Otizm Spektrum Bozukluğunda Refleks Tabanlı Motor ve Gelişimsel Problemler: Fear Paralysis ve Moro

Year 2021, Volume: 22 Issue: 4, 945 - 968, 01.12.2021

Ekrem Akbuğa , Murat Eliöz

https://doi.org/10.21565/ozelegitimdergisi.662070

Abstract

Otizm Spektrum Bozukluğu (OSB) birçok gelişim alanında kendisine özgü sorunlara sahip nörogelişimsel bir bozukluktur. OSB’de refleks ve motor gelişim ile duyusal işlevsellik üzerine çeşitli araştırmalar mevcuttur ancak Fear Paralysis Refleks (FPR) ve Moro refleks ile ilişkilendirilmiş çalışmalar sınırlıdır. FPR ve Moro, refleks harmonisinin ilk gelişen refleksleri ve kendilerinden sonraki reflekslere temel geçit olmaları açısından önemlidirler. İki refleksin işleyiş sürecindeki sorunlar motor gelişim başta olmak üzere bütün gelişim alanlarında bozulmalara neden olabilmektedir. Ayrıca OSB, dispraksi, epilepsi, alerjiler, serebral palsi, disleksi gibi sorunlara yol açabilmekte veya eşlik edebilmektedirler. Bu reflekslerdeki işlevsel bozulmalar sonucunda duyusal entegrasyon ve motor gelişim başta olmak üzere OSB ilişkili birçok problemin oluştuğu görülmektedir. Moro refleksindeki bozulmalar bazı testlerle tespit edilebilir ve Moro entegrasyonunu sağlayan egzersiz/tekniklerle ilgili sorunların çözümüne katkı sağlanabilir. Sonuç olarak FPR ve Moro reflekslerindeki sorunların OSB problemleriyle eşleşmesi OSB’yi daha erken dönemlerde tanılamak ve müdahale etmek için öncelikle bu reflekslerin gelişimlerinin takip edilmesini önemli kılabileceğini düşünmekteyiz.

Keywords

Fear paralysis refleks, Moro refleks, motor bozukluk, motor gelişim, otizm, refleks

Reflex-based Motor and Developmental Problems in Autism Spectrum Disorder: Fear Paralysis and Moro

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes specific problems in many developmental areas. There are various studies on reflex, motor development and sensory functionality in ASD. However, the studies on Fear Paralysis Reflex (FPR) and Moro reflex are limited. FPR and Moro are important as they are two of the initially developing ones that imply reflex harmony and the main gateway to subsequent reflexes. The problems in these can cause impairment among development areas, especially in motor development. They may cause or accompany ASD, dyspraxia, epilepsy, allergies, dyslexia. Many problems occur related with ASD as a result of the deterioration in these reflexes as part of sensory-motor development. Some tests may detect the deterioration in Moro reflex and offer exercise-based solutions to ensure the reflex integration. In conclusion, the problems in FPR and Moro should be taken into account in the diagnosis and intervention in terms of the development of these reflexes.

Keywords

Autism, fear paralysis, Moro, motor disorder, motor development, movement, reflex

