Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders

Abstract

We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.

Identification and reduction of retained primitive reflexes by sensory stimulation in autism spectrum disorder: effects on qEEG networks and cognitive functions

“…Because the brain’s hemispheres develop at distinct rates and durations, combined with the aberrant, asymmetric persistence of basic reflexes, a maturational imbalance can occur in which one hemisphere matures normally while the other is delayed. This can create large imbalances in synchronisation and temporal coherence, decreasing the ability for large cortical networks to have effective coherent function between the two hemispheres (ie, effective shared activity) 37. This can result in a functional disconnection syndrome, which can present with varied symptoms depending on the time, hemisphere, and degree of the maturational delay.…”

“…Reflexes were graded on a scale of 0–4 based on clinical judgement (0=0 fully integrated; 1=25%; retained; 2=50% retained; 3=75%; 4=100% completely retained when tested by three examiners. The testing procedures are described more fully in table 1 and in online supplemental appendix 1 2 3 10–12…”

“…It has also been demonstrated that this functional disconnection can relate to a cortical maturational imbalance between networks 10. It has been hypothesised that a delay in cortical maturation in certain networks may result in an increased cortical maturation and development in other networks, leading to developmental asynchrony and unevenness of functional skills 10 11.…”

“…It has also been demonstrated that this functional disconnection can relate to a cortical maturational imbalance between networks 10. It has been hypothesised that a delay in cortical maturation in certain networks may result in an increased cortical maturation and development in other networks, leading to developmental asynchrony and unevenness of functional skills 10 11. Some authors12 13 consider RPRs as predictive of diffuse cerebral dysfunction since these signs are significantly correlated with cognitive deficits in a wide age range of individuals as determined by the Halstead-Reitan neuropsychological test battery 12.…”

“…In a large-scale post hoc analysis of children with RPRs, their presence was found to be highly correlated with cognitive impairment 14. Considering that cognitive functions tend to be lateralised, cognitive deficits could assist in localising specific areas of treatment interventions for those individuals with ASD that could lead to the diminishing of RPRs with concomitant cognitive improvement 10 14 15…”