Craniosacral Test and Primitive Reflexes in Infant Neurodevelopment
Condition: Child Development Disorder
MeSH terms: Developmental Disabilities
Study type: Interventional

Summary: 
      Question(s): Can active primitive reflexes (APR) and cranial blocks (CB) in healthy children
      interfere with neurological balance causing psycho-behavioral and cognitive dysfunctions?
      Design: Cross-sectional and descriptive study analyzing perinatal, neurobehavioral and
      physiotherapeutic parameters. Participants: School population of both genders (n=120) divided
      in two groups: 3-6 years old (n=60) and 6-8 years old (n=60). Intervention: Systematic
      evaluation of the children based on a parent survey, assessment by teachers and
      physiotherapeutic exploration. Outcome measures: Perinatal (surveyed parents) and
      neurobehavioral problems (assessed by teachers) were related to the presence of RPA and BC
      (analyzed by physiotherapeutic exploration).

      Key words: primitive reflexes, craniosacral disfunctions, neurodevelopment, childhood, early
      diagnosis, screening.
    

Detailed description: 
      Primitive reflexes (PR) are indispensable for the survival of the individual in the early
      stages of life. PR are necessary for a coordinated response to sensory stimuli during the
      period of cortical immaturity until the maturation of the central nervous system (CNS).
      However, PR must be gradually abolished as the subject's development proceeds, allowing for
      voluntary and functional movement responses. This process of PR abolition is due to the
      synaptic plasticity of the CNS. Persistent ROP can be identified by means of a systematic
      neurological examination. On the other hand, through craniosacral exploration, blockages in
      the craniosacral system can be evidenced; under physiological conditions, this system seeks
      to balance the mobility of membranes and cranial sutures, based on the coordinated movement
      of the cranial bones and the sacrum. If neurological homeostasis is disturbed in the child
      after diagnosing possible BC, this could manifest in the persistence of RPA and/or vice
      versa.

      Observation of the child's different behavioral patterns in social and emotional areas, as
      well as his or her physical and psychological capacities, could help to detect early possible
      alterations in the onset of neurodevelopment. Such detection is essential for the health
      professional to be able to establish an appropriate treatment.

      The aim of this study is to detect early infant neurodevelopmental dysfunctions and their
      possible relationship with RPA and/or BC in apparently healthy children.

      Therefore, the research questions of this study were:

        1. Are RPA and/or BC related to child neurodevelopmental disturbances?

        2. In relation to the previous question, by means of the systematic evaluation of RPA and
           BC could children with neurodevelopmental disorders be identified in order to treat them
           early?

      Design A cross-sectional, observational and descriptive study was conducted in a school
      population.

      Participants, therapists, centers A total of 120 children between 3 and 8 years of age from a
      school in Córdoba (Spain) were evaluated. Subjects of both sexes were included and were
      divided into two groups according to age ranges: 3 to 6 years and 6 to 8 years. The
      neurodevelopmental assessment was made taking into account the growth stages standardized by
      the WHO.

      Prior approval was obtained from the Research Ethics Committee of Córdoba for the present
      study. The harmonized tripartite standards of the Helsinki declaration, the Biomedical
      Research Law (Law 14/2007), and the Organic Law on Personal Data Protection (Organic Law
      3/2018) were respected at all times. The application of tests and data collection for the
      research was performed within the facilities of the educational institution, with the
      collaboration of the teachers and having the due authorization of the academic director and
      the parents or legal representatives of the students.
    

Intervention name(s): Series of questions to parents of children in a virtual form.; Intervention by teachers; Physiotherapeutic evaluation
Intervention type(s): Diagnostic Test; Other; Procedure
Intervention description(s): A questionnaire of 5 questions was provided in an online format addressed to the parents or legal representatives of each child. These questions were related to the child's own aspects (behavioral, psychomotor and cognitive parameters), as well as parameters oriented to the mother (pregnancy and childbirth).; The school teachers examined neurobehavioral aspects of the students using the "Battelle Developmental Inventory" (BDI), which assesses five areas of development (personal/social, adaptive, motor, communicative and cognitive) between 2 and 8 years of age. The results are assigned in age-adjusted percentages, classified as: low (0-50%), normal (50-80%) and high (80-100%). Low and high values are considered impairments in one or more of the evaluated areas.; A physiotherapeutic evaluation of the state of the RP and craniosacral system was performed according to the method of Andrzej Pilat and John E. Upledger.
The 14 primitive reflexes explored were: Moro reflex, cervical asymmetric, supine labyrinthine tonic, prone labyrinthine tonic, palmar grasp, plantar grasp, lateral trunk propulsion, parachute, Galant, search, cervical symmetric, Babinski, cochleo-palpebral and acoustic. These reflexes were considered as: inactive (0), or active (1).
In the evaluation of the craniosacral system, the following parameters were explored: dura mater sway, frontal bone, parietal bones, temporal bones, temporomandibular joint and sphenoid bone. These parameters were considered as: normal (0), or blockage (1).
Intervention model: Single Group Assignment
Intervention model description: 120 children aged 3 to 8 years from a school in Córdoba (Spain). Subjects of both sexes were included and were divided into two groups according to age ranges: 3 to 6 years and 6 to 8 years.
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: primitive reflexes; craniosacral disfunctions; neurodevelopment; childhood; early diagnosis; screening