According to the American Academy of Child and Adolescent Psychiatry (AACAP), 20% of five-year-olds and 10% of seven-year-olds experience nocturnal enuresis, or frequent bedwetting issues. While the age range for toilet training varies, it’s widely thought that bladder control is something that may not develop fully until age seven. 

While bedwetting has been attributed to a number of causes across research, from anxiety and ADHD to a genetic predisposition, the primary biological issue is the body’s inability to feel when the bladder is full. When nerves that control the bladder are slow to mature and muscle tone in the region remains low, a child’s brain may not receive those bathroom signals while in a deep sleep.

Our reflexes emerge and integrate during our early months of infancy to help us grow and develop. These movements are purposeful, teaching survival skills from navigation to balance, from understanding threats to exploration. Our reflexes help us as to find food, build attachments and ultimately live independently. Among the many systems impacted by our reflexes are those that expel waste (bladder, bowels).

The Spinal Galant reflex, which emerges with sensations along the spine on the lower back, is closely aligned to the delicate nerve endings that support bladder function. That’s why, when testing a newborn, strokes on the lower back to the waist will almost always result in a release of urine. As Spinal Galant, the side-to-side movement from the hips, strengthens and integrates, so does the nerve and muscle tone that supports bladder function and control.

When addressing bedwetting, there are a number of easy tips available to parents, from controlling evening fluid intake and eliminating caffeine to moisture alarms that help a child wake at the onset of a leak. Plastic mattress covers, nightlights in bathrooms and handy clean clothes may help rough nights but ultimately, the root of the issue needs to be addressed to see progress toward a dry, sound sleep. 

By identifying an active Spinal Galant reflex, and working on targeted rhythmic movement exercises to support its integration, the bladder will also be supported and strengthened. Along the way, it’s important for parents, caretakers and siblings to understand this is something most children cannot control. Avoid reward systems as much as shameful language along this journey. Instead, empower your child to play a role in understanding their body and the movements that work to support their development overall.

Lily’s day was filled with moments of fear and uncertainty. The changing table was a physical battle with her parents from the moment she was placed on her back. Car rides were nightmares, with Lily’s mom trying desperately to reach around and calm her with snacks. From the moment she was buckled in, she wailed.  Bathtime was filled with dread, as Lily refused to tilt her head back for an effective wash. She fought the entire time. 

As daily activities were met with fear and dysregulation, Lily’s parents sought solutions and explored sensory support. Her teachers at daycare held her tight as she battled through severe meltdowns and her parents trudged through countless moments of chaos throughout the day. When the family found Thrive, they learned that those moments triggered by an immature vestibular system. For Lily, many of the positions that cause alarm called upon unintegrated TLR backward reflexes. Her defensive reflexes reacted with panic and alarm.  

Elizabeth quickly identified her Moro reactions, stemming from the unintegrated TLR reflex, in Lily’s evaluation. The vestibular system, responsible for a feeling of balance and stability in moments of movement, is something that has been linked to fear of falling, fear of heights and motion sickness when not fully in sync. The movement, particular backward head movements, are processed by the vestibular system. When Lily would swing on the playground, much like riding in a car, her experience of the backward turn in motion sent her into fight or flight mode. 

“All of these little things clicked for me when we started working with Elizabeth. I never really noticed or attributed them to reflexes before,” recalls her mother, who gained a greater understanding of her daughter’s behavior through Thrive.

As she moved through life, Lily’s Moro was in overdrive. Her limbs extended outward always, and she favored walking on her toes. Criss-crossed legs felt unnatural. Car seats, with the forward-backward movement of a vehicle in motion, felt threatening from her harnessed position and compounded her discomfort. Tilting her head backwards in the bath activated Moro and the backward tilt of her neck activated her TLR reflex.

Through Lily’s work at Thrive, she’s gained more mobility in her body and a greater sense of control that’s replaced her fear with a feeling safety. Joyful activities like swinging back and forth on the playground are no longer moments of discomfort. She’s able to lay back and allow her diaper to be changed without a struggle.  When it’s time for her weekly sessions at Thrive, she’s walking in with flat feet and riding home in a quiet car.

For some, it’s the bobbing of a boat that leads to a persistent lightheaded and queasy feeling. The sensation of takeoff or landing while seated on an airplane, or perhaps the twists and turns of a windy car ride, might set off cold sweats and pallor. While it’s challenging to prevent, understanding how motion sickness is connected to our vestibular system may provide insight as we prepare for summer travel. 

