Why We Do What
We Do
Here is the research behind each therapy we offer, in plain language. We tell you how strong the evidence is for each one, and you can open any section to read the studies themselves.
Light therapy for the developing brain
A well studied cellular mechanism, encouraging adult research, and pediatric studies that are newer and still growing.
Uses gentle near infrared light, absorbed by the mitochondria that produce energy inside every cell
Comfortable and noninvasive; children simply sit or play while the light is applied
The proposed mechanism, improved cellular energy and reduced inflammation, is well studied in the laboratory
Applying light to the head for development is an off label use of an FDA cleared device, which we explain fully below
Photobiomodulation, sometimes called low level laser therapy, uses gentle near infrared light applied to the head. The light is absorbed by mitochondria, the structures that produce energy inside every cell, and is thought to support cellular energy production, healthy blood flow, and a calmer inflammatory environment in the brain. Our therapists include it alongside sensory integration, motor work and reflex integration because it is comfortable for children, it asks nothing of them beyond sitting or playing, and the research behind it has grown steadily. The cellular mechanism is well studied, and the adult research is encouraging. It is an exciting area, and one we follow closely.
What the research says
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A review article drawing together the laboratory and clinical work published up to 2016, describing how red and near infrared light is thought to affect brain cells.
Hamblin MR. (2016). BBA Clinical, 6:113-124. View on PubMed
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Ten adults with autism used a near infrared light device on the head twice a week for eight weeks, without a comparison group. The researchers reported improvement in social communication scores and described the approach as feasible and worth studying further.
Ceranoglu TA, Cassano P, Hoskova B, et al. (2022). Photobiomodulation, Photomedicine, and Laser Surgery, 40(1):4-12. View on PubMed
Photobiomodulation is never the whole plan. It is one part of an individualized program built around your child's goals, and whether to include it is always a decision we make together with your family.
What the studies in children found
Two randomized controlled studies in children, plus further published work. Encouraging results from an evidence base that is still growing.
A randomized sham controlled trial in 30 children aged 2 to 6 reported greater improvement in autism rating scores than sham treatment
A randomized, placebo controlled study in 40 children and teenagers reported a greater reduction in irritability
A further study following 21 children over six months reported improvements in attention and sleep
Trials for ADHD are underway; until they report, we make no claim about ADHD
Several studies have looked at light therapy in autistic children and teenagers. Two of them randomly assigned children to receive either the real treatment or a placebo, which is the design best able to show whether a therapy caused a change, and both reported better results in the group receiving the real treatment. We would rather show you exactly what each study found, and how many children took part, than ask you to take the phrase "research shows" on trust.
What the research says
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Thirty children aged 2 to 6 with autism were randomly assigned to receive either real near infrared light to the head or a sham version, twice a week for eight weeks. The researchers reported greater improvement in autism rating scores in the group receiving the real treatment, and no moderate or severe side effects.
Fradkin Y, De Taboada L, Naeser M, et al. (2024). Frontiers in Neurology, 15:1221193. View on PubMed
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Forty children and teenagers aged 5 to 17 with autism received either real or placebo low level laser sessions applied to the head over four weeks. The researchers reported a greater reduction in irritability in the group receiving the real sessions.
Leisman G, Machado C, Machado Y, Chinchilla-Acosta M. (2018). Advances in Experimental Medicine and Biology, 1116:111-130. View on PubMed
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Researchers reviewed the records of 21 children aged 5 to 15 who had used a light device at home for six months, without a comparison group, and reported that autism rating scores decreased over that period alongside improvements in attention and sleep.
Pallanti S, Di Ponzio M, Grassi E, et al. (2022). Children, 9(5):755. View on PubMed
The reflexes that were meant to fade
A well-designed randomized trial supports it for reading difficulty. The evidence for its wider use is still building.
Babies are born with primitive reflexes that normally integrate during the first years of life
Persisting reflexes are found more often in children with autism, ADHD and learning differences, though association is not the same as cause
One randomized, double-blind trial in 60 children found reflex-based movement improved reading in children who had both a retained reflex and reading difficulty
That trial has not been independently replicated in more than 25 years
Your baby was born with automatic movement patterns called primitive reflexes, which normally become inactive as the nervous system matures. When they persist, they are associated with difficulty in balance, coordination, handwriting and attention. Reflex integration therapy uses specific repeated movement patterns intended to help that process complete. We screen for retained reflexes as one input among several, and we tie any reflex work to a functional goal, such as handwriting or sitting through a meal, rather than treating the reflex score as the point.
Studies that tested whether it helps people
Effects of replicating primary-reflex movements on specific reading difficulties in children: a randomised, double-blind, controlled trial
2000Randomized, double-blind, placebo-controlled trial 60 children aged 8 to 11 (20 per group)
What it found: After twelve months, children doing the specific reflex-based movement sequence gained 19.6 months of reading age, compared with 7.3 months in the placebo-movement group and 6.9 months in the no-movement group.
What it cannot tell you: Single site, 60 children, and never independently replicated. The outcome measured was reading in children with reading difficulty, not autism, attention or behavior.
Read it on PubMedBackground and mechanism papers These explain how something might work. They are not evidence that it does.
Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders
2022Narrative review Not a study
What it says: Argues that retained primitive reflexes in autism correlate with motor and cognitive difficulty, and that motor-based inhibition exercises may support neuroplasticity.
Why we label it background: A narrative review written by proponents of the approach, not an independent evidence appraisal. It proposes a case; it does not test one.
