ATNR:Asymmetrical Tonic Neck Reflex, Spinal Galant Reflex, SSP: Safe and Sound Protocol

Retained Reflexes and Auditory Processing Disorder

Today, in an online forum on auditory processing disorder, someone asked an interesting question about whether there is a link between shoulder dystocia and auditory processing disorder.

There followed some interesting (although not unsurprising comments). The majority said no, because their children had been delivered by C-section. There were many instrumental deliveries due to babies getting stuck, a few extremely rapid births and a lot of babies who needed resusictation or who had been oxygen-deprived at birth. There were also quite a few examples of shoulder and hip dystocia.

During labour, mother and baby work together reflexively. The baby doesn’t have to be told what to do, and nor does the mother – otherwise we’d be extinct. If that cooperative dance isn’t working properly, a baby will need help to arrive safely.

The spine in-utero

The neural tube forms within the first 5 weeks of pregnancy. It consists of a primitive brain and spinal cord – our central nervous system. When this little nervous system forms, it reacts to external stimuli – in the early days, by recoiling (fear paralysis reflex) and later by expanding and contracting (moro reflex).

The Spinal Galant reflex starts to emerge at around the 20-28th week, and should mature within the three months of life. This is extremely important as it helps a foetus to start to develop a sense of whole body, with the development of a midline, as well as an upper and lower body and a back and front of body. The spine is also a conductor of sound in utero, and children (and adults) I see in clinic who have auditory processing challenges ALWAYS have spinal reflexes, and often active ATNR, Moro and FPR reflexes too.

Not much later, the Asymmetrical Tonic Neck Reflex starts to develop. Together, the Spinal and ATNR reflexes help a baby to do the wiggle and twist that is the birthing process.

If these reflexes have not emerged strongly enough, birthing becomes a challenge and intervention may be required. Either this, or a birth may be so rapid that a baby doesn’t get a chance to go through the steps to help these reflexes mature, so they remain “stuck” in the system after birth and won’t integrate at the appropriate time. Babies born by C-section do not get a chance to fully develop these reflexes either.

Cue the importance of plenty of floor time and natural development without “props” as a baby grows. The more we try to “support” development with bouncers, walkers and containment methods such as Bumbo seats, the less chance we are giving children to integrate these reflexes themselves.

Signs of a retained Spinal Galant Reflex

To test for the Spinal Galant reflex, I tickle a couple of centimetres on either side of the spine and watch what happens. Sometimes the skin will twitch, sometimes the whole hip will flick involuntarily. I’ve seen extreme reactions in adults as well as children.

A retained spinal galant will cause the following challenges:

– cannot sit still

– poor auditory processing

– midline issues

– short-term memory challenges

– bed wetting past the age of five

– poor coordination, for example, challenges swimming breaststroke

– poor concentration

– poor stamina

– dislike of tight clothing around the waist/cannot bear labels in clothing

The Spinal Galant reflex later matures into the lifelong postural Amphibian reflex. A person who hasn’t developed an Amphibian reflex may have an awkward gait, and little integration between upper and lower body, which will cause coordination challenges.

An unintegrated Spinal Galant can potentially lead to lower back problems later in life, and even potentially scoliosis.

How can we get rid of a retained Spinal Galant reflex?

To encourage your toddler/child to integrate a possibly unintegrated Spinal Galant, get them to scoot around the floor on their back, roll on a balance ball, or roll a ball up and down a wall using their back. You can also get them to dance the “twist”, sit on a balance ball, walk around the floor on their bottom or do snow angels.

However, it may be that it’s appropriate to see a professional to look at the full picture and check to see whether any other reflexes are present.

Because the Spinal Galant can be very much intertwined with the Fear Paralysis and Moro reflexes, sometimes a fair amount of work will need to be done so that everything integrates properly. This is why it’s important to realise that you will need to make a commitment to do movements every single day without fail.

It is also important to bear in mind that when we work with children, we do not aim to “fix” them. What we do is to reduce or remove dysfunctions due to “short circuits” in the body and brain that are causing emotional, behavioural and learning challenges.

3 thoughts on “Retained Reflexes and Auditory Processing Disorder”

  1. Hi Emma. From your experience. Children diagnosed with APD. Will there always be issues with APD despite interventions or can APD be rectified with reflex integration? Would you include listening therapy into the therapeutic intervention?

    1. Hi Declan – Hard to say, as people tend to stop coming when they think their journey is done. I’ve certainly seen enormous improvements in my clients – and my own children – with a combination of reflex integration and the Safe and Sound Protocol, which works at that very primitive fear level as well as helping repair damage to middle ear muscles if there has been persistent glue ear.

      1. Thanks for the reply Emma. Would you recommend SSP over listening therapy if you have used both? I’m a trained therapeutic listening provider & I am currently training in RMTi. My LB who is 7 has a diagnosis of DLD. Since we started RMTi 6 months ago there has been steady progress but was wondering about the SSP? Auditory processing & expressive language is still a struggle so was wondering about trying the SSP to work at that deeper level where maybe RMTi can’t? Thanks.

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