Asymmetrical Tonic….What Now??

I’ve been a teacher for quite awhile. 20+ years actually. I’ve taught pre-schoolers, I’ve taught 2nd graders, I’ve taught 4th and 5th graders. I’m also a mom to two teenage children. And in all that time of being a teacher and a mom, I had never heard of the Asymmetrical Tonic Neck Reflex (ATNR) until about two years ago. Never.

Now you may be asking- why would this reflex be something that I would expect to know about as a teacher? Well, I’ll tell you. It’s because the ATNR is a reflex (that when unintegrated- or “finished”) can cause a child to have all sorts of difficulties that could show up in the classroