In the womb, babies develop primitive reflexes that are integral to their survival and future development. But, what are primitive reflexes? They are a set of special reflexes that develop in the brain stem before birth. They help the baby with positioning in the womb, birthing, breathing, feeding, urination, etc. Throughout the first year of life these primitive reflexes go away or “integrate” as higher levels of the brain develop into more mature or voluntary movement. If primitive reflexes do not integrate, they can interfere with the neurological organization of the brain which may limit developmental and academic skills. If any reflexes remain after 12 months of age, they are called retained primitive reflexes. Each primitive reflex comes with its own set of movements and leads to new and different developmental milestones.

Palmar Primitive Reflexes

Firstly, there is the palmar reflex, which is important for the development of purposeful grasping. You may see by placing an object in the palm of an infant’s hand. Their reflex response is to hold on to the object. Children with a retained palmar reflex may: fatigue easily with handwriting or fine motor tasks, have sensitive palms, open and close their mouths while using their hands for tasks (writing or cutting), and/or difficulty with speech articulation. The mouth and hands connect via neural pathways in infancy, therefore the connection is still strong in those who have retained the palmar reflex.

Moro Primitive Reflexes

The Moro reflex, or the startle reflex, causes a baby to stretch out their arms and legs and quickly bring them back in with jerky movements. This response is similar to the feeling of falling, a loud sound, or a drastic change in temperature. Children with a retained Moro reflex are often sensitive to stimuli (sounds, textures, lights), lack emotional and self-regulation skills, and have a difficult time paying attention in class. Without an integrated Moro reflex, a child’s fight or flight response may be active, easily causing difficulties in many areas of life.

Asymmetrical Tonic Neck Reflex

The asymmetrical tonic neck reflex (ATNR) is important to build connection between the hand and eyes. The reflex builds skills to develop each side of the body, hand-eye coordination, and helps to build muscle tone. While infants are on their bellies, the arms and legs move as the baby turns their head. Therefore, they are exposed to a ton of visual stimulation by looking at their arms moving, looking at objects in the environment, and grabbing toys. Children with a retained ATNR may have challenges with the following: crawling, handwriting, visual tracking, crossing midline, and coordination.

Symmetrical Tonic Neck Reflex

The symmetrical tonic neck reflex (STNR) assists the infant with moving from laying on their belly onto hands and knees. This is sometimes referred to as the crawling reflex. It helps with the flexion and extension of the baby’s upper and lower extremities. Therefore, children with a retained STNR may have: difficulty crawling, poor posture and low muscle tone, W-sitting, and poor sustained attention.

While there are many more primitive reflexes, these are some of the most common ones that OTs address in therapy. We are all born with primitive reflexes. They should naturally integrate in order to promote higher level learning and motor development. However, sometimes they don’t. This can potentially cause challenges for children. An occupational therapist can test for any primitive reflexes and assist with integrating any retained reflexes.

For more information regarding primitive reflexes and signs to look for check out this great handout from Solve Learning Disabilities.

The ability to cross midline is an essential part of child development. What is midline crossing? Midline crossing is when one side of the body crosses over the central line of the body and performs a task on the other side of the body. You can think of the midline as an imaginary line that runs down the center of the body from the top of the head to the toes. Crossing the midline can be done with your eyes, hands, arms, feet, or legs.

The left side of our brain controls the right side of the body. This side of the brain is responsible for tasks like speaking, writing, math, science, and using reasoning. The right side of the brain controls the left side of the body. This side of the brain is responsible for tasks such as creativity, imagination, intuition, music, and art. The ability to cross midline is very important for many of our daily tasks including climbing stairs, walking, dressing, typing, catching a ball and so much more. Midline crossing is also required for developing hand preference.

Difficulty with Midline Crossing

What you may notice if your child is struggling with midline crossing includes moving their paper to one side when writing or drawing or switching hands in the middle of fine motor activities. They may also struggle with catching a ball with both hands, hitting a ball with a bat, skipping, or kicking a ball. Additionally, they may have trouble with reading as our eyes need to be able to scan from the left to the right side of the page when reading text. 

Activities to Try

These activities can be tried at home to encourage your child to cross the midline. 

• Play gross motor games – Some games to try include playing t-ball, swimming, martial arts, tennis, and skipping.
• Cross Crawls – While standing, have your child touch their opposite hand or elbow to the opposite knee and then switch. Do this 20-30 times.
• Arts and Crafts – Activities such as coloring, drawing, threading, cutting, and folding can naturally prompt midline crossing. Try doing these activities on a vertical surface.
• Animal movements – Encourage your child to try to move like different animals. Some examples include crawling like a crab, hopping like a bunny, and standing like a flamingo. 
• Transferring objects – Have your child transfer objects or toys from one side of the body to the other. Then repeat the activity going the opposite direction. 
• Ball Toss – Have two targets set up, one to the left of the child and one to the right. Have your child sit crisscrossed and throw a ball to a target on the opposite side of their body. The right hand will throw to the target on the left and the left hand will throw to the target on the right. You can also try to gradually increase the angle of the throw by moving the targets. 
• For Babies – Have them spend time on their tummy, exploring and playing. Which naturally encourages crossing the midline. Additionally, as they get older, encourage time crawling and pushing toys around. For children who skipped crawling, have them go back and practice crawling with proper coordination to the left and right sides of the body. 

Neck pain is a common ailment that affects millions of adults worldwide. Whether it’s caused by poor posture, muscle strain, or underlying conditions, neck pain can significantly impact one’s quality of life. While there are various treatment options available, physical therapy (PT) has emerged as a highly effective and holistic approach to managing and alleviating neck pain. In this blog article, we will explore the numerous benefits of physical therapy for adults suffering from neck pain and how it can help them regain their mobility and live pain-free lives. 

Targeted physical therapy Exercises and Stretches for neck pain

Physical therapy offers a range of targeted exercises and stretches that specifically focus on the neck muscles and surrounding areas. These exercises help to strengthen weak muscles, improve flexibility, and enhance posture, ultimately reducing pain and discomfort. Therefore, a skilled physical therapist will need to design a personalized treatment plan based on the individual’s specific needs. Thus, ensuring that each exercise is performed correctly and safely. 

Physical Therapy Manual Techniques for Neck Pain

Secondly, physical therapists employ various manual therapy techniques to alleviate neck pain. These techniques may include joint mobilization, soft tissue mobilization, and myofascial release. By applying gentle pressure and manipulation, physical therapists can release tension, reduce inflammation, and promote healing in the affected area. Manual therapy techniques can also improve blood circulation, which aids in the delivery of essential nutrients to the injured tissues. 

Posture Correction

Poor posture is often a leading cause of neck pain in adults. Physical therapists play a crucial role in identifying and correcting postural imbalances that contribute to neck pain. They educate patients on proper ergonomics, body mechanics, and postural awareness. This enables them to make necessary adjustments in their daily activities. By addressing the root cause of the problem, PT helps individuals maintain a healthy posture, preventing future instances of neck pain. 

Pain Management

PT offers various pain management techniques that provide immediate relief to adults suffering from neck pain. These may include hot or cold therapy, electrical stimulation, ultrasound, or traction. These modalities help to reduce pain, inflammation, and muscle spasms, allowing individuals to regain their range of motion and function. 

Physical therapy is a highly effective and non-invasive approach to treating neck pain in adults. By combining targeted exercises, manual therapy techniques, posture correction, and pain management strategies, physical therapists can help individuals regain their mobility, reduce pain, and improve their overall quality of life. So, if you are experiencing neck pain, don’t hesitate to consult a physical therapist. Allow yourself to embark on a journey towards a pain-free and active lifestyle. Remember, it’s never too late to seek professional help and take control of your well-being. 