References

• Amerikan Psikiyatri Birliği. (2014). Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı [American Psychiatric Association: Desk Reference to the Diagnostic Criteria from DSM-5] (5. baskı) (DSM-5), ( Köroğlu E., Çev.). Ankara: Hekimler Yayın Birliği. (Orijinal kitabın yayın tarihi 2013)
• Berne, S. A. (2006). The primitive reflexes: Considerations in the Infant . Optometry and Vision Development, 37(3), 139-146.
• Bhat, A. N., Galloway, J. C., & Landa, R. J. (2012). Relationship between early motor delay and later communication delay in infants at risk for autism. Infant Behavior and Develeopment, 35(4), 838-846. doi:10.1016/j.infbeh.2012.07.019
• Blomberg, H. (2015). The rhytmic movement method: A revolutionary approach to improved health and well-being. North Carolina, USA: Lulu Publishing Services.
• Brandes, B. (2015). The Symphony of Reflexes. South Carolina: Quantum Reflex Integration.
• Cekici, H., & Sanlier, N. (2019). Current Nutritional Approaches in Managing Autism Spectrum Disorder: A Review. Nutritional Neuroscience, 22(3), 145-155. doi:10.1080/1028415X.2017.1358481
• Chandradasa, M., & Rathnayake, L. (2019). Retained Primitive Reflexes in Children, Clinical Implications and Targeted Home-based Interventions. Nursing Children and Young People. doi:10.7748/ncpy.2019.e1132
• Chinello, A., Gangi, V. D., & Valenza, E. (2018). Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder. Research in Developmental Disabilities, 83, 287-295. doi:10.1016/j.ridd2016.07.010
• Daluwatte, C., Miles, J. H., Sun, j., & Yao, G. (2015). Association Between Pupillary Light Reflex and Sensory Behaviors in Children with Autism Spectrum Disorders. Research in Developmental Disabilities, 37, 209-215. doi:10.1016/j.ridd.2014.11.019.
• De Stefano, L. A., Schmitt, L. M., White, S. P., Mosconi, M. W., Sweeney, J. A., & Ethridge, L. E. (2019). Developmental Effects on Auditory Neural Oscillatory Synchronization Abnormalities in Autism Spectrum Disorder. Fronties in Integrative Neuroscience, 13-34. doi:10.3389/fnint.2019.00034
• Edwards, C. W., & Al Khalili, Y. (2019, June 17). Moro Reflex. 2019 tarihinde StatPearls: https://www.ncbi.nlm.nih.gov/books/NBK542173/ adresinden alındı
• Eliöz, M., Akbuga, E., & Çebi, M. (2016). Motor development problems of children with autism and the motor skills in age 3. Innovative Solutions in Modern Science, 8(8), 109-116.
• Ertürk, O., Kokmaz, B., Alev, G., Demirbilek, V., & Kiziltan, M. (2016). Startle and Blink Reflex in High Functioning Autism. Clinical Neurophysiology, 46, 189-192. doi:10.1016/j.neucli.2013.02.001
• Franz, E. A., & Gillet, G. (2011). John Hughlings Jackson's evolutionary neurology: a unifying framework for cognitive neuroscience. . Brain, 134, 3114-3120. doi:10.1093/brain/awr218
• Futagi, Y., Toribe, Y., & Suzuki, Y. (2012). The Grasp Reflex and Moro Reflex in İnfants: Hierarchy of Primitive Reflex Responses. International Journal of Pediatrics, 191512. doi:10.1155/2012/191562
• Goddard, S. (2012). Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Programme. New Jersey: Wiley-Blackwell.
• Goddard, S. (2014). Neuromotor Immaturity in Children and Adults: The INPP Screening Test for Clinicians and Health Practitioners. Chichester: Wiley Blackwell Publishing.
• Goddard, S. (2005). Reflexes, Learning and Behavior: A window into the Child's Mind: A Non-Invasive Approach to Solving Learning and Behavior Problems. . Eugene OR: Fern Ridge Press.
• Hunt, W. A., Clarke, F. M., & Hunt, E. B. (1936). Studies of the Startle Pattern: IV. Infants. The Journal of Psychology: Interdisciplinary and Applied., 2, 339-352.
• Kaplan, M. (2015). The Secrets in Their Eyes. Philadelphia: Jessica Kinsley Publisher .
• Kaur, M., Srinivasan, S., & Bhat, A. (2015). Atypical Object Exploration in Infants at-risk for Autism During the First Year of Life. Frontiers in Psychology, 1-15. doi:10.3389/fpsyg.2015.00798
• Khan, O., Garcia-Sosa, R., Hageman, J., Msall, M., & Kelley, K. (2014). Core Concepts: Neonatal Neurological Examination. NeoReviews, 316-324. doi:10.1542/neo.15-8-e316
• Kohl, S., Wolters, C., Gruendler, T. O., Vogeley, K., Klosterkötter, J., & Kuhn, J. (2014). Prepulse Inhibition of the Acoustic Startle Reflex in High Functioning Autism. PLOS ONE, 9(3), e92372. doi:10.1371/journal.pone.0092372
• Konicarova, J., & Bob, P. (2012). Retained Primitive Reflexes and ADHD in Children. Activitas Nervosa Superior, 54, 135-138.
• Masgutova, S. K., Akhmatova, N. K., Sadowska, L., Shackleford, P., & Akhmatov, E. A. (2016). Neurosensorimotor reflex integration for autism: a new therapy modality paradigm. Journal of Pediatric Neurological Disorders, 2(1), 1-12. doi:10.41.72/2572-5203.1000107
• Masgutova, S., & Masgutov, D. (2015). Reflex integration disorder as a new treatment paradigm for children with autism. Neuro-Sensory-Motor and Reflex Integration, 171-180. https://pdfs.semanticscholar.org/c092/4325cbab5d1d39bc775f58c61160a825dcc1.pdf adresinden alındı
• Miniksar, D. Y., & Bayhan Çon, P. (2018). Concomitance of Autism Spectrum Disorder and Dyslexia in a Case. Klinik Psikofarmakoloji Bulteni, 28, 226.
• Moro, E. (1918). Das Erste Trimenon. Münchener Medizinische Wochenschrift, 65, 1147-1150.
• Nickel, L. R., Thatcher, A. R., Keller, F., Wozniak, R. H., & Iverson, J. M. (2013). Posture development in infants at heightened vs. low risk for autism spectrum disorders . Infancy, 18(5), 639-661. doi:10. 1111/infa.12025.
• Panksepp, J., & Biven, L. (2012). The Archaelogy of Mind: Neuroevolutionary Origins of Human Emotion. New York: W.W. Norton and Company.
• Piek, J. P., Dawson, L., Smith, L. M., & Gasson, N. (2008). The role of early fine and gross motor development on later motor and cognitive ability. Human Movement Science, 27(5), 668-681. doi:https://doi.org/10.1016/j.humov.2007.11.002
• Ronconi , L., Facoetti, A., Bulff, H., Franchin, L., Bettoni, R., & Valenza, E. (2014). Paternal autistic traits are predictive of infants visual attention. Journal of Autism and Developmental Disorders, 44(7), 1556-1564. doi:10.1007/s10803-013-2018-1
• Rousseau, P. V., Matton, F., Wasterlain , A., & Lahaya, W. (2017). The Moro Reaction: More than a Reflex, a Ritualized Behavior of Nonverbal Communication. İnfant Behav Dev., 46, 169-177.
• Setoh, P., Marschik, P. B., Einspieler, C., & Esposito, G. (2017). Autism spectrum disorder and early motor abnormalities: connected or coincidental companions? Research in Developmental Disabilities, 60, 13-15.
• Taylor, M., Houghton, S., & Chapman, E. (2004). Primitive reflexes and attention-deficit/hyperactivity disorder: developmental origins of classroom dysfunction. International Journal of Special Education, 19(1), 23-37. https://files.eric.ed.gov/fulltext/EJ852040.pdf adresinden alındı
• Teitelbaum, O., & Teitelbaum, P. (2008). Does Your Baby Have Autism. New York, USA: Square One Publishers.
• Tietalbaum, P., Tietelbsum, O. B., Fryman, J., & Maurer, R. (2002). Reflexes Gone Astray in Autism in Infancy. The Journal of Developmental and Learning Disorders, 6, 15-22.
• Töret , G., & Özmen, E. R. (2014). Erken Çocukluk Döneminde Otizm Spektrum Bozukluğu Olan Çocuklarda Taklit Becerileri. [Imitation Skills of Children with Autism Spectrum Disorders in Early Childhood]. Ankara Üniversitesi Eğitim Bilimleri Fakiltesi Özel Eğitim Dergisi, 15(3), 51-66.
• Walker, S. (2013). Retained Neonatal Reflexes: a revolutionary approach to treating children with learning difficulties and behavioural problems. USA: Blue Peg Publishing.
• Wang, M., Lekhal, R., Aaro, L., & Schjolberg, S. (2012). Co-occuring Development of Early Childhood Communication and Motor Skills: Reuslts from a Population-based Longitudinal Study. Child: care, health and development, 77-84. doi:10.1111/cch.12003
• Younger, D. S. (2015). Motor Disorders. California: Rothstein Publishing.