Ruth is in Grade 0. She is a friendly girl of average build who seems eager to please, but finds it difficult to comply with instructions. She is easily distracted and is constantly fidgeting or moving on her chair. Her teacher and parents are concerned about her school behavior and lack of ‘school readiness’ and also very concerned about her habit of masturbating openly during rest time in the afternoons.

Ruth’s diet is already controlled because of her allergies and an earlier operation to her small intestine. She is not allowed to eat lots of sweets and chocolates and drinks at least 4 glasses of water per day. She is not taking any supplements, so an essential fatty acid was recommended.

The evaluation revealed problems with her vestibular system, muscle tone, proprioception, kinesthesia and interhemispheric integration. She also shows immature differentiation. Differentiation should develop before lateralization, which means she doesn’t have an internal map or external map of space and cannot distinguish left and right.

Eye movements are very jerky, and she finds them very difficult to do with her eyes taking strain during tracking. During the convergence exercise her eyes could not stay with the focal point and often lost it. She shows cross-dominance, having a dominant left eye but dominant right hand, foot and ear.

Aberrant primitive reflexes that are present must be inhibited, for example the ATNR, which causes balance problems, difficulty crossing midline, oculomotor problems with poor ocular pursuit movements, visual and spatial perception. Audition is also a problem, but can be addressed more later after basic systems have improved.

She was given a programme of activities to follow to address these concerns. To address her differentiation problems and also to help distract her from masturbating, her practitioner devised an additional activity: her mother made her a necklace of string with two beads on it. She wears it during the day during school and when watching TV in the afternoons and is encouraged to ‘fiddle’ with the beads. When she lies down to rest at school, both hands should be occupied with the exercise.

After 10 days, Ruth showed remarkable improvement. She wasn’t masturbating as much anymore and could sit still. She loved the exercises so much that she woke her mother up on the Saturday and Sunday to do the exercises.

Ruth was re-evaluated eight weeks later and her practitioner was pleasantly surprised by the reports and results of a re-evaluation. She could sit still and didn’t fidget any more. She had completely stopped masturbating and no longer needed to fiddle with her fingers. She was generally more confident in herself, her balance and coordination had improved and she was crossing the midline more naturally. Proprioception and kinesthesia showed improvement and overflow of movement was reduced, showing better differentiation.

There were also major shifts as far as aberrant reflexes were concerned. She seemed to have integrated the STNR and showed greatly reduced signs of an ATNR. Her visual tracking was less jerky than before, and although she was still losing a focal point, this happened less often. With the improvement in vestibular-cerebellar functioning, it was decided to send her to a Developmental Optometrist for possible visual therapy.

Internalising the knowledge of left and right showed some improvement but needed more work.

Ruth continues with the programme and is helped enthusiastically by her mother who is thrilled with the results.

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