What are speech sound disorders and what are the different types? Children learn to say different sounds as they grow and develop. They do not pronounce first words the same way an adult might say them. In fact, we do not expect later developing sounds (r, th) until the around 5-6 years of age. So children may exhibit some distorted sounds or sound substitutions in their early years of talking. Children learn some sounds early (p, b, m, w). They should gradually learn how to say new sounds, improving the ability for others to understand them. Some children may have increased difficulty learning how to say their sounds, and they may have a speech sound disorder. 

There are various reasons that children may have difficulty producing sounds, and there are different classifications of speech sound disorders.

Speech Sound Disorder #1: Phonological

Phonological speech sound disorders are due to difficulty understanding the rules of the speech sound system, often learned naturally by children. Errors might include “tat” instead of “sat” or “wabbit” instead of “rabbit.” Sometimes, children may pronounce the sound accurately in another position of the word. For example, a child says “s” at the end of words accurately, but does not say “s” at the beginning of words correctly. Other times, a child may substitute a whole group of sounds for a different sound. For example, they produce s, sh, f, and ch as t (“shin,” “chin”, and “fin” become “tin”).

#2: Articulation

An articulation disorder involves difficulty producing specific speech sounds. A child may eliminate, add, distort, or substitute a speech sound. This is typically because they do not know how to produce the accurate speech sound. Structural abnormalities of the facial structures (teeth, lips, tongue, palate) may also cause an articulation disorder.

#3: Childhood Apraxia of Speech (CAS)

CAS is a motor speech disorder. This means the child has difficulty planning and producing speech sounds due to difficulty with the brain telling the mouth muscles how to move. This brain-mouth disconnection makes it hard for the child to move their lips or tongue to produce speech sounds. Sometimes the child may not say much at all. CAS is often characterized by the child not saying words the same way every time, putting stress on a wrong syllable or word, distorting or changing sounds, and saying shorter words more clearly than longer words. 

Speech sound disorders can have variable causes, leading to variable errors, requiring various treatment strategies. Sometimes, speech sound disorders can overlap as well. Ask your child’s speech therapist for the best strategies to use at home to help their speech sound progress. You can find speech and language developmental milestones here.

Odds are that you, or someone you know, has suffered from a concussion (or multiple). But did you know that concussions are actually considered mild forms of traumatic brain injury? Concussions are serious…and therefore should be taken seriously.

The CDC estimates that nearly 3 million incidences of sports-related concussions occur every year, and this doesn’t even include all the other causes of concussion! Even more concerning is that half of concussions go unreported or undetected. Football accounts for more than half of all concussions. Girls soccer comes in second, and girls have roughly twice the concussion risk of boys within the same sport.

But, team sports aren’t the only place to look for these. Concussions are common in snow sports, accounting for 20% of injuries in skiing and snowboarding. Unfortunately for shredders, snowboarders have 50% higher rate of head and neck injury compared to skiers.

Signs and Symptoms of a Serious Concussion

• Dazed, stunned, or confused
• Disoriented to time, place, events, or unable to recall events
• Answers questions slowly, forgets instructions
• Loss of consciousness (not always!)
• Mood or behavior changes
• Headache, nausea, vomiting
• Imbalance, dizziness, blurred vision
• Sensitivity to light or noise
• Difficulty concentrating or feeling sluggish, hazy, or groggy

Most concussions should resolve within 7-10 days, but if symptoms persists, you may need to talk to your doctor, or see a PT/OT to get a screen.

Concussions are Serious! BEWARE: Second Impact Syndrome

Research suggests that a person who suffers a second concussion before the initial concussion has healed, has a 100% chance of permanent brain damage and a 50% chance of dying.

