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The ATNR emerges at about 13 weeks after conception and normally disappears at 6-7 months after birth. The ATNR stimulates the development of muscle tone, initiates neural pathways, and assists the fetus in the birthing process.


The ATNR reflex pattern is activated by turning the infants head to one side while the infant is lying on it's back(a horizontal plane), this results in the limbs on the same side to extend(straighten) and the limbs on the opposite side to flex(bend).

The ATNR helps develop visual and auditory processing as well as early hand-eye coordination. When the head turns and the arm extends, the eyes follow the arm making the infant aware that the hand is part of their body and extending their visual ability to focus to an arm's length.

ATNR Sketch.png

The ATNR also helps develop the vestibular system necessary for balance. The vestibular system is in the inner ear and detects movement and changes in the position of the head and informs the individual whether the head is upright or tilted(even with the eyes closed). If the vestibular system is not working properly the child may not develop the neural connections for developing muscle tone.

If the ATNR is not integrated so that the body parts can operate independently of one another, and in cooperation with the other side of the body, it can cause great challenges for the child's development. A retained ATNR makes crossing the midline of the body difficult resulting in vision and coordination problems.

Integration of the ATNR is very important because it helps develop the corpus callosum enhancing communication between the two brain hemispheres. The ATNR is the most commonly found retained primitive reflex in young children with motor challenges and educational difficulties.

Characteristics and effects of a retained ATNR reflex:

  • visual difficulties, eyes don't work together(binocular vision) causing blurring and double vision

  • poor eye-hand coordination, difficulty throwing and catching a ball

  • poor coordination and balance

  • difficulty crossing the midline or doing cross-lateral movements

  • difficulty with sports such as swimming that require the bodies coordination of left/right and top/bottom

  • Right-left confusion, mixed laterality, dominant hand/eye/leg/ear not established

  • drops objects when the head turns

  • messy eater, has trouble bringing hand to the mouth(midline) when the head turns

  • childish behavior, tendency to to be selfish, impatient-wants everything now


How does a retained ATNR reflex affect my child's learning?

  • high probability of Dyslexia, omission of letters, words, lines, reversal of letters and numbers

  • poor binocular vision, erratic eye movements causes print to jump around page, poor comprehension

  • difficulty crossing the midline makes reading and writing difficult because eyes and hand need to be able to move across the paper

  • impaired handwriting due to hand/eye, head/arm linkage, turning the head causes arm to straighten

  • illegible handwriting, gripping pencil too tight or applying too much pressure, hand fatigue or cramping

  • handwriting not automatic-difficult to write and think at the same time.

  • high probability of Dyscalculia(math difficulty), sequencing challenges

  • high probability of Dysgraphia(writing difficulty)

  • difficulty following multiple instruction


If this sounds like your child, there is a high possibility their Asymmetrical Tonic Neck reflex needs to be integrated so they can move forward.

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