Does It Get Worse Before It Gets Better?
- Jul 14
- 4 min read
Lara Cawthra is a Paediatric Chiropractor and MNRI® Core Specialist who supports infants and children with gentle, neurologically focused care. She’s passionate about helping kids build strong foundations for movement, learning, and regulation while empowering parents every step of the way.
In nearly 30 years of clinical practice, this is one of the questions I am asked most often by parents, “We started reflex integration work, and my child seems more anxious, more reactive, more dysregulated than before. Is that supposed to happen?”
My answer is almost always the same. Yes, this can happen, and it does not mean anything has gone wrong. For parents in the middle of it, this can be genuinely alarming. They came to reflex integration work hoping to see their child settle, and instead they are watching meltdowns increase, sleep become further disrupted, or sensory reactivity spike. I want to use this article to explain why this happens from a neurodevelopmental perspective and how I guide families through it.
Why regulation can dip before it improves
Primitive reflexes are rooted at the brainstem level. They are not simply reactive movement patterns, they are the foundational wiring around which the rest of the nervous system is organised. When we begin working to integrate a reflex such as Moro, we are effectively adjusting the sensitivity of a smoke alarm that has been triggering too easily, too often, for too long.
Recalibrating that alarm is rarely a smooth, linear process. More often, the system moves through a period of instability before settling into a new, calmer baseline. This is particularly true of the Moro reflex, which I often describe to families as a gatekeeper reflex. Because it sits upstream of so much of the nervous system’s threat response, beginning to shift it can temporarily unsettle the wider system before genuine reorganisation takes hold.
A layered process, not a switch
I frequently use the analogy of peeling an onion when I explain reflex integration to parents, because it captures something a simple “before-and-after” narrative misses. Integration does not happen as a single event. It happens in layers, and each layer that shifts can bring a period of heightened sensitivity before a calmer layer is revealed underneath.
Alongside this, myelination, the process by which new neural pathways become efficient and stable, is not instantaneous. It can continue to develop for as long as two years. Families who understand this timeline from the outset are far better equipped to interpret a difficult week as part of a longer trajectory, rather than as evidence that the approach is not working.
Why regulation must come before integration
When I see a child’s dysregulation escalating rather than settling, my first clinical question is not “how do we push the integration work harder,” but “does this nervous system need more support with regulation before we ask more of it?”
This is a distinction I think is under-discussed outside specialist circles. Reflex integration work asks a great deal of a developing nervous system. If that system is already dysregulated, adding intensity to a home program can compound the problem rather than resolve it. This is why I consistently advocate a “little and often” approach, brief, consistent movement input woven into daily rhythms, rather than a large, front-loaded program that overwhelms an already reactive system.
Distinguishing normal wobble from a program that needs adjusting
Part of my role as a practitioner is helping families tell the difference between an expected, temporary wobble and a pattern that genuinely needs the program reviewed.
A short period of increased sensitivity as a reflex begins to shift is a normal part of this work. Escalating anxiety, developmental regression, or dysregulation that does not settle over time is not something to simply wait out. In those cases, the pacing, dosage, and sequencing of the program need to be reassessed by the practitioner guiding the work, and where a broader anxiety picture is present, this should sit alongside, not instead of, appropriate input from pediatric or mental health professionals.
The takeaway for families and practitioners
If there is one message I want families and fellow practitioners to take from this, it is that dysregulation getting louder before it gets quieter is often a sign that the nervous system is actively reorganising, not a sign of failure. Regulation comes first. Integration follows. Progress in this work is rarely linear, and patience, paced correctly, is not passive, it is part of the clinical strategy.
Read more from Lara Cawthra
Lara Cawthra, Paediatric Chiropractor and MNRI Core Specialist
Lara Cawthra is a Paediatric Chiropractor and MNRI® Core Specialist who loves helping kids grow, move, and thrive. She works with babies, children, and their families, using gentle tonal chiropractic care and MNRI® techniques to support healthy neurological development. Lara has a particular interest in supporting children with developmental delays, sensory challenges, and neurodivergent needs, always focusing on what each child needs to feel safe, regulated, and confident in their body. Known for her warm, down-to-earth approach, Lara is passionate about empowering parents with knowledge and practical tools so they feel supported every step of the way.
