In my last blogpost, I looked at the implications of autism being viewed primarily as a disorder of interpersonal relatedness. I noted that taking this view gives us an explanation as to why the triad of impairments occur together - because good social interaction, communication and flexibility of thought and imagination all develop as a result of the interpersonal experiences and communication shared by child and caregiver in the early years.
One of my readers asked an excellent question in response to the blogpost:
'How does all this fit in with reflex integration that so successfully helped my autistic son?'
I responded by saying that I don't feel I have sufficient expertise to answer that question, but I know a woman who does. I'm handing you over now to my good friend and colleague Claire, who very kindly gave a detailed response that I have decided to feature as a blogpost, rather than hiding it away in the 'comments' section.
I’ve just qualified as a neurodevelopmental therapist (INPP) so am delighted to hear that a reflex integration programme made a real difference for your child. It would be interesting to hear more about which programme you followed and what differences it has made for him.
I’ll attempt to answer your question about how this might fit in with Zoe’s post about autism potentially being reversible if you work on what Peter Hobson describes as a disorder of interpersonal relatedness. But please bear in mind I’m hypothesizing based on what we know about autism and neurological development.
I think Peter Hobson accurately describes what happens developmentally in all those on the autistic spectrum. In simple terms the guided participation relationship between the child and the caregiver breaks down resulting in the range of symptoms/behaviours we broadly recognise as “autism”. This clearly occurs in every case of autism. Outside the scope of Hobson’s work though is the question of why this relationship breaks down. And the answer to that is that there are doubtless a number of 'reasons' – 'reasons' that we may later come to recognise as the different 'causes' of the various phenotypes of autism.
Zoe highlighted a couple of potential 'causes' in her post – the absence of vision which is key in developing the infant/caregiver relationship and the absence of a “caregiver” in cases like the Romanian orphans. The latter is somewhat different to autism as the breakdown in the relationship occurs on the caregiver side of the equation. In autism and a subset of (not all) visually impaired infants the breakdown occurs because of disordered functioning on the part of the infant.
Of course there are many other reasons for this relationship breakdown. Based on what we know now we are likely to identify other causes in atypical immune responses, environmental “toxins”, atypical sensory functioning etc. Theoretically once we are able to identify and address the specific cause of someone’s autism we can “cure” it – if I can use that term without being pilloried. So, for instance, if visual impairment lies at the heart of an individual’s autism restoring sight would “cure” the autism – but only, of course, if the “cure” is applied at developmentally the right time. In the case of vision the right time developmentally would be no later than the time of birth as vision plays a critical role in the development of the interpersonal relationship from that moment.
If vision is restored later in life or at the point when the visually impaired infant learns to use other sensory systems (auditory/tactile etc) to develop the interpersonal relationship his/her development will already be seriously delayed and/or disordered. One of Zoe’s points is that approaches like RDI that work on establishing the interpersonal relationship can be used effectively in either case (ie either if the cause of autism is addressed later in development or even if the cause is never addressed).
As for reflexes specifically and how this fits in I think that the issues an effective reflex integration programme addresses are potentially involved in one or more “causes” of autism. There is a “blueprint” for the development of our reflexes. Deviation from that blueprint can result in a whole range of cognitive, physical, communication, social, emotional, sensory dysfunctions. In simple terms the stages of reflex development that we go through – before birth and in those very early months – entrain the many functions of the brain that need to happen “automatically” if we are to function effectively and efficiently. So for instance typical reflex development leads to a fully functioning visual system (ability to fixate, to track across a page, to follow a moving object visually, to switch from near to far vision, to switch attention from one object to another, to block out peripheral visual input and focus until such time as you need to take in peripheral input etc etc). These are all skills that should happen automatically. In cases where the typical reflex development has not occurred much of the brain’s energy will go towards performing what should be automatic, thus reducing the capacity and the ability to perform higherfunctioning “thinking” skills like academic skills, executive functions, problem solving etc. This creates a very stressed neurological system and a very stressed individual. A person with such visual problems will not be able to recognise “patterns” and make sense of visual input, they will be drawn to non significant objects/ people in their environment, they will not be able to deal with new situations . If you want to examine one specific aspect (why aren’t autistic infants addicted to facial gazing) it is likely they may not be able to fixate (so how could they be addicted to faces as is necessary), they are likely to be drawn to visual movement (hence look at mouths that move more than eyes etc).
The problems associated with vision are similar to all the other senses (auditory/tactile/proprioceptive /vestibular ) but I don’t have space to expand here.
So clearly if such problems lie at the heart of an individual's autism, addressing reflex development is key. But, in addition, using an approach like RDI to help to re-establish a more typical developmental trajectory as underpinned by interpersonal relationships is also important.
I’m not sure if that helps at all. Let me know!
End of Claire's response
If anyone would like to know more about reflex integration and development and how movement feeds the brain's development, Claire has kindly offered to write a follow-up blogpost to explore this in more detail.
Click this link for more information on INPP and how to find a Practitioner.
And a big thanks to Claire for her guest post :)