What can make Reflexes Dysfunctional
One or a combination of four basic conditions can cause primary infant motor reflex dysfunction or deeper pathology:
- Congenital Disorders
- Prolonged, Intermittent or Chronic Stress
- Non-Congenital Disease
Each of these conditions can cause the central nervous system, sensory system, or motor system to become compromised. Congenital disorders, trauma, and non-congenital disease can also cause innate, neural pathways necessary to engage motor reflex programs to become blocked or damaged.
Congenital disorders can occur due to either genetic abnormalities (e.g., color blindness, Downs Syndrome, Cystic Fibrosis) or teratogenic effects, which are maternally related issues that can cause birth defects. These include:
- Infectious maternal diseases (Aids, Rebella, Syphilis, etc.)
- Chronic maternal conditions (Hypo or Hyperthyroidism, Diabetes, etc.)
- Prescriptions, over the counter medications and supplements, or other addictive substances ingested by the mother (alcohol, cigarettes, caffeine, recreational drugs), malnutrition, stress or radiation.
Regardless of the cause, when a baby comes into the world with a congenital disorder, there is a possibility that neural pathways necessary to engage innate reflex programs may be blocked or damaged or one of the neurosensorimotor systems necessary for primary infant motor reflexes to emerge and function may be impaired.
Trauma or Disease
Trauma is defined as an unexpected life-threatening event that results in a debilitating outcome that disrupts normal physical or emotional function. Trauma can result in physical and emotional debilitation. Physical trauma can occur in the womb, during the birth process, at birth or any time after birth, and can be caused by in-utero or birth complications, an accident, violent attack, or natural disaster. Emotional trauma can be caused by neglect, abuse, social isolation, or separation, humiliation, observation of a horrific event, the death of a loved one, or more. If trauma occurs in the womb, or during the typical maturation period of a primary infant motor reflex, neural pathway blockage or damage, or a compromised neurosensorimotor system can impact reflex emergence, maturation and integration.
If life-threatening trauma occurs after a primary reflex pattern has integrated, the autonomic nervous system can trigger primary infant motor reflexes to re-surface as a behavioral adaptation immobilization strategy. In 1994, Stephen Porges proposed as part of his Polyvagal theory that this behavioral adaptation strategy is one of three survival strategies automatically engaged by the autonomic nervous system to ensure the body’s survival. (refer to Stephen Porges’s [link to porges] contribution to reflex understanding for more information regarding the body’s behavioral adaptation strategies) When a primary infant motor reflex re-surfaces, it often remains present until a knowledgeable resource identifies its presence and uses techniques to foster its integration.
Reflex Dysfunction & Prolonged Intermittent or Chronic Stress
The early work of Walter Cannon revealed that the autonomic nervous system manages two general states of function in the body as a normal course of daily function:
1. The Non-Alarm State
Managed by the parasympathetic subsystem of the autonomic nervous system. The parasympathetic system
Is responsible for normalizing function in the body during non-alarm states to ensure long-term survival.
2. The Alarm State
Managed by the sympathetic subsystem of the autonomic nervous system. Responsible for engaging the mobilization
state in the body in order to ensure near-term survival.
These two autonomic subsystems (parasympathetic and sympathetic) function in a symbiotic fashion with one system in more or less control based on the body’s internal alarm state. Hans Selye revealed that when the sympathetic nervous system maintains predominate control without allowing the parasympathetic nervous system to restore normative function with regular frequency, not only can the body sustain internal physiological damage, but its overall ability to function effectively, and maintain emotional and behavioral stability, begins to diminish. If this occurs during the typical primary infant motor reflex maturation period, the underlying neurosensorimotor function can be challenged making it difficult for the reflex to mature and integrate. If it occurs after all the primary infant motor reflexes have integrated, then low-level trauma, normally managed effectively by the bodies near term survival system, can trigger reflex patterns to re-surface. In other words, prolonged intermittent or chronic stress can compromise maturation and integration of primary infant motor reflexes and can even cause primary infant reflexes to re-surface when a person is faced with low-level trauma.
Disease that occurs sometime after birth and is not attributable to genetic issues can cause the neural pathway and neurosensorimotor system issues previously discussed. If the disease presents itself prior to the typical maturational time period of primary infant motor reflexes or after the infant reflexes have integrated, the same challenges discussed as part of congenital and trauma conditions can occur.
Blocked or Damaged Neural Pathways
When neural pathways are blocked or damaged, the body often attempts to engage innate reflexive motor programs through alternate related pathways. Depending upon the magnitude of the blockage or damage, the resulting primary infant motor reflex may:
- Emerge, mature and integrate with little or no problem or apparent problem (can remain hidden)
- Emerge, not fully mature, and remain dysfunctionally present (not integrating)
- Emerge pathologically, functioning in a strange and unexpected fashion (not integrating)
- Simply not emerge
The work of Alexander Luria helped to demonstrate that blocked neural pathways can be “de-inhibited” (activated), and damaged pathways restored through functionally related pathways in the brain. Because innate motor reflex programs are genetically programmed regardless of the challenges that may be present, function can be improved and sometimes even restored when neural pathways are de-inhibited or restored through functionally related pathways. The results depend upon the magnitude of the issues that are present.
If a congenital disorder is present, trauma has occurred, or prolonged intermittent or chronic stress is present, the question becomes how have the underlying neurosensorimotor systems (sensory systems, central and peripheral systems, motor system) necessary for primary infant motor reflex integration been impacted? If any combinations of these systems are not working correctly, primary infant reflexes may not integrate appropriately.
As a result of congenital differences, an individual’s sensory system may be over-reactive, under-reactive, or may not work. In the case of trauma or prolonged chronic or intermittent stress, an otherwise normally functioning sensory system may become over-reactive, under-reactive, or may stop working altogether.
A person with an over-reactive sensory system may find moderate amounts of stimulation overloading or irritating. A scratch can feel like a deep cut, a light touch like an aggressive push, an everyday sound like nails scratching on a chalkboard, or simple eye contact like a glaring stare. In the same vein,a person with an under-reactive sensory system may not respond to a small or even moderate amount of sensory stimulation. For them, a deep cut can feel like a simple scratch, an aggressive push like a light touch, scratching nails on a chalkboard like any other sound, or a glaring stare like simple eye contact. In either case, the sensory system is misinterpreting the environment and sending sensory input to the central nervous system that is out of line with reality.
Because perception is reality, the central nervous system regulates and directs internal and external responses based on the input it receives, generating a corresponding over- or under-reactive response. To the outside world, an individual with a challenged sensory system can appear emotionally and behaviorally dys-regulated, when in fact the magnitude of emotion generated and behavior exhibited actually reflect the appropriate over or under-reaction of the challenged sensory system. An over-reactive sensory system can cause the sympathetic nervous system to over-engage its ‘alarm state’ mobilization system, causing restoration and growth challenges for the body.
An under-reactive sensory system can cause the parasympathetic system to over-engage the ‘non-alarm state.’ While the purpose of the parasympathetic system is to allow the body to restore and grow to ensure long-term survival, if the body does not understand when sensory input is dangerous or life-threatening it will not engage mobilization or immobilization strategies to ensure survival. In other words, people with an under-reactive sensory system can often be prone to harm during dangerous and life-threatening situations and are often more likely to engage in high-risk activities.
As a result of congenital or traumatic events, a motor response can range from being dysfunctional to pathological. A dysfunctional motor response can be hyperactive, causing too much muscle tension, overdeveloped muscle tone, and muscles too rigid to allow adequate extension, restricting the functional range of movement; or hypoactive, causing too little muscle tension, underdeveloped muscle tone, and muscles too soft to control or support the body. A pathological motor response, more severe in nature than a dysfunctional response, may be:
- Reversed – The opposite of what is expected
- Incorrect – A response expected for some other stimulus
- A-reflexic – generating no response at all
A primary infant motor reflex that exhibits either a dysfunctional or pathological motor response will not be appropriately integrated.
Central Nervous System (CNS)
Under normal conditions, the CNS actively fulfills its role mediating the appropriate reactions to sensory signals inside and outside the body to ensure basic bodily functions and activities remain well regulated. Due to congenital defects, trauma or disease, or long-term intermittent or chronic stress, CNS performance can be compromised causing incoming sensory information to be blocked or misinterpreted (under or over exaggerated) and outgoing directives to produce motor responses that are dysfunctional (hypo- or hyperactive, under or over-reactive) or pathological (a-reflexic, incorrect or reversed). For this reason the presence of developmentally inappropriate primary infant motor reflexes has long been viewed, by medical professionals, as an indication of possible neurological issues.