Our vestibular system is housed within our inner ear, consisting of sensory organs filled with fluid. Three semicircular canals react to our body’s movement, side to side, up and down or right and left. The fluid shifts against tiny hair cell receptors and sends signals to the central nervous system to keep the body in balance against shifts in movement. A mature system is able to move without getting sick, an immature system is what causes the motion sickness. TLR is what creates the mature foundation for sensory processing of forward and backwards motion.

The vestibular system is the anchor for all sensory systems. A well-established vestibular system with be able to communicate with the visual system and proprioceptive system to understand the sensory experience. An immature vestibular system will cause motion sickness. Our sensory input from our eyes and our muscles and joints combines to inform the system. Oftentimes, travelers experience mixed signals in their body as they sit on moving vessels like planes, boats and cars. The disconnect between what we see and what we feel or don’t feel alerts those autonomic (and sickly) reactions. Interestingly, virtual reality and other immersive games result in similar challenges, since participants experience a moving environment while oftentimes limited in their own movement.

Our reflexes play a major role in creating the foundation for a mature vestibular system, which supports our balance and awareness of our movement within our surroundings.  Compensation strategies for immature systems suggest focusing on fixed objects may help travelers feel less sick (eyes on the horizon while on a boat, sitting in the front of the car and looking at the dashboard, for example). Natural remedies like pressurized wrist bands and chewing ginger help to mask nausea as well. 

Hank was a passionate baby, his mother lovingly recalls. His laugh was infectious and when he was happy, he was a boisterous and playful little child. When he was angry, though, he was more than mad. There was truly no middle ground as Hank struggled with emotional regulation.

Hank’s inconsolable tantrums started around age two. He rejected hugs, threw toys and more often than not, wound up hitting his body against a wall or the side of his crib. He would lash out with biting. Hours long jags got so bad that his parents had to pad his crib.

“We had a hard time keeping him safe,” said Hank’s mother of his frightening moments of self-harm. “Anything we did would only agitate him more.”

As time went on, his reactions impacted his sleep. Hank would often wake with night terrors. He would require earphones to tolerate the sound of the espresso maker in the morning, as distress extended from night back into day.

Hank’s mother, an Occupational Therapist, tried every sensory processing strategy she knew without progress. When an outpatient OT working with Hank explored retained reflexes, they saw simple exercises prove challenging and, in his frustration, further dysregulating. That’s when the family knew they needed a specialist like Elizabeth.

“She was so helpful explaining the science behind all of the reflexes, and even some things we could start doing at home,” she says of a phone call with Elizabeth while Hank was on the waitlist for his full evaluation. The family was eager to dig in.

Once Hank began his weekly sessions, it was clear that he was living with an extremely active Fear Paralysis and Moro. His need to smash his mouth or bite was an attempt at oral self-soothing, something he struggled with since losing his pacifier. Elizabeth led Hank slowly through the work, recognizing his Moro required a gentle path toward safety. Within the first week of work, Hank’s meltdowns went from nine or more a day to only a few a week. He slept through the night almost immediately after the evaluation. 

Most significantly, Hank was not biting nor was he hurting himself physically while upset. He was starting to process his emotions, name them and begin the path to regulation. His mother recalls a day not too far into the sessions when she looked down from the same espresso machine and saw her son, without headphones and within inches of the noisy machine. He looked up and asked, mommy, are you making your coffee? The moment was so special for the progress it meant for them both.

Babinski, like Babkin, is another reflex that rounds out our grasping reflex integration. Complimentary to the Palmar Grasp Reflex where toes curl, Babinski teaches the toes to stretch and the foot to turn slightly inward when the outer side of the foot is stroked. The ability for our feet to flex and extend, as well as turn in and out, helps us push off the ground as we learn to crawl on bellies, knees and eventually walk. 

Related to posture, this reflex provides a sense of safety and stability navigating the world around us. The two work to support upright movement and, if immature, may result in poor balance and difficulties in walking. Without full integration, children may demonstrate physical challenges, from toe walking to stiff or sore legs. Delayed development of foot reflexes results in poor motor planning and a tendency to trip or fall. 

The connections between our reflexes span our entire body and Babinski is a reminder of those linkages. We have a fascial chain that runs from our big toe to our tongue, connecting our feet with our mouths. The relationship between the two parts is evident in our earliest reflexes, when infants babble and wiggle their toes simultaneously. When we encounter speech and articulation challenges in development, there is almost always a linkage to the foot.