Read it on PubMedCalming the nervous system at its source
Pilot studies in children are encouraging. Ear-based stimulation is considered investigational for these uses.
The vagus nerve carries much of the signalling involved in calming down after stress
Stimulation at the ear is gentle and non-invasive: no surgery, no needles
Early pilot studies in children with autism have reported improvements in anxiety and sleep
This use is investigational, and we describe below exactly what that means
The vagus nerve runs from the brainstem through much of the body and carries much of the signalling involved in calming down after stress. Non-invasive vagus nerve stimulation applies gentle stimulation at the ear, where a branch of the nerve runs close to the surface. No surgery is involved. Early studies in children have been encouraging, particularly for anxiety and sleep. The research is at an early stage, and we would rather tell you that plainly than let a hopeful word do the work.
Studies that tested whether it helps people
Remotely supervised at-home delivery of taVNS for autism spectrum disorder: feasibility and initial efficacy
2023Open-label feasibility study, no control group 12 participants
What it found: At-home ear-based stimulation proved feasible, with reported improvement in anxiety scores and sleep quality.
What it cannot tell you: Twelve participants, no control group, and 22 adverse events recorded including headache, local pain, itching and stinging. This is a feasibility study. It was not designed to establish that the therapy works.
Read it on PubMedVagus Nerve Stimulation and Seizure Outcomes in Pediatric Refractory Epilepsy: Systematic Review and Meta-analysis
2021Systematic review and meta-analysis 101 studies
What it found: Confirms the effectiveness of surgically implanted vagus nerve stimulation in children with drug-resistant epilepsy.
What it cannot tell you: This concerns implanted devices and epilepsy. We include it so the distinction is visible. It is not evidence for ear-based stimulation, and it is not evidence for anything we offer.
Read it on PubMedBackground and mechanism papers These explain how something might work. They are not evidence that it does.
Transcutaneous Auricular Vagus Nerve Stimulation in Pediatric Patients: A Systematic Review of Clinical Treatment Protocols and Stimulation Parameters
2023Systematic review of protocols 15 publications and 15 trials
What it says: Documents growing clinical interest in pediatric non-invasive vagus nerve stimulation and catalogues the stimulation settings used.
Why we label it background: We list this as a caution rather than as support. The review found no dedicated pediatric devices and no study that justified its stimulation parameters for children.
Read it on PubMedTranscutaneous Vagus Nerve Stimulation: A Promising Method for Treatment of Autism Spectrum Disorders
2016Hypothesis and perspective paper No participants
What it says: Proposes that ear-based vagus nerve stimulation could influence brain regions involved in social communication, and argues the idea is worth testing.
Why we label it background: This paper contains no patient data at all. It proposes a hypothesis. It is not evidence, and the word "promising" in its title describes an idea, not a result.
Read it on PubMedThe "little brain" behind timing and coordination
Well-established brain science that informs how we design activities, rather than a claim about a specific program.
The cerebellum contains more neurons than the rest of the brain combined
It contributes to timing, coordination, language and attention, not only to movement
Differences in cerebellar structure and connectivity have been described in autism, ADHD and dyslexia
Evidence that commercial timing-training programs change developmental outcomes is weak
The cerebellum sits at the back of the head and was long thought to handle movement alone. It is now understood to contribute to timing, coordination, sequencing, language and attention. This is why cross-body reaching, postural work and timing activities appear throughout our sessions. We use this science to design what we do, rather than as a claim that any single exercise program changes development on its own.
Studies that tested whether it helps people
Effect of Interactive Metronome training on children with ADHD
2001Controlled trial, not blinded 56 boys aged 6 to 12, of whom only 19 received the training
What it found: Boys who received timing-based training showed improvement across most of the measured variables, including attention and motor control.
What it cannot tell you: Nineteen boys in the treatment arm, no blinding, parent-rated outcomes where parents knew the group assignment, and 58 outcome variables analyzed without evident correction. A co-author is the inventor of the device tested. No independent replication in 25 years. We include it because it is widely cited, and because you should be able to see its weaknesses.
Read it on PubMedBackground and mechanism papers These explain how something might work. They are not evidence that it does.
The Cerebellum and Neurodevelopmental Disorders
2016Review Not a study
What it says: Cerebellar differences appear across autism, ADHD, dyslexia and developmental coordination disorder, and the cerebellum contributes to cognition and language as well as movement.
Why we label it background: Descriptive review. Establishes associations, not treatment effects.
Read it on PubMedCerebro-cerebellar circuits in autism spectrum disorder
2015Review Not a study
What it says: Reviews evidence that connectivity between the cerebellum and the rest of the brain differs in autism.
Why we label it background: Review of imaging findings. Not an intervention study.
Read it on PubMedHypoplasia of cerebellar vermal lobules VI and VII in autism
1988Small case-control imaging study About 18 participants and 12 comparisons
What it says: First report that specific cerebellar regions appeared structurally smaller in autistic individuals.
Why we label it background: Historically important, published in 1988, and not consistently replicated. Later work attributes much of the effect to age and IQ differences between the groups. We include it for context, not as current fact.
Read it on PubMedA note from our team: These studies support the methods we use, but every child is different. We always tailor treatment to your child's unique needs and goals. If you have questions about any of this research, we're happy to walk you through it.
Questions about our approach?
Research in pediatric applications of these modalities is still emerging, and we stay current with new findings so our approach continues to reflect the best available evidence. We love when parents ask questions, so if you want to learn more about any of the research or therapies we use, we are happy to discuss them during your consultation.
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