VISION THERAPY - Retained Reflexes and Vision

Retained Reflexes and Vision

Why are we working on gross motor skills in vision therapy? These are the foundational skills for a stable visual system. We must be able to control our larger muscle groups before being able to gain control of the more intricate muscle groups such as the extraocular muscles. The gross motor skills we work on in vision therapy include balance, core stability, gait alignment, body awareness and retained primitive reflexes. If you think of our vision as a camera on a tripod or stand, we know the tripod must be stable to take a clear good quality image, therefore if the base is weak or is unstable it affects the entire system. We need to have a strong awareness of our own body (in addition to the other visual skills) in order to understand better where we are in space, where we are in relation to other objects and plan where we are going as we move throughout space- all crucial skills for obtaining information about our environment.

A reflex is an automatic reaction to a stimulus, it is always an unconscious reaction, the sensory nerve in direct connection with the motor nerve. All babies are born with a set of primitive reflexes to help the birthing process and start development. As a baby develops from infant to toddler, these reflexes should integrate into the system as stronger neural pathways form however, some children retain these reflexes. This inhibits development of proper pathways of the gross motor system adding in an extra pathway the brain must go through. In day to day life, this can look like poor coordination, poor fine motor skills such as printing and using cutlery, mood swings, inability to sit still, etc.

Throughout development if our brain is not viewing our visual input to the visual system as reliable or it doesn't make sense, the brain will hold onto these primitive reflexes as a survival mechanism. This is the same reason we are born with the reflexes to begin with, protection and survival as an infant. It is as higher pathways develop, these primitive reflexes become inhibited and suppressed, but if our visual skill maturation is delayed in any way these primitive reflexes are often held onto. The issue with retaining these reflexes as a child is they get in the way of developing other skills, both in gross motor and fine motor skills (ie., riding a bike and printing). As a developmental foundation these reflexes need to first be worked on so that higher level skills can develop and be maintained. Another issue with retained reflexes is that the brain is actively processing on a level it developmentally shouldn't be, so by working on removing these no longer needed retained reflexes, more energy can be put into executive function tasks such as learning.

Primitive Reflex Purpose of Reflex Appears Should Integrate By Signs of Retention
Moro Primitive fight or flight reaction Birth 2-4 Months Hyper Sensitivity, Hyper Reactivity, Poor Impulse Control, Sensory Overload, Social and Emotional Immaturity
Spinal Galant Assist Baby with Birth process Birth 3-9 Months Unilateral or Bilateral Postural Issues, Fidgeting, Bedwetting, Poor Concentration, Poor Short Term Memory
ATNR To Assist Baby Through Birth Canal and Develop Cross Pattern Movements Birth 6 Months Poor Eye-Hand Coordination, Difficulty with Handwriting, Trouble Crossing Vertical Midline, Poor Visual Tracking for Reading and Writing
TLR Basis for Head Management and Postural Stability Using Major Muscle Groups In Utero 3 ½ Years Poor Muscle Tone, Tendency to Walk on Toes, Poor Balance, Motion Sickness, Spatial Orientation Issues
STNR Preparation for Crawling 6-9 months 9-11 Months Tendency to Slump While Sitting, Poor Muscle Tone, Poor Eye-Hand Coordination, Inability to Sit Still and Concentrate
Grasping Palmar Automatic Flexing of Fingers to Grab Birth 5-6 Months Difficulty with Fine Motor Skills, Poor Manual Dexterity, Messy Handwriting
Rooting Automatic Response to Turn Towards Food Birth 3-4 Months Fussy Eater, Thumb Sucking, Dribbling, Speech and Articulation Problems
Landau Assist with Posture Development 4-5 Months 1 Year Poor Motor Development