An example of this happening may be a football player who sustains a concussion and continues to play then receives another blow to the head. This leads to rapid and profound brain swelling, and possible complications of Second Impact Syndrome include:

• Learning disabilities
• Personality changes
• Walking disability
• Other brain or nerve disorder
• Permanent brain damage or death

When to go to the Emergency Room (in the first 48 hours)

• Loss of consciousness or seizures
• Increased headaches
• Slurred speech
• Repeated vomiting
• Abnormal confusion or unusual behavior
• Limb weakness

What to do if you or your child sustains a Serious concussion

Rest, rest, and more rest…but seriously, physical AND mental rest for the first 48 hours (no school). Then, slowly and gradually return to work/school. Once your child is able to do one hour of homework at home for 1-2 days, they may try to return to a modified school schedule. No return to sport/activity until able to return to school successfully

Diet: reduce inflammatory foods, such as processed foods with saturated fat and refined sugar, processed meats, fried foods, etc., and eat enough to fuel the brain.

Lastly, consider scheduling an appointment with a PT, OT, or speech therapist, as we are trained in concussion screening, vestibular management, return to sport, and return to learn.

Resources/References

1. Concussionresourcecenter.org
2. Cdc.gov/headsup/index.html

Having raised 5 children and now watching my children and their journey of parenting, I can fully agree with the following statement. Being a parent is a beautiful and rewarding journey, but it also comes with its fair share of challenges. As parents, it is our responsibility to create a nurturing and supportive environment for our young children to thrive in. Here are some key ways to be a supportive parent, encouraging the growth and development of our little ones as you go along the journey.

Parenting with Unconditional Love and Acceptance

One of the most important aspects of being a supportive parent is to love and accept your child unconditionally. Let them know that they are valued and cherished, regardless of their achievements or mistakes. The statement, “I love you, but did not like what you did,” can be used to let your child know you love them, even when they make mistakes. This will build a strong foundation of trust and self-worth, allowing them to feel safe and secure in their own skin. 

Foster open Communication

Encourage open and honest communication with your child from an early age. As your child grows so do their emotions. At an early age, help them identify simple feelings of being happy, sad, mad, and frustrated. Technology may be stealing communication away. Tablets and iPads are often used to make things better, or easier, so put phones away and turn off screens during family time. Mealtime is a perfect place to foster communication. It may be helpful to create a safe space where they feel comfortable expressing their thoughts and emotions. Listen attentively, without judgment, and validate their feelings. This will help them develop strong communication skills and build a healthy emotional intelligence. 

Parenting with Structure and Boundaries

Children thrive in an environment that provides structure and clear boundaries. Establish consistent routines and rules, which will help them feel secure and understand what you expect of them. However, it is important to be flexible and adapt to their individual needs. Balancing structure with flexibility will allow them to develop their own sense of autonomy and decision-making skills. 

Nurture Their Interests and Talents

Support your child’s interests and talents by providing opportunities for them to explore and develop their skills. Encourage them to pursue their passions, whether it be through sports, extracurricular activities, hobbies, or creative outlets. This can be challenging if their passions are not anything you are familiar with, or even enjoy. By nurturing their interests, you are helping them build self-confidence and a sense of purpose. Be cautious of comparing a child to siblings or other peers, rather, focus on the uniqueness and special talents/gifts that you see in your child.

Be a Role Model

Children learn by observing their parents’ behavior. Be a positive role model by demonstrating kindness, empathy, and resilience. Growing up, I never heard my parent argue or fight. While this made for a peaceful home in that regard, it did not allow me to watch how parents handled conflict. When I, as parent myself, had my first marital fight, I fully thought that the marriage was headed straight for divorce. Show them how to handle challenges, disagreements, and setbacks with grace and determination. By modeling healthy behaviors and attitudes, you are setting them up for success in their own lives. 

Most important, remember being a supportive parent is a continuous journey of learning and growth. It requires patience, understanding, and a genuine commitment to your child’s well-being. Remember, you are their biggest cheerleader and advocate. So, embrace the joys and challenges of parenthood, and watch your child flourish into a confident, resilient, and compassionate individual. 

Check out Big Life Journal for more resources to help with parenting and your individual journey!