Autism,ADHD and Reflex Integration

Autism/ADHD and Primitive Reflex integration with reference to MNRI and QRI

Dated 16/9/18 to 22/9/18

Primitive reflexes (CNS reflexes)are present in an infant but absent in a neurologically healthy adult. These reflexes normally disappear within the first year of life due to inhibition by a mature/developing frontal lobe of the brain. If these reflexes are recurring during adulthood,it can reflect damage to the frontal lobe or spinal cord.If these primitive reflexes are unintegrated or retained in a toddler it shows a brain injury.

Expressing our sincere gratitude to Jasmeet and Meghna Mehta who participated in the reflex integration discussion and provided with informations on MNRI and QRI .

A reflex is an involuntary  or automatic, action that your body does in response to something — without you even having to think about it. You don't decide to kick your leg, it just kicks. There are many types of reflexes and every healthy person has them. In fact, we're born with most of them.

Jasmeet very well explained reflexes ,integration of reflexes and how MNRI helps unintegrated reflexes, integrate.

Why are reflexes important ?

From the womb , the childhood reflex movements literally grow the brain. Repeti- tive, automatic reflex movements are essential for the development of balance, mobility, vision, hearing, speaking, learning and communicating.
Reflex movements are the first foundations of the nervous system. Like a block tower, all further development depends on the readiness of the foundation.
Reflexes originate in the brain stem, or survival brain. When reflexes remain active, the survival brain is constantly stimulated. In this survival mode, there is less ability to access the prefrontal lobes, where we think, create, communicate and make beneficial decisions. In other words, we are more likely to react instead of control- ling our impulses.
Unintegrated reflexes trigger the “fight or flight” response, creating chronic stress. Even when there is no logical reason for stress, we can feel stressed because our physiology is constantly reacting as if threatened. Stress becomes a habit, often below the level of our awareness.

Most reflexes have a time period by which they get integrated. Once integrated either they disappear or integrate to form secondary reflexes.

 https://youtu.be/zV9XaVQrSvA

Masgutova Neurosensorymotor Reflex Integration(MNRI)

https://masgutovamethod.com/learning-the-method/mnri-education-curriculum

https://masgutovamethod.com/testimonials/36/i-am-a-parent-of-a-child-with-an-autism-diagnosis-he-also-has-a-diagnosis-of-anxiety-disorder-adhd-and-fragile-x-he-is-16-years-old-and-has-made-immea


MNRI Method is designed to facilitate the emergence, maturation, and integration process of primary reflex motor patterns for anyone, regardless of condition or age.

How can MNRI address a developmental disability like Asd
How can we connect reflexes and Asd?

When there are neurological deficit / Trauma to the brain , these reflex are either in state of hyper or hypo (either active or non responsive). When in such state - they disturb the development of the child. Very often ignored , play a critical role in our child's development.

To exemplify

Fear Paralysis Reflex FPR emerges in the 5th to 8th week of womb life, and ideally is integrated before birth. FPR is most likely a protective mecha- nism in the face of danger and may help us learn to cope with stress. FPR is a “freezing” reaction similar to a deer caught in the headlights.
There is tightening of the jaw and eye muscles; limb muscles contract and pull in toward the core. The breath is held, and there may be a significant drop in heart rate. Those who study reflexes do not always agree on what triggers FPR, but in general we can think of the FPR as a response to a perceived threat. If the FPR is not fully integrated at birth, it can cause lifelong challenges related to fear. There is an underlying anxiety preventing an individual from moving forward toward meaningful goals. When the Fear Paralysis Reflex is unintegrated it interferes with the integration of successive reflexes, especially the Moro Reflex.

Possible long term effect of an active FPR is
– shallow, difficult breathing
– Underlying anxiety or negativity
– Insecurity, low self-esteem
– Depression, isolation, withdrawal
– Constantly feeling overwhelmed
– Extreme shyness, fear in groups
– Excessive fear of embarrassment
– fear of separation from a loved one,
clinging
– sleep and eating disorders
– feeling stuck
– Elective mutism
– low tolerance to stress
– Withdrawal from touch
– Aggressive or controlling behavior,
craving attention
– Extreme fear of failure, perfectionism
– Phobias


With children with ASD most common reflexes not integrated are
1. Babinski
2. ATNR
3. STNR
4. Spinal Galant
5. Spinal Perez
6. Robinson Grasp
7. Foot Tendon Guard (especially if the child walks with heals up)

What is unique with MNRI?

There are many reflex integration program, MNRI Is has the most research available for reflex integration. An MNRI Therapist is taught how to assess if the reflex is integrated and how to integrate.It has well researched papers for children who have ASD, Cerebral Palsy, ADD, Down Syndrome etc.

MNRI reflex integration program has been well researched and documented.

