoline and Gymnastics for Reflex Integration:
Asymmetric Tonic Neck Reflex (ATNR): ATNR is triggered when the head is turned to one side, causing the arm on that side to extend and the opposite arm to bend. This reflex should integrate around 6 months of age, but when it persists, it can significantly impact a child’s physical and cognitive abilities.
Signs and Symptoms of a Retained ATNR:
Gross Motor Challenges:
Difficulty rolling and crawling
Lack of balance and stability
Instability and clumsiness, often appearing robotic when running or crawling
Mixed laterality (not having a clear right- or left-side dominance)
Difficulty crossing the midline
Challenges following multi-step movement instructions
Frustrations and difficulties in sports
Fine Motor Challenges:
Struggles with eye-hand coordination
Handwriting difficulties
Poor speech production
Visual Skills Challenges:
Difficulty with binocular vision
Challenges with spelling and reading skills
Poor visual-motor skills (e.g., handwriting, dressing, feeding)
Difficulty copying from paper or a whiteboard
Challenges with visual tracking and following a moving target
Fatigue during reading
Difficulties with math
Auditory Skills Challenges:
Challenges with processing auditory information
Attention and Concentration Challenges:
Poor speech and language development
Difficulty concentrating and maintaining attention
Lack of focus and attention
Trampoline Integration: We incorporate activities that encourage cross-body movements and eye tracking on the trampoline. These activities help diminish the reflex and promote more integrated movement patterns. Specific activities include:
Running on the spot
Walking along the lines of the trampoline
Single-leg balance on the trampoline
Hitting, catching, and throwing balls while jumping
Assisted rolling
Jumping turns in seated, quadruped, and standing positions
Gymnastics Integration: We use a variety of gymnastics skills that specifically target ATNR integration, including:
Army crawling under mats and through tunnels
Hands-and-knees crawling under mats and through tunnels
Running and walking on a balance beam
Balancing on different surfaces, such as a balance beam or mat
Log rolling and cartwheels
Bear crawls and push-ups
Leg kicks and marching with opposition (e.g., opposite arm and leg movements)
Any skill that requires opposition
Climbing ladders, leaps, and turns
These activities help engage both sides of the body and encourage coordination, balance, and reflex integration, which are essential for addressing a retained ATNR.
If you're noticing any of these signs or challenges in your child, don't hesitate to reach out. Call us today to schedule a free 15-minute consultation or your initial session.
Stay tuned for our next blog, where we discuss the Symmetric Tonic Neck Reflex (STNR) and how it impacts development.
View the research article by clicking on the link below: