How a retained primitive reflex in a child can be mistaken for ADHD or Anxiety Disorder.

It has become commonplace to give a child an ADHD diagnosis when they have a hard time sitting still (ants in the pants), always on the move and lose focus. It is also common to attribute bowel and bladder incontinence (lack of control) to emotional difficulties, or past traumas resulting in a diagnosis of Anxiety Disorder.

In my practice, children presenting with these two diagnoses often have a common factor, a retained primitive reflex known as a Spinal Gallant (SG). Unless the diagnostician did a hands-on physical examination with the child, and knew what to look for, this Spinal Gallant reflex would be missed.

The human brain is hard wired with primitive reflexes to help us survive in-utero, make it through the birthing process, and to live as an immature being in the first year of life. As we learn and gain physical skills through experience many of these primitive reflexes integrate into the nervous system, but when they don’t, they can get in the way of normal movement and function. 

The SG reflex emerges at about 20 weeks in utero and is actively present at birth. In the womb, it enables the fetus to hear and respond to sounds, as vibration is transmitted along the spine. It helps propel the infant through the birth canal during vaginal delivery, and after birth it helps empty the bladder. Typically this reflex integrates at about 9 months of age, but when it doesn’t go away it can be elicited by pressure to either side of the spine from the neck to the pelvis.

It is more common to see retained SG reflex in children born by cesarean section, assisted vaginal births (forceps or vacuum) and children who didn’t get enough tummy time or crawling time before walking.  Wiggling through the birth canal is one way the SG gets integrated into the nervous system.  The other way is experiencing the different stages of developmental movement, like learning to organize body parts to roll over, sit up and propel forward on the hands and knees.

When a child has a strong SG reflex, bladder and bowel control issues and/or enuresis (bed wetting) can result, even in school-aged children. Pressure along the spine from waistbands of pants or tight fitting clothing, backs of chairs or lying in bed can stimulate the reflex and empty the bowel or bladder. Children will often avoid certain types of touch and articles of clothing to avoid the reflex being stimulated.

Even if a retained SG doesn’t cause bowel and bladder control issues, the child can be distracted by sensations affecting attention, focus, and organizational skills which may lead to being mistakenly diagnosed with ADHD.

Stimulant or anti-anxiety medication is not going to do the child with a retained SG much good, and neither is counseling or cognitive behavioral therapy.  Hands-on rhythmic integration work and encouraging developmental movement patterns is what is called for.  We need more professionals trained at checking for these retained reflexes and who know how to successfully work with the child who has them.

Julia Grover