DR. Svetlana and her son have researched and are always evolving the program since last 20 years.
It's one programme that is approved by 1.Psychological association of America, 2.Occupational therapy association of America
3.Physio therapy association of America  and
4. ASHA  -American speech- language- hearing association )

https://masgutovamethod.com/the-method/the-mnri-method-approach-programs

If the child has retained the Babinski reflexes, here are a few signs you may notice in your child:

Toe walking
Issues with proprioceptive and vestibular system
Muscles in the back of the legs are affected, altering gait
Trouble with balancing
Gravitational Insecurity (not being confident with their sense of stability)
Trouble with vestibular, visual and sensory systems

How can we assess the child  for MNRI?

Technically an assessment will list the reflexes to be worked on, no of days in a week and also priority 1 and 2 where you work on priority one and then on priority 2. Each assessment is valid for 6 months

https://www.ncbi.nlm.nih.gov/pubmed/23659315

https://www.ncbi.nlm.nih.gov/pubmed/24092983

https://journals.lww.com/jrnldbp/Pages/articleviewer.aspx?year=1984&issue=06000&article=00004&type=Abstract

What are the drawbacks of MNRI?
Mnri clinics are expensive by Indian standards but 6 hours of therapy for 6 days brings about significant difference

Quantum Reflex Integration (QRI)

https://reflexintegration.net/product/qri-harmonic-low-level-lasers/

https://youtu.be/0fmILtzJ3Dc

https://youtu.be/IKiwQoXxyYU

https://youtu.be/vfyjEQ0wXMw

https://www.facebook.com/groups/1029765563773500/


Meghna Mehta explained that QRI uses a cold laser, no exercises are involved,and it's easier to do on ASD kids.
Qri integrates reflexes faster also is better for integrating Moro and FPR which are typically very important for kids with asd.
Many parents testified the advantages and ease of QRI cold lasers on Asd kids that the onset of seizures have come to a halt after starting QRI, thanks to integrated FPR that raises the seizure threshold.

What happens when cold lasers (noninvasive) are used?
Laser penetrates the skin and affects muscles, nerves, bone, fascia etc. You trace the path on the body for each reflex. Qri also makes use of acupressure points.
Cold Laser is very safe and fda approved, used widely for many years. Precaution is that it should not be used on known cancer ,thyroid and avoid shining in the eyes.
Laser directly affects cellular mitochondria. It increases atp production which helps to  increase the cell division and helps and with inflammation.

It used by OTs/PTs/chiropractors/sports medicine drs.

https://reflexintegration.net/product/quantum-reflex-integration-sansur-bali/

Thank you all participants
#Asd parents and Therapists Group,Kerala.

Asd and Vision Disorders Faq

Vision Disorders Explained By Parents and Queries Answered By Experts On the field.

Dated 27/8/18

Asdparents and Therapists Group was highly privileged to have two eminent optometrists on board to answer queries from parents on vision disorders and Visual perception disorders. Our sincere gratitude to
*Diwakar Rao, working in Sankara Eye Hospital, HOD of Vision Therapy Department, Specialized in Vision Therapy & Behavioural Optometry & Neuro Optometric Rehabilitation.

*Nikhita Jacob , optometrist from sankara  vision clinic , Bangalore

*Zahi-r-Ibrahim Opthalmologist

Vision disorder is basically vision impairment where the vision is affected due to various reasons like refractive error.

Visual perception disorder is related impairment of perceptual skills like discrimination between things, matching the shapes, colors and similar actions in day-to-day life.

Q.What are the possible symptoms of vision disorder?

A.Blurring of vision, going closer to objects, rubbing eyes, squeezing eyes.

Q.My child usually fidgets fingers or objects in front of the eyes.Could you explain the same?

A.Referring to your queries with regard to fidget with fingers or staring at hands is due to visual stimulus.
Most of the special kids have very sensitive visual stimulus, to avoid this over stimulation they adopt eye poking, flapping of hands or even staring at objects.
Their is no written evidence on this.

Q.My daughter have the habit of eye-poking ,sometimes eyeball comes outside. what can i do for this?

A.Eye poking is due to very sensitive visual stimulus. Not to worry about.Eye poking symptoms reduce over a period of time with Vision therapy.
Initially we can help them like using a sticker on the child’s shoes so they know which foot to put them on.
Four line papers to help with word spacing and sizing and correct line alignment.
Use a marker to outline the boundaries for coloring.
Break visual activities into small steps.
Later slowly stop helping them in such routine duties and let them to do it on their own.

Q.My son does cornergaze , mostly when he focus more on TV ,when objects move ,can you explain why is it happening ?

