Prevalence of Retained Primitive Reflexes in a class of Healthy Preschoolers
Description
The purpose of this study was to assess the prevalence of retained primitive reflexes in healthy preschool children in the Southeastern United States. Method: Twenty-one children between ages 3 and 5 years enrolled in the same preschool class participated in the study. A physical therapist tested each child for the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR) and the prevalence of each reflex was determined for the children overall and for boys and girls separately. Results: Only one child study displayed no presence of retained primitive reflexes. Six children (29% of subjects) scored between 1 and 2 on all reflexes tested, and 14 children (50% of subjects) scored a 3 or 4 on at least one of the reflexes. The TLR (95% of subjects) was the most commonly retained reflex, followed by the right ATNR (86% of subjects), left ATNR (81% of subjects), and STNR (67% of subjects). The number of subjects with evidence of reflex retention was nearly identical for each reflex in both boys and girls. Conclusions: Because of the high prevalence of primitive reflex retention found in this study and in previous work, routine screening of primitive reflexes in preschool-age children may be prudent to identify children who may need early intervention in the form of reflex integration therapy.
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ATNR. To test for the ATNR children were asked to assume a quadruped position on their hands and knees. A physical therapist held each child’s head in a neutral position and then turned it to the right 5 times and to the left 5 times. Both left and right sides were assigned a score ranging from 0 to 4 based on the following observations: 0: No reaction; 1: Opposite arm bends slightly; 2: Opposite arm clearly bends; 3: Opposite arm bends significantly; 4: Opposite arm collapses as a result of head rotation. STNR. To test for the STNR children were asked to assume a quadruped position on their hands and knees. The physical therapist held each child’s head in a neutral position before lifting it up into extension and down into flexion 5 times. Children were then assigned a score ranging from 0 to 4 based on the following observations: 0: No reaction; 1: Slight movement of one or two arms or slight movement of the trunk; 2: Clear movement of the elbow or hips; 3: Elbow flexion when the head is lowered followed by elbow extension when the head is lifted; 4: Full elbow flexion or pushing hips back to sit on the heels. TLR. To test for the TLR children were asked to stand up, keep their feet together, and put their hands on their hips. They were then asked to tilt their head back while the physical therapist supported the child’s head in this position for 10 seconds. Children were then asked to move their head slowly to look at their toes and then hold the position for 10 seconds. This was repeated 5 times. Children were then assigned a score ranging from 0 to 4 based on the following criteria: 0: No reaction; 1: Small disruption to balance; 2: Clear disruption to balance; 3: Near loss of balance, disorientation; 4: Loss of balance, dizziness. Statistical Analysis Frequencies for reflex retention were run in SPSS 25 to determine the number of children with retained left ATNR, right ATNR, STNR, and TLR. Additionally, these frequencies were determined separately for boys and girls.