Saturday 2 June 2012

Reflex stimulation and inhibition, sensory integration and RDI - what goes where?

Here is the response from Claire to the questions raised recently by Debbie and Nick. I've taken Claire's response out of the comments section and added it here so that it can form part of our ongoing discussions.

Gosh – not sure where to start! Think your questions pretty much embrace motor, sensory, cognitive, social and emotional development. And, of course, they are all intimately interwoven so it is always hard to unravel them to try and make sense of them developmentally. Will try and explain the bits I understand from my perspective as someone who has trained to provide a reflex stimulation and inhibition progamme (INPP) and also as the mum of a son who is autistic who had a sensory integration programme when he was younger. Others please chip in.

As you say if you were to put SIT, a reflex programme and RDI in developmental order – you would start with reflexes then sensory therapy then RDI. Of course this is overly simplistic. Failure of primitive reflexes to be stimulated and inhibitied and postural reflexes to be established will result in sensory integration problems (as well as other stuff, like emotional problems, postural problems, behavioural difficulties, gross and fine motor issues etc). Though sensory integration problems may be caused by issues other than reflexes, eg damage to developing brain.

What I was taught at INPP was that if you use sensory integration therapies (which complement reflex programmes) before addressing problems with early primitive reflexes – moro, ATNR, TLR particularly – the child doesn’t hold on to gains made during sensory integration therapy. This was certainly my experience with my son and left me wondering what comes before sensory development as it was clear we were working in the right area for him. I think if a person has problems only with the emergence of postural reflexes (which are developmentally later) sensory integration programmes have been successful and gains do hold.

And it is actually movement that proceeds sensory development. Movement that initially occurs automatically through reflexes. If a child can’t use movement to explore its world (going right back in utero as the fetus explores its body within the womb) it can’t create an physical image of either its own body, the world it can reach out and touch, and later the world it can see beyond the reach of its hand. An early crude experiment with 2 new born kittens illustrate this point. The kittens were kept together but only 1 was allowed to move its legs, the other was not. The second kitten did not develop vision. Deprived of its ability to touch the world it was impossible for its brain to make sense of the images of light that its intact retinas passed to its brain.

RDI addresses issues further on developmentally (though you can actually see the problems from the moment a baby is born sometimes). Clearly if an infant is unable to build up an image of its own physical self (eg where my body ends and the rest of the world starts/ my hand is attached to my arm etc) he/she is not going to be able to co-regulate with an adult as he/she will not have fully grasped the concept of them being 2 separate physical entities.

Thanks to Claire and everyone who has been participating in this discussion.  I've learned loads from it and hopefully it'll also have helped others :)

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