A.Most of the kids have corner gazing, fond of seeing moving objects and rotating objects is due to visual stimulus.

https://www.autism.com/vison

https://www.covd.org/page/Autism

http://www.newimageeyecenter.com/vision-perception.html

Chitra Chandran explained how to ready a child in the spectrum for Vision examination in the hospital.
Preparation is always needed,the only difference is that, compared to preparing a day before as applicable for some kids, deliberately tell the child while on the way to the hospital nowadays ( a step ahead towards dealing with emergency)
Give instructions in advance on how to listen to the doctor and  nurse,and explain  that they r trying to help the child.
Also let them understand how to ask them  or parent  for any help

She pointed out some issues faced  by asd kids for eye examinations such as sensory issues towards touching the chin and  forehead , keeping eyes open for a long time and so on. She also suggested that for touch sensitivity, we should try giving that kind of rough feel with some object at forehead and chin beforehand itself n try keep them desensitized

https://lynnhellerstein.com/succeed-in-school/

https://lynnhellerstein.com/casestudies/

https://link.springer.com/article/10.1007%2Fs10803-012-1475-2

Mrs Akila Vaidyanathan explained that Vision is affected by dysfunction of the organ or it's parts the nerve etc. Perception  is affected by how we process the sensory data collected by the organ  (same goes for  hearing)... both are  related but the latter is also affected  by attention or the lack of it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327555/

https://www.greatplainslaboratory.com/articles-1/2015/11/13/rickets-and-eye-poking-in-autism-associated-with-calcium-deficiency

Q.Could someone explain more on convergence insufficiency.Is it the reason why children lack the ability to focus on fast moving objects and catch it?

A.Convergence insufficiency actually causes inability to focus but that is not the only reason when it comes to moving objects. Eye movements required to focus on moving objects are called saccades and pursuits, which is mostly affected in ASD kids. That could also be the reason that the child is not able to fixate at moving objects.

Q.How heritable are refractive disorders?

A.If the parents are having a moderate to high power, then most likely the child will have refractive power.

Q.Are vision disorders (not visual perception disorder)  more in asd population than general population?

A.Not really required. Indeed most ASD kids have good vision and affected perceptual skills.

Zahi-r-Ibrahim explained that Refractive errors are independent of issues caused by visual processing.Sometimes individuals struggle to see ,not because they have a refractive error, but due to visual stress.
Glare be it from the surrounding, or glare from a reading surface affects the individual.

Scotopic sensitivity - (visual stress)  , arises from the glare from the surrounding, which impacts on visual processing of information.
In scotopic sensitivity,( visual stress )  individuals affected by it , often cannot read or write very well and are sensitive to light n sound
Individuals who have refractive errors and have been wearing glasses to correct refractive errors , still affected by visual stress ,affecting their reading and writing ,hence affirms
Refractive error independent of
Refractive error.

Q.My daughter mostly likes to squint her eyes every now and then.what could be the reason?

A.Possible reason can be refractive error.We can correct refractive error by glasses.I will recommend comprehensive eye examination

Q.I have squint ( I wear glasses ).when I wear my glasses u won’t see my squint  but when I am physically exhausted ,my squint is obvious .What’s wrong with the eyes?

A.Your symptoms look like intermetant Divergent squint, which get obvious towards end of day, or when you are tired.
Possible cause is poor eye muscle control.
I will suggest eye examination.
Vision therapy will help in your case.

Q.Why does my son constantly rub the eyes?

A.It can be because of foreign body sensation in eye.
It can be because of poor focusing ability (Accommodation insufficiency)
In this case distance vision will be normal.
Problem will be seen for near vision.

Q.Is there any test to find out ,the issues from glare from the  surrounding and from flash cards .How I can help him for this problm?

A .If struggling with glare from flash cards - change the background colour.
Sky blue , pink and yellow.
The colour flash card  to which his response is quickest is the colour that is helping to reduce the glare best.
Use that colour flash card.
Perhaps low light switch to black white flash cards - better contrast .
Daylight - colour paper.
Its a case of trial and error ,if it works use that.


https://www.autismspeaks.org/blog/2015/04/10/%E2%80%98how-can-we-tell-if-our-nonverbal-teen-needs-glasses%E2%80%99

Thank you all
#Asd Parents and Therapists Group,Kerala

Visual Perception

Autism ,Vision and Visual Perception

Dated 26/8/18 to 8/9/18
Visual Problems and Autism

Autistic individuals have difficulty processing and responding to information from their senses, as well as difficulties with communication and social interaction. Visual problems are also very common.
Often, the signs of these vision problems can be masked by the behaviours that autistic individuals use to cope with the sensory overload of the world around them. The behaviors that are attributable to both autism and vision problems can include lack of eye contact, staring at spinning objects or light, fleeting peripheral glances, side viewing, and difficulty attending visually.
Autistic people may also have problems coordinating their central and peripheral vision.
For example, when asked to follow an object with their eyes, they usually do not look directly at the object. Instead, they will scan or look off to the side of the object. Eye movement disorders and crossed eyes are common.

