The Clinical Significance Of Primitive Reflexes

11288096_xland Dominance Profile in ADHD, Learning Disabilities, and Autism

by Dr. John Sotis

When we are born, we have a brain stem, but most of the cerebral cortex is yet to be built. We therefore have a dilemma: we need to move in order to build our brains, yet we don’t have a brain that is developed enough to tell us to move. Fortunately, we have what are known as primitive reflexes, which cause us to move and thus build the brain – what is known as “bottom-up” development. With the exception of one, these reflexes are formed in utero and are based in the brain stem. They help us in the birth process and during the early months of life in order to promote developmental milestones and basic functions of survival. If all goes according to schedule, the frontal lobe blossoms, then inhibits primitive reflexes, breaking them up, and re-assembling them in the form of postural reflexes, which lead to sitting upright, preparing us for bipedal ambulation.

Anything that interferes with this normal progression results in failure to inhibit some of the primitive reflexes, causing a desynchronization between the left and right hemispheres of the brain, what is known in scientific literature as Functional Disconnection Syndrome. This manifests in the form of learning disabilities, attention deficit, sensory processing issues, developmental delays, obsessive-compulsive disorder, tics, autism, and related neurobehavioral disorders. The “fallout” from this disconnect depends on which hemisphere is deficient, and which specific brain regions are aberrant.

In order for “top-down” interventions (Applied Behavioral Analysis, counseling, tutoring, etc.) that appeal to higher cortical centers, to be maximally effective, “bottom-up” development must be complete. This occurs as a consequence of inhibiting primitive reflexes, while harnessing postural, sensory-motor, and ocular (eye) mechanisms, as is done in the Hemispheric Integration method. If these infantile reflexes persist, it’s like having an invisible ball and chain dragging off the back of a bicycle. When these reflexes are elicited by testing, the “ball and chain” becomes visible; the exercises prescribed are the “saw” that cuts them off, as it were. This frees up the brain so that it can mature and develop symmetrically with regard to the skills and characteristics of the two cerebral hemispheres. It also promotes neuroplasticity – that is, the brain is moldable, like plastic, so that neurons can make stronger and more numerous functional connections. When primitive reflexes are remediated, communication between the two brain hemispheres is enhanced, especially when specific pathways are stimulated by correcting sensory, motor, proprioceptive, and vestibular aberrancies. This is the premise upon which Hemispheric Integration is based and there is a plethora of scientific research to substantiate it. Sadly, very few clinicians bother to check primitive reflexes past the age of one year, rationalizing that they should have cleared up by then. Yet, their persistence is a “red flag” that needs to be dealt with. Out of all the children I’ve examined for neurobehavioral disorders, only a handful have had a clinician who identified the child’s primitive reflexes, and in not one case have these reflexes been remediated! I have had children make significant functional gains in a short time as a result of dealing with their baby reflexes. As an example, speech therapists have at times remarked that the child’s verbal ability suddenly began to improve. This is but one case of why it’s critical to have a functional neurologist as part of the team so that “top-down” modalities are even more efficacious.

While there are over 30 primitive reflexes present in a healthy newborn, there are 11 that are most commonly retained in neurobehavioral disorders. Below is a list of them, along with potential consequences of their persistence:

• Snout and Rooting: problems with speech articulation, persistent thumb sucking, and difficulty with solid foods.

• Palmar Grasp: difficulty with individual finger movements and handwriting.

• Babinski: abnormal gait.

• Moro: anxiety and panic attacks, over-sensitivity and reactivity to sensory stimuli, sensory overload, poor impulse control, social and emotional immaturity, motion sickness, poor balance and coordination, distractibility, mood swings, and inability to adapt to change.

• Tonic Labyrinthine: toe walking, aberrant eye tracking, academic struggles, organizational problems, poor spatial skills, and motion sickness.

• Symmetrical Tonic Neck: difficulty with eye-hand coordination, swimming, binocular vision, copying tasks, refocusing near-far vision, “clumsy child syndrome”, slouching, simian posture, and messy eating habits.

• Asymmetrical Tonic Neck: difficulty with eye-hand coordination, aberrant eye tracking, refocusing near-far vision, expression of ideas in written form, and academic struggles.

• Spinal Galant and Perez: daytime bladder accidents, nighttime bedwetting, poor concentration, and academic struggles.

• Glabellar Tap: I’m unaware of concrete ramifications of this reflex as it relates to neurobehavioral disorders; nonetheless, it is known as a frontal release sign – that is, the frontal lobe is incapable of inhibiting it and thus, it releases. This often occurs with dementia and Parkinson’s disease and is then termed Myerson’s sign. I have found this reflex in many individuals with neurobehavioral disorders and, as with all persistent primitive reflexes, needs to be remediated.

Mixed Dominance/Crossed Laterality

Another critical component for optimal brain function is one’s dominance profile – that is, eye, ear, and foot dominance should match one’s dominant hand. Many individuals with ADHD, learning disabilities, and autism have mixed dominance, also known as crossed laterality. If, for example, one is right side dominant for hand, ear, and foot, but one’s left eye is dominant, sensory processing speed in the brain slows down. The reason is that the portion of visual information from the dominant left eye that crosses to  the right hemisphere has to cross again over to the left hemisphere to synchronize with auditory information that has crossed over from the dominant right ear. In effect, vision has to jump through two “hoops” for every one “hoop” that auditory jumps through. Very few individuals are aware of their mixed dominance, unless they use firearms and find it more natural to site with the eye that is opposite their dominant hand. This is another invisible “ball and chain” that almost no one assesses. For this reason, I teach clinicians and educators to screen children in order to intervene before it’s too late (dominance profile can’t be changed in adults). Testing this takes less than 5 minutes, is very simple, yet extremely important. By patching one eye or plugging one ear for a portion of each day for several months, a synchronized dominance can be achieved. Occasionally, foot dominance is opposite the dominant hand, in which case the individual needs to perform repetitive activities with the foot on the side of hand dominance (kicking a soccer ball, writing one’s name on the floor with the great toe, and picking up crayons by flexing the toes).

Hemispheric Integration is a clinically proven, non-pharmaceutical, brain-based method of creating neuroplasticity and enhancing communication between the left and right cerebral hemispheres. In addition to correcting ocular, motor, sensory, proprioceptive, and vestibular aberrancies, any retained primitive reflexes are remediated and dominance profile, if mixed, is corrected (if the individual has not reached adulthood). Blood work is performed to assess inflammation, immune system function, vitamin D levels, and more, with dietary changes and supplementation where indicated. For more information on this cutting edge methodology, visit or call (401) 383-1711 for a free consultation.

Dr. John Sotis is a chiropractor and a functional neurologist – a title held by only a small percentage of practitioners. He has maintained a private practice since 1987, treating a wide variety of neuromusculoskeletal conditions. Dr. Sotis completed a year of post-graduate training under Dr. Robert Melillo, world-renowned researcher, professor, clinician, and author of the books Disconnected Kids, Reconnected Kids, and The Scientific Truth About Preventing, Diagnosing, and Treating Autism Spectrum Disorders. This course of study qualifies Dr. Sotis to practice Hemispheric Integration. He is an active speaker, lecturing for various agencies and school systems, teaching clinicians and educators about the neurobehavioral epidemic, and is an active member of the International Association of Functional Neurology and Rehabilitation.

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