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:

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1175974/full?mcp_token=eyJwaWQiOjEwMTM5MTA4MjM0ODUzNSwic2lkIjozNzA0MTc5MDEsImF4IjoiMDQyYWY0MTIxYzgxN2VjMWY5OTljNTRhNjgxNDU5N2MiLCJ0cyI6MTcyNTIxNzU0NywiZXhwIjoxNzI3NjM2NzQ3fQ.xznS4-DjP-aZRUvzQwH3QgB8rDC0qgxb4QLuQlUXXDk