#100 to #104 - The Primitive Reflex Podcast Series

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC June 10, 2020

In celebration of reaching 100 podcast episodes, Rach & Jess are diving into primitive reflexes with a 5 day series. Within these 5 episodes, you will hear information on the top 5 primitive reflexes that they, as Occupational Therapy Assistants, work with when treating within the pediatric population.

Below, you'll find all 5 episodes, along with their links to different podcast platforms. We also have blog posts to accompany the episodes which you can dive deeper on.

If you'd like to see a full overview, check out our article all about primitive reflexes.

Now, if you'd like to dive really deep on all things Primitive Reflexes, we offer a full Primitive Reflex Integration Training

We didn't cover the Palmar Grasp Reflex in this series, but we cover that in episode #149, which you can find here.

Episode #100 - The Moro Reflex

The Moro Reflexis an involuntary movement in response to sudden stimuli. It should be fully integrated by six months after birth. If it's still around after six months, it's considered a retained primitive reflex and might require special attention from an occupational therapists.

To dive deeper on the Moro Reflex, check out our article on it, which also contains videos to help test for it



Episode #101 - The Tonic Labyrinthine Reflex

The Tonic Labyrinthine Reflex (TLR) is a direct response to gravity, which is very new to infants! The TLR should be fully integrated by 3 years old.

To dive deeper on the Tonic Labyrinthine Reflex, check out our article on it, which also contains videos to help test for it



Episode #102 - The Asymmetrical Tonic Neck Reflex

The Asymmetrical Tonic Neck Reflex (ATNR) is from a relationship of head movements causing certain arm and leg movements. It should be fully integrated by no later than 9 months of age.

To dive deeper on the Asymmetrical Tonic Neck Reflex, check out our article on it, which also contains videos to help test for it



Episode #103 - The Spinal Galant Reflex

The Spinal Galant Reflex is to help children during the birthing process. When stimuli is provided to the lower back, infants will move away from that stimuli. The Spinal Galant Reflex should be fully integrated by 6 months of age.

To dive deeper on the Spinal Galant Reflex, check out our article on it, which also contains videos to help test for it



Episode #104 - The Symmetrical Tonic Neck Reflex

The Symmetrical Tonic Neck Reflex (STNR) assists babies with move from laying on their belly to getting onto all 4's. It should be fully integrated by 11 months of age.

To dive deeper on the Symmetrical Tonic Neck Reflex, check out our article on it, which also contains videos to help test for it

 

Please remember - neither Rachel nor Jessica are certified in any one integration technique. Their experience in the field of primitive reflex integration comes from over 6 years of learning from mentors, research, continuing education studies, and personal experience. The information provided in these 5 episodes are for educational purposes only - they are not designed to diagnose or treat any conditions. 

 

SHOW NOTES AND RESOURCES

  • View all of our courses HERE - including the brand new Primitive Reflex Crash Course! 

 

Don't miss our YouTube video about the 5 Signs of Retained Primitive Reflexes in the Classroom

 

 

What is the Moro Reflex?

The Moro Reflex, or startle reflex, is one of the primitive reflexes found in newborn babies. At the time of birth, a baby's body naturally creates an instinctual reflex to guard them from harm. This reaction causes babies to move their arms and legs outward whenever they encounter something alarming or frightening.

What is a startle response? 

A startle response is the sudden jerking of limbs and arms, accompanied by a loud cry. It may look like fear or shock, but this reaction is natural for infants at certain stages in their development. This may result in the sudden release of two powerful hormones: adrenaline and cortisol. These hormones prepare our bodies for potential danger by causing an increased heart rate and heightened alertness.

When does the Moro Reflex first become visible? 

The Moro Reflex first appears in the womb at nine weeks post-conception. Not only that, babies can even startle in the womb when presented with loud noises or similar stimuli. This is a normal, healthy response that should be observed in newborns.

Generally, integration should take place between two to four months of age. As the reflex fades away and becomes part of the body's system, it forms more sophisticated movement patterns that are beneficial for future growth.

Potential Cause of an Unintegrated Moro Reflex

During the initial trimester of pregnancy, when your baby is still in utero, nausea and vomiting can be a persistent problem. This could be because:

  • You're not receiving the necessary vitamins and minerals your body needs,
  • A severe viral infection,
  • Alcohol, drug use or smoking, or
  • Severe stress.

Birth trauma can disrupt the Moro reflex in several ways, including:

  • Prolonged labor or placenta previa,
  • Using forceps or the vacuum,
  • Baby is in a breech position or requires a cesarean section,
  • Umbilical cord is wrapped around the baby's neck or other type of fetal distress, and
  • Born premature or post mature, meaning born two weeks early or two weeks late.

It is not your fault if you have endured a birth trauma that has caused your child to still exhibit primitive reflexes. We understand what you are going through and do not want you to blame yourself. 

Why Might Moro Reflexes Not Integrate?

Newborns may be impacted by various factors, including but not limited to:

  • a low birth weight (under five pounds),
  • Being incubated or having prolonged jaundice,
  • Required resuscitation at any point,
  • Has heavy bruising or being considered a blue baby, and
  • Problems feeding within the first six months.

During infancy, you may notice unintegrated reflexes, including but not limited to:

  • Had an illness involving a high fever, delirium, or convulsions within the first 18 months of their life,
  • Any adverse reactions to any of the vaccines, and
  • Learning to walk or talk later than 18 months.

Though having any of these factors may increase the likelihood, there is no assurance that you or your child will possess primitive reflexes yet to be integrated.

The Impact Of An Unintegrated Moro Reflex

While this is not an exhaustive list, here are some of the most typical physical reactions we may experience.

  1. Car Sickness
  2. Poor stamina or endurance
  3. Poor eye contact
  4. Light sensitivity
  5. Vestibular sensitivity
  6. Sound sensitivity
  7. Allergies and/or a poor immune system 
  8. Adverse reactions to drugs 
  9. Hypoglycemia
  10. Poor tolerance to change
  11. Anxiety and nervousness
  12. Mood swings
  13. Over Reactive to stimuli
  14. Difficulty with ball skills or ball games

As practitioners, it is common to encounter a child in our clinic with an anxiety diagnosis. In many cases, the patient displays symptoms of distress and worry. During our evaluations, we often realize that the Moro reflex has not been completely integrated, resulting in a more anxious child.

How Do You Integrate The Moro Reflex Naturally?

This question is perfectly answered by a quote found in the book Reflexes, Learning and Behavior by Sally Goddard:

"Modern baby equipment has been a godsend for parents, but 
molded baby seats, buggies and car seats should never replace
the floor as a baby's first playground. It is time spent in free play 
on the floor that helps a child learn to control his body and 
therefore gain confidence on the floor. There is freedom to move 
and to gain experience from different types of exploratory 
adventures that the child can't have, from the confines of a chair."

Wearing your baby and enabling them to explore the ground through play can have a remarkable impact on primitive reflexes by promoting normal movement patterns. It's understandable that there are times when you'll have to rely on containers, but be mindful of how frequently you're utilizing them.

What To Do If You Have Concerns?

Remember, you are your child's advocate and it is essential to ensure that all areas of concern are explored.  We understand how difficult it can be to watch your child struggle with unintegrated primitive reflexes; however, there is a way to help them overcome their challenges through gentle integration exercises and treatment plans. With the proper care and support, your child can quickly become fully integrated and reach their full potential.

The moro reflex is an intrinsic part of a child’s development and should be monitored closely to ensure proper integration. If you have any concerns about the moro reflex or its integration, it is important to consult a professional for evaluation and treatment.


What Is A Tonic Labyrinthine Reflex?

The Tonic Labyrinthine Reflex (TLR) comprises two opposite motions of the head - one directed forwards and the other backwards. What's more, the TLR is vitally linked to the Moro reflex.

To put it simply, this provides babies with a basic way of responding to the effects of gravity. In utero, they are not subjected to these forces; upon birth however, they need support in understanding and adapting to them. Fortunately, TLR is here as an aide - enabling infants in managing gravity effectively while also assisting their adaptation process.

When Should The TLR Be Integrated?

Even in the womb, babies start to show signs of the TLR reflex; as soon as they are born, their limbs tend to extend. It is easy to visualize a baby inside its mother's tummy - usually curled up into an anterior flexion position - yet shortly after birth that same little one will be outstretched with all fours!

The forward reflex typically integrates into the body's system by four months, while the backward reflex usually is gone by six months; though sometimes it can take as long as three years until it integrates. Due to the diverse range of integration, assessing a child's TLR usually takes place after they turn three.

So by six months, as the baby gains head control, the response should be modified but not necessarily fully integrated. This then leads to a higher level of writing reactions and movement.

Possible Causes for an Unintegrated TLR

Potential causes of delayed integration of the TLR can be attributed to a variety of reasons, including certain prenatal experiences. If you were pregnant, you may have experienced:

  • Severe morning sickness
  • Recurrent vomiting
  • Eating too little or unhealthily
  • Severe viral infection, within the first 12 weeks or between the week of 26 and 30
  • Alcohol, drug use, or smoking
  • Exposure to radiation
  • Severe stress.

If you experienced a difficult delivery, such as:

  • Prolonged labor
  • Placenta previa,
  • Use of forceps or the vacuum
  • Child was in a breech position, possibly requiring a C section
  • Umbilical cord was wrapped around the baby's neck or other type of fetal distress
  • Baby was born two weeks early or two weeks late.

When it comes to newborns, some possible influencing factors may include:

  • Low birth weight (under five pounds)
  • Baby requires incubation
  • Prolonged jaundice
  • Required resuscitation or had heavy bruising
  • and if there are problems with feeding in the first six months of life.

If you noticed any of the following during infancy:

  • High fevers, delirium or convulsions within the first 18 months of life
  • Adverse reactions to vaccines
  • Delay in learning to walk or talk that goes beyond 18 months of age.

Have you noticed the remarkable similarities between the Tonic Labyrinthine reflex and Moro reflex? Unresolved traumas during pregnancy, birth, or infancy can disrupt the natural integration process of the primitive reflexes.

Potential Symptoms of an Unintegrated TLR

A lack of integration for a TLR can lead to an array of developmental issues. If these issues are not addressed and released, they can manifest in individuals as young as infants and persist into adulthood.

Thus, it is wise to be aware of the signs and indicators that should not go unnoticed. Common symptoms include:

  • Challenges with creeping and/or crawling as an infant
  • Poor posture
  • Weak or low muscle tone
  • Decreased balance
  • Poor ocular motor skills
  • Visual perceptual challenges 
  • Auditory processing difficulties
  • Decreased organization skills
  • Poor sense of space and time
  • Decreased sequencing
  • Challenges with multi sensory processing
  • Spatial awareness difficulties
  • Avoidance of sports or other movement activities. 

Do you recognize the pattern now? Those who haven't integrated the Moro reflex are likely to be hesitant and uninterested in ball games, while those with an unintegrated TLR may also struggle to get involved in sports.

How Does a Fully Integrated TLR Look Like?

As our primitive reflexes become fully integrated into the body, higher level movement patterns develop which support us in a range of activities – from sports and social gatherings to school functions and even more complex tasks like working or driving. 

Therefore, when these reflexes become ingrained in us from infancy, our body cannot move as it should or master the more complex cognitive skills that are essential for development. Just like the Moro reflex, the TLR reflex necessitates natural movements for successful integration. 

For your baby to reach their full potential, let them explore and play on the ground. Letting them lay on their back or roll over to both sides is essential in helping your little one learn through tummy time. This reflex helps develop motor skills as well as coordination!

What Can You Do If You Suspect An Unintegrated TLR?

To successfully integrate the TLR, there are some beneficial interventions to consider. The most commonly used approach for releasing a TLR is proprioceptive input - an effective and helpful technique that has been proven to result in successful integration.

By introducing this type of control, we can foster powerful connections between the mind and body. Not only will it give us greater agility at executing movements, but stretching and movement also help reduce tension in our connective tissues while stimulating our senses. Furthermore, improved muscular command comes as a result of these activities!

It's imperative to keep in mind that blending primitive reflexes is an ongoing practice, and it could take some time before your child demonstrates substantial progress. If you believe your child may have an unintegrated TLR, it is important to talk to the relevant professionals about how to best support them.

 

What Is The Asymmetrical Tonic Neck Reflex?

The Asymmetrical Tonic Neck Reflex (ATNR) is responsible for the infant kicks that you feel while pregnant. During childbirth, this reflex allows flexibility in your baby’s shoulders and hips to enable them to “unscrew” down the birth canal as they pass through it - a movement which isn't possible when delivered via C section. ATNR helps babies make their grand entrance into our world with ease!

What Skills Do The ATNR Develop?

As early as 18 weeks in the womb, the ATNR reflex can be observed. By your baby's first birthday, this reflex should have fully integrated and will help them to construct extensor tone while honing skills on each side of their body one at a time.

Furthermore, this type of exercise helps strengthen hand-eye coordination. By simply turning your head to the side, you can initiate a similar reaching motion with that same arm. For instance, if you turn your head toward the right side then follow through by moving your right arm in sync with it - there's no better way to improve hand-eye coordination!

Potential Causes For An Unintegrated ATNR

To start off, we have identified potential causes of pregnancy such as:

  • Severe sickness
  • Severe viral infection during the first 12 weeks or between 26 and 30 weeks
  • Excessive alcohol use, drug use, or smoking
  • Radiation
  • Severe stress.

Possible causes for the ATNR not integrating during birth can include:

  • Prolonged labor
  • Placenta previa
  • Use of forceps or the vacuum
  • Baby's was in a breech position or required a C section
  • Umbilical cord wrapped around the neck or any other type of fetal distress
  • Born prematurely, or post maternally, which would be two weeks early or two weeks late.

In babies at birth, we often observe:

  • Low birth weight, typically under around five pounds
  • Required incubation or prolonged jaundice
  • Required resuscitation
  • Considered a blue baby or has heavy bruising
  • Problems with feeding within the first six months of life.

During the infant stage, we could observe:

  • Illnesses with high fever, delirium or convulsions within those first 18 months
  • Any adverse reactions to a vaccine
  • Delayed learning to walk or talk, which should be no later than 18 months.

Symptoms Of An Unintegrated ATNR

Should you experience any unusual side effects that correlate to an ATNR, symptoms may include:

  • Challenges with crawling or skipping crawling all together
  • Scooting or using a bear crawl position
  • Inability to tuck both legs underneath themselves
  • Decreased engagement with toys
  • Poor handwriting
  • Decreased ability to express written ideas
  • Challenges with eye tracking
  • Poor ability crossing midline
  • Poor hand dominance
  • Right versus left confusion
  • Motor movements challenges, such as skipping or marching
  • Mixing up their letter B's, D's, Q's, and P's.

When children mix up or reverse letters, it's essential to take note of the fact that they may do so consistently. Generally speaking, this can happen as late as six years old and even during early stages of first grade. Our goal is to concentrate on older children who have been reading and writing for an extended period of time, but still struggle with letter recognition and reversals.

How To Help The ATNR Integrate Naturally

As your child grows and explores their environment while on the ground, you can help them transition from one stage to another - crawling, rolling over, and sitting up. To do this, start by laying your baby on their back and then rolling them gently onto either side. Move further to encourage activities, like tummy time or crawling, until they can sit up independently.

For this reason, it is wise to only use a baby container when absolutely needed. Furthermore, too much exposure to a screen can negatively impact their skill development. To promote healthy development, babies and infants need tactile learning experiences - opportunities for them to look at an object and reach out for it with both hands; feeling it, playing with it in order to cultivate hand-eye coordination skills.

What To Do If You Have Concerns

For the best advice, it is crucial to consult with your therapist, pediatrician, and any other specialists that you may be working with. If you think it’s possible that your child could have an unintegrated ATNR, they can assess and test for any underlying issues.

They also can recommend the appropriate interventions to help integrate the reflexes and help your child learn how to better control their movements. The earlier we address these potential issues, the easier it will be for a child to learn and be successful in their environment.

 

The Spinal Galant Reflex

Spinal Galant Reflex (SGR) plays a key role in assisting your baby's growth and coordination of body movements. When you apply pressure along the spine, either lengthwise or laterally, SGR will trigger an automatic response resulting in hip movement toward that area. The importance of this primitive reflex cannot be understated - by stimulating the SGR properly, you can help facilitate your child’s physical development while enhancing their postural strength.

The SGR is especially crucial during the birthing process. As your labor progresses, contractions will activate and stimulate both your lumbar spine and nearby hip muscles, helping to make sure that your baby moves safely through the birth canal.  Beyond childbirth, your infant's SGR can offer a wealth of insight into their growth and progress.

When Does It Emerge?

The SGR may facilitate the transmission of sound to a fetus in utero via vibrations, with the potential to influence hearing and auditory processing development from an early stage. At around 20 weeks of gestation, this reflex can be first noticed in utero and continues to integrate between three to nine months after birth. If the spinal galant isn't integrated by nine months, it could potentially hinder a child's capacity to manage their bladder control, often resulting in bedwetting when they get older.

Potential Causes Of An Unintegrated SGR

During pregnancy, if any of the following events occurred, it could have caused an interruption in the integration, such as:

  • Severe sickness or viral infection during the first 12 weeks or between 26 and 30 weeks
  • Any alcohol use, drug use or smoking
  • Exposed to any radiation
  • Excessive amount of stress.

In addition, if any kind of traumatic episode took place during delivery, this may prevent your reflex from fully integrating, like:

  • Prolonged labor
  • Placenta previa 
  • Use of forceps or the vacuum
  • Breech position
  • Cesarean section was required
  • Umbilical cord wrapped around baby's neck or any other type of fetal distress
  • Prematurity, as early as two weeks early, or post-maturity, which would be two weeks late. 

Disorders Connected To An Unintegrated SGR

In newborns, the lack of integration of SGR may lead to various health issues. The most common ones include:

  • Low birth weight (under five pounds)
  • Requiring incubation
  • Prolonged jaundice
  • Resuscitation needed after birth,
  • Considered a blue baby or had any heavy bruising
  • Problems with feeding within the first six months of life. 

If any of the following are present in infancy, we may recognize an unintegrated SGR:

  • Illnesses causing high fevers, delirium or convulsions within the first 18 months of life
  • Adverse reactions to any vaccines
  • Learning to walk or talk is delayed more than 18 months.

As we previously mentioned, the spinal galant reflex (SGR) should have naturally developed between three to nine months. If your child has yet to demonstrate this response, you may observe:

  • Bedwetting beyond the age of five
  • Being very fidgety
  • Inability to remain seated
  • Decreased concentration 
  • Sensory Sensitivities
  • Challenges learning to read

How To Assess

The spinal galant reflex can be found on either one or both sides of the back, depending on the individual. To accurately assess this, it is essential to test each side of the back separately to determine whether or not there are varying responses. Afterwards, follow this same process on the other side that has yet to be examined.

Your baby should demonstrate an equal reaction when touched on either side of their back. If only one side presents a response, this could signify that the spinal galant is activated in just half of the body. This can then impede your little one's ability to roll over, sustain posture and even walk correctly.

How To Support Natural Integration

The spinal galant can be incorporated naturally and fluidly through the execution of natural movement patterns. Helping your baby develop healthy movement habits is essential, so encouraging them to explore on the floor through tummy time positions and rolling activities can make all the difference. Even if they need a bit of assistance with their rolls, you should be there supporting them every step of the way!

If You Have Concerns

It is important to recognize that an unintegrated spinal galant reflex can have a deep  impact on your little one's development. If you have concerns, make sure to discuss them with your occupational therapist and your pediatrician. Knowing the symptoms and how to assess them may help you identify any potential issues and, more importantly, find ways to help integrate the reflex naturally. With early identification and timely support, you can ensure that your little one is able to reach their milestones accurately and at the right age.  

 

The Symmetrical Tonic Neck Reflex

The Symmetrical Tonic Neck Reflex (STNR) is highly similar to the TLR reflex, due to its two distinctive components: flexion and extension. Flexion involves your baby compressing into a ball-like shape while extension refers to their limbs extending away from their body. Both of these responses indicate healthy development in babies!

When Should The STNR Be First Observed?

Although there is some research to suggest that the STNR doesn't emerge within utero, it plays an essential role in integrating the TLR reflex for infants and has a notably brief lifespan. At our practice, we definitely recognize this as a primitive reflex; its significance lies in the division between upper body movements and lower body motions.

