This post is a condensed summary of our podcast about the Asymmetrical Tonic Neck Reflex. To listen to the full episode scroll to the bottom of the page or find us on all of the major streaming services.
This post is all about school problems and the Asymmetrical Tonic Neck Reflex (ATNR). This is the second most common primitive reflex I see and it is one of the biggest contributors to academic problems, specifically reading and writing difficulties.
It is VERY common in the children I see with dyslexia and ADHD. If you have a child who is struggling in school this is the blog post for you.
Now If you aren’t familiar with primitive reflexes I have a blogpost here describes what they are and why they are important. The short version though, is that babies are born with a set of reflexes that they keep for a short period of time and then these reflexes should disappear. When that doesn’t happen you see a lot of problems with the way the rest of the brain develops. The ATNR reflex is one of the most common ones and today we are going to take a look at how it affect school performance.
This reflex is triggered whenever the baby turns their head to either side. When their head moves, the arm and leg on the side they are facing extend and the arm and leg on the other side bend.
In older children this creates an invisible connection between their head, their eyes and their hand so that it is difficult for them to use these body parts in an independent and mature way. It also creates an invisible barrier at the midline of the body so that it is difficult for kids to cross their midline effectively. You can see this the clearest when you look at visual tracking. It can be very difficult for these children to move their eyes in a smooth line particularly when their vision crosses their midline.
This reflex also messes with their ability to understand directionality specifically left and right. I am going to get in to the reason why all of these things happen in a second, but know that it is very common for these kids to have poor left and right spatial awareness. This really shows up in reading when you are making the distinction between similar letters like: b, d, p and g.
Older children with a retained ATNR have to put a lot of effort into controlling their eyes instead of that process happening automatically. Even with tremendous effort their eyes don’t work well. If you try to add in any other cognitive processes like learning then you really see this fall apart.
Something that most people don’t know is that our brain is not able to multi task. We just switch back and forth very rapidly. Children with a retained ATNR who are doing school, let’s say learning to read, are constantly switching back and forth between trying to learn to read and trying to make their eyes work.
The other part about this reflex is that it helps us coordinate and differentiate the two sides of the body. The way that we control and move our body affects the way our brain develops. When the two sides of our body aren’t working together effectively it negatively affects the way the two sides of our brain work together. When kids are stuck having to put in a lot of effort to control physical process that should be automatic you see all kind of problems with cognitive development. And by cognitive development I mean things like: rational thinking, planning, learning new information, remembering directions, decision making ect.
This also contributes heavily to balance and hand-eye coordination problems. And again, you see variations in how well kids cope with this. Some very athletic kids do decent when they are playing a sport they love but their coordination fall’s apart in other areas. Most kids with an ATNR are clumsy and uncoordinated. They look funny when they run or uncoordinated when they try to catch something. They may do great running as long as they are looking forward but as soon as they turn their head to look somewhere else they lose balance.
Often times you see these physical deficiencies most clearly in their posture at school. Kids cope with this reflex by utilizing “bad” posture. These are the kids that lay their head on the desk while they are writing, or move their papers to one side of their body. Sometimes they use a really firm pencil grip and press really hard on the paper to try to control their arm better. These kids also tend to get labeled as lazy or over emotional about school because it seems like they don’t want to do easy things or they have no frustration tolerance. Most of the time these kids also have other compounding problems like problems with their vestibular system which affects focus and attention, posture, spatial awareness and all kinds of stuff.
So if you have a child with reading or writing difficulties, or a child with an ADHD or dyslexia diagnosis, this reflex is something you should consider testing. Now I am very particular about recommending testing or treatment exercises to families without evaluating the child first. I see a lot of videos on youtube giving testing and treatment advice and some of them are very concerning. There are some reflexes like the Moro, which is the infant startle response, that you want to be very careful testing and even more careful treating. Also experimenting with treating the Moro in particular can lead to a very overstimulated child.
But there are other tests that we use that are generally quite safe and effective and the main ATNR test is one of them. Now keep in mind that when I do a comprehensive assessment in the office I use this test and multiple other tests to get a more complete picture. One of the ones I use is called the Hoff Schilder test and it is pretty accurate as a stand alone test.
If you want to get more information about testing reflexes, the most accurate resource for parents would be a book called Reflexes, Learning and Behavior by Sally Goddard. She is one of the founders of the Institute of Neuro-Physiological Psychology. That is the post-graduate school I attended and the leading school and research institution on primitive reflexes. She includes some really good testing information that is designed for parents to screen their kids at home and her testing information is very solid. Just please don’t trust everything you see on youtube. Its worth purchasing the book.
In the video below I walk you through how to use this test to check for an ANTR.
If any of this stuff sounds like your child them please visit my website to learn more. I have a screening questionnaire that you can fill out and I offer free phone consults. These reflexes are very treatable and you can see amazing changes in how kids function. It is much more effective that slapping a bandaid on the problems and trying to cope.