Discussion
The aims of this study were to analyze the relationships among the level of inhibition of primary reflexes, MC and the development of the crawling pattern in children aged 5 to 6, and to assess the differences based on the participants’ gender, which were specified in four hypotheses.
Regarding the first hypothesis, the results showed that the non-inhibition of primary reflexes was higher in those children with lower MC, as they obtained higher scores in the test applied (Goddard, 2015). Significant differences between children with and without developmental impairments were found (Matuszkiewicz & Gałkowski, 2021), with large effect size for TLR and STNR, in line with other studies where these reflexes were found to be the least integrated ones in infants (Hickey & Feldhacker, 2021; Madejewska, Choińska, Gieysztor & Trafalska, 2016].
Differences were also observed, with medium effect size, in MR and ATNR, suggesting that the participants’ low MC might have its origin in the lack of reflex inhibition, which may also affect other domains, as these problems rarely occur in isolation (Matuszkiewicz & Gałkowski, 2021; McPhillips & Sheehy, 2004).
Regarding correlations between MC scores and reflex inhibition in group A, the Macb-2 total score showed negative and statistically correlations with ATNR, one of the most frequent reflexes in preschool children (Gieysztor et al., 2017), and MR. The latter may be justified by its relationship with balance and coordination (Goddard, 2014), which are the most common motor problems in children with psychomotor disorders (Pecuch et al., 2018) and are also skills that allow children to effectively participate in Physical Education (PE) lessons (Dalziell, Booth, Boyle & Mutrie, 2019)
Likewise, in group A, manual dexterity presented significant correlations with MR and STNR, which could be justified considering the relationship between MR and coordination and balance already mentioned, and the transfer of these skills to ball games and sports (Goodard, 2005). These data suggest that children with movement difficulties show greater presence of these reflexes (Pecuch et al., 2020), which seems to affect their general coordination as well as their performance in tasks involving hand-eye coordination.
Regarding group B, negative and significant associations were found between all dimensions and the overall Macb-2 score and all reflexes assessed. These results suggest that the lower the reflex evidence, the higher MC (Gieysztor et al., 2017; Gieysztor et al., 2018; Goodard, 2005; Goodard, 2015).
However, the positive relationship between aiming and catching and ATNR in children without motor difficulties should not be disregarded (r = 0. 36, p < 001). It disagrees with other study (McPhillips & Sheehy, 2004), where authors stated that children with persistent ATNR were at risk of motor difficulties, as poor inhibition of this pattern may be the cause of fine and gross motor control problems, and could disrupt the emergence of motor skills such as rolling, crawling, creeping, and catching or kicking a ball (McPhillips & Sheehy, 2004). Therefore, the first research hypothesis is accepted, but further studies are needed to assess the relationship between ATNR and throwing and catching skills.
When assessing the second study hypothesis (reflex non-inhibition will be lower in children who have developed the crawling pattern), significant differences were found, with small effect size, in the percentage of reflex inhibition between children who had developed the crawling pattern and those who had not. Therefore, the hypothesis is accepted. Furthermore, these results point to the fact that active primary reflexes may have influence on the development of the crawling pattern in children, due to their negative contribution to the development of the cross-lateral pattern (Krog, 2015).
In this sense, and as mentioned above, the STNR acts as a bridge to the next stage of creeping and crawling development (Krog, 2015). The results obtained in this research are consistent with this statement, since the scores observed for this reflex were significantly higher among those children who had not developed the crawling pattern. This can be explained by the fact that the STNR allows children to adopt a quadruped position, and it will prevent progression or movement in this position if it remains active (Goodard, 2005).
As for the third hypothesis (having developed the crawling pattern will be associated with greater MC), significant differences were found in the global score and all dimensions of the Mabc-2 between children who had crawled and those who had not. These differences may reveal the importance of the acquisition of the crawling pattern in the development of more complex skills, as the integration of the right and left sides of the body is essential to achieve adequate spatial awareness and to properly develop hand-eye coordination (Hannaford, 2005). Failure to acquire this pattern can affect performance in simple tasks such as throwing a ball or batting (Henderson, French & McCarty, 1993) and, consequently, lead to low satisfaction when performing sport activities and low participation in PE lessons (Gieysztor et al., 2018; Goddard, 2015). This issue is important as children who feel safe while participating in PE are more likely to be intrinsically motivated to continue participating (Rudd et al., 2020).
In the group comparison, 91.1% of group A participants versus 37.5% of group B had not crawled, resulting in significant differences between groups (U = 334.000, p = .00). This allows us to accept the third hypothesis, as well to consider the importance that the acquisition of this pattern may have in the development of other later skills (Kubicec, Jovanovic & Schwarzer, 2020).
As a secondary goal, we aimed to assess the differences based on the participants’ gender. In this regard, it was hypothesized (4) that reflex inhibition would be lower in male participants. Boys scored higher than their female counterparts in all the reflexes assessed, showing lower reflex inhibition. Nevertheless, only significant differences were observed in the MR, with p < 0.05 in the whole sample and p < 0.01 in group A (Table 9). Thus, the hypothesis is partially accepted.
These results are in keeping with previous research that proved that boys presented higher incidence of active reflexes, both in a healthy population (Gieysztor et al., 2018; Hickey & Feldhacker, 2021; Madejewska et al., 2016; Matuszkiewicz & Gałkowski, 2021; Rashikj-Canevska & Mihajlovska, 2019) and in children with some kind of difficulty (Mc Phillips & Jordan-Black, 2007; McPhillips & Sheehy, 2004).
The gender differences show that gender can play an important role in children with motor difficulties. Thus, girls showed higher integration of some reflexes and higher motor development than their peers (Gieysztor et al., 2018), and a higher percentage of them had developed the crawling pattern compared to boys.