Overall development goes from large skills to fine skills, simple to complex, crawling to walking and so on. The first time your child holds any sort of writing utensil they may want to hold it with a fist. This could be completely normal early on as they are just gaining the ability to use more fine muscle control, but many parents have wondered why their children refuse to hold these utensils “properly” as they get older. 

The most common explanation has to do with a primitive reflex that is still present, and this reflex is making your child’s ability to hold the utensil nearly impossible. If you have not read any previous blogs, primitive reflexes are automated responses that everyone is born with to aid in the birthing process, feeding, learning to move, and keeping us safe. We are only born with around 20% of our total adult brain volume, and this means that simple tasks and decision making is not possible. Instead, these primitive reflexes help us to get through our first years of life. These reflexes work on a time clock, and once they have been used enough times, they should be inhibited by our more advanced brain centers, because they are no longer needed. 

There are a large number of these primitive reflexes, but the most common one that is in play with a fist grip, and other writing difficulties is a reflex called Asymmetric Tonic Neck Reflex or ATNR. This reflex has a number of benefits from helping a child wiggle down the birth canal, hand eye coordination development, learning to crawl, and more. This reflex should go away at or around 6 months of age. If this reflex stays persistent like any other primitive reflexes it can cause “abnormal” neural development and lead to a number of issues. 

The phrase “abnormal neural development” sounds scary, but with the proper plan of attack it does not have to be at all. All brains are plastic, this means that they are very apt to rewire, make new connections, and even create new neural cells. This is especially true in a child’s brain, which have many times been compared to a sponge. They not only learn far quicker than adults, but their brains can adapt and grow far greater as well. 

As you can see in the picture above as the baby looks in one direction, the arm, leg, and hand on the opposite side of the body flex. This also causes the other side of the body to extend out and causes the hand to open. Now imagine trying to write and every time you look at the page it causes your hand to release, fist grip make more sense now? 

Checking this reflex is easy, and the same way the reflex is checked can be used to get rid of the reflex. In an older child have them get on their hands and knees with a nice flat back, then gently turn their head in on direction a positive response will cause the opposite arm to bend. Primitive reflexes work on a bell curve. This means that as you attempt to elicit the reflex it will get stronger with multiple repetitions, and then finally fatigue or go away. 

The key to primitive reflex remediation is frequently performing exercises to fatigue the reflex, this helps to strengthen the area of the brain that is used to inhibit these reflexes (Supplementary motor area in the frontal lobe, for you nerds). We usually tell our parents to work these reflexes 2-3 times a day or more if possible. Reflex remediation is not a quick fix but will be worth the time you set a side I can promise you that! 

If you have any questions about your child, or would like to set up an appointment with Dr. Jake please feel free to reach out for an appointment or a Free consult. Also check out a page on our website linked below to learn how to check other reflexes on your child.

Dr. Jake Boraas
Drjakefhi@gmail.com
(563)-265-5494

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