Many autistic people are *visually defensive. Visually defensive persons avoid contact with specific visual input and might have hypersensitive vision. They have difficulty with visually holding still and frequently rely on a constant scanning of visual information in an attempt to gain meaning.
Since autism spectrum disorders (ASDs) affect how we process and respond to sensory information, it’s important to evaluate exactly what visual sensory information is going in. https://youtu.be/NfDfXCiQRqY

Devyna Lembard gave us an insight into eyesight and Vision.There is a big difference between eye‐sight and vision. Eye‐sight is the ability to see clearly at 20 feet so usually people call it 20-20 vision but, Vision goes far beyond just this

Our nervous system is no different than it was 50,000 years ago
– Our visual system supported survival by letting us know about the dynamic three dimensional space around us and it still does the same.
– Our visual system enabled us to move our body when and where we needed to
– Therefore, our visual and vestibular system have been intimately synchronized to the extent that if the vestibular system has an processing issue then the visual perceptual skills will also get hampered.

In last 20 years,  Visual responsibilities for survival have changed
• We no longer are required to be skilled with the visual assessment of and bodily movement through dynamic three dimensional space
• It has become cognitive survival in a static, two dimensional symbolic near‐point environment
• Now, we need to sit, not move or speak, and process two dimensional language symbols at 16” for long periods of time
• And now, this is often when looking at a light source i.e computer,  iPad or phone.
• This is a socially compulsive, biologically unacceptable task.
• Cognitive survival in a static, two dimensional symbolic near‐point environment does not require 20/20 eyesight!
• At the time of the Civil War, the Snellen chart was developed
• A myth began, and persists today, that 20/20 is perfect vision. This is one of the most naive statements that can be made about vision
• It is especially the cruelest conclusion that can be drawn for a child struggling in school, who has visual problems, but who has 20/20 eye‐sight
• Hence, there has been a shift away from visual / vestibular integration to visual / vestibular dissociation!

The Vestibular System Provides:
An inertial gravity receptor which establishes a
gravitational reference point for our body at all
times and under all conditions
A central vertical axis centeredness of the body
in time and space as a foundation for 3
dimensional orientation and movement
around this center for relating to objects,
people, and events in our world
The ability to self‐regulate behavior with
social‐emotional skill & confidence
A cognitive foundation for orientation,
planning & execution of purposeful
engagement with an integrated weaving of
past, present, & future

Perceptual Stability in Space Requires congruence of:
Vestibulo‐spinal for dynamic postural alignment & control
Vestibulo‐cervical for neck stabilization & head control
Vestibulo‐visual & auditory for head orientation & stability for oculomotor control and sound localization & processing
Vestibulo‐cerebellar for position in space so as to regulate & modulate sequencing & timing of motor output based on signals received & matched to cortical inte.
Vestibular Sensory‐Motor Bridge Triads
1.  Vestibulo‐cochlear‐oculomotor triad of the head
Cervical control for spatial‐temporal
orientation of the head supports looking &
listening

2.    Vestibulo‐proprioceptive‐tactile triad of the body
Cervical integration of the head & body
in time & space affords static positioning &
purposeful movement for meaningful,
adaptive engagement in life skills and occupations

https://www.parentingautismindia.com/2016/11/good-website-eye-can-learn.html

https://www.parentingautismindia.com/2016/10/helpful-book-eye-power.html

Visual perception is among the last of skills a child develops. Eye-hand coordination is a prerequisite. Visual tracking in vertical, horizontal, diagonal, and circular planes is an essential precursor to visual perception. Visual perception consists of visual discrimination, visual figure ground, visual-spatial relationships, visual form constancy, visual memory, and visual closure.
Some are explained below:

Visual-spatial relationships—the ability to determine, from among four forms of identical configuration, the one single form or part of a single form that is going in a different direction from the other forms or from parts of forms

Visual sequential memory—the ability to remember for immediate recall (after a few seconds of exposure) a series of various forms from among four separate series of forms

Visual discrimination—the ability to match or determine the exact characteristics

Visual memory—the ability to remember for immediate recall characteristics of a form

Visual form constancy—the ability to see a form and find that same form even though the form may be smaller or larger and, whatever the size, whether rotated, reversed and/or hidden among other forms

Visual figure-ground—the ability to perceive a form visually; to find this form with other forms hidden in a conglomerated ground of matter

Visual motor skills—the ability to coordinate eye and hand movements to draw geometric shapes, letters, and numbers or to complete a maze

Visual perception—the ability to incorporate and process visual information; to perceive stimuli in forms that are recognized by the brain

Visual closure—the ability to recognize incomplete forms and “fill in” the lines mentally to match a completed form.

https://youtu.be/f-9N-mRRbMc

Devyna Lembard

Thank you all
#Asd parents and Therapists Group,Kerala.