This skill enables us to understand how to use both halves of our body, the upper and lower. To put that into perspective, an infant's rocking motion in quad is a movement that can potentially join the STNR progress towards another stage of mobility.

Integration of the STNR reflex typically occurs between nine to eleven months, shortly after a child is able to crawl and explore their environment. If it has not integrated by six to nine months, crawling will become increasingly difficult for them as they struggle against this primitive reflex.

Importance of Tummy Time for STNR Integration

We have observed that the TLR reflex commences when a baby transitions from tummy time to hands and knees position. This is where their body will start integrating the TLR reaction, leading to the emergence of STNR. As babies learn how to move their limbs without shaking their head simultaneously, crawling develops - this process includes incorporating STNR as well.

We want children to learn how to separate their heads and necks from the rest of their bodies. Those who lack enough tummy time or never even crawl can suffer from STNR, which ultimately affects every aspect of a child's development and growth. It is essential that we ensure our kids are given ample opportunities for physical activities in order to keep this natural progression intact.

Potential Causes Of An Unintegrated STNR

A wide range of factors during pregnancy can lead to an unprocessed Symmetrical Tonic Neck Reflex (STNR). Examples include, but are not limited to:

  • Severe sickness, whether it's just the first 12 weeks or throughout the entire pregnancy
  • Severe viral infection during the first 12 weeks or between 26 and 30 weeks of pregnancy
  • Alcohol use, drug use, or smoking
  • Exposure to radiation
  • Severe stress.

If we observe signs of birth trauma, such as:

  • Prolonged labor
  • Use of forceps or vacuum
  • Baby was in a breech position or if they require a C section
  • Umbilical cord wrapped around the baby's neck or other type of fetal distress
  • Born prematurely, two weeks early, or post-maturely, beyond two weeks. 

When examining a newborn, it is essential to look out for the following signs:

  • Low birth weight, under five pounds
  • Baby requires incubation
  • Prolonged jaundice
  • Required resuscitation
  • Heavy bruising
  • Problems with feeding within the first six months of life.

During its formative years, if the infant experiences:

  • High fever, delirium or convulsions within those first 18 months
  • Adverse reactions to any vaccine
  • Late learning to walk or talk.

It is essential to note that this list of issues should not bring about distress if you or your child have experienced any of them. What matters most now is that you are here, knowledgeable and prepared to learn how best to assist your kid. If you're all set on taking steps towards progress and improvement - then the magnitude of what needs doing has already been understood!

Potential Symptoms Of Unintegrated z

Has your baby not yet integrated the STNR? Look out for these potential signs or symptoms:

  • Delayed crawling or janky crawl, like Emily from Casio kids calls it
  • Scooting on their bottom, instead of crawling on all fours
  • Poor posture or W sitting
  • Lays their head on the desk while working
  • Decreased hand eye coordination
  • Challenges with near and far point tracking
  • Considered clumsy or a messy eater 
  • Decreased attention
  • Challenges with reading and writing
  • Difficulty copying from the board. 

After evaluating this list, you may be thinking that these indications resemble those of ADHD, a visual impediment, dyspraxia or dyslexia. A research study by Petr Bob in 2013 found connections between two additional primitive reflexes — the asymmetric and symmetric tonic neck reflexes — and symptoms related to ADHD.

This is why it is essential to inspect the entire child's situation before making any immediate diagnosis. As primitive reflexes are known as foundational elements for advancing higher-level skills such as academics, athletics and other activities.

Natural Integration Of The STNR

It's essential that your infant spends a considerable amount of time playing on the floor in order to stimulate primitive reflexes and encourage their development. Even once they've moved beyond the baby stage, children can still progress through developmentally appropriate patterns.

Rolling over, crawling and performing somersaults are just a few of the activities that help them to strengthen their senses and neuromuscular connections. An especially beneficial position for kids is laying on their tummy—which has been proven to have numerous positive effects!

Our purpose is to bring up content, vibrant and self-sufficient people. We can fulfill this mission by aiding them in grasping the use of their body; primitive reflexes playing an essential role during that process. Remember, if you have concerns, discuss them with your pediatrician and occupational therapist first.


 

BORING, BUT NECESSARY LEGAL DISCLAIMERS

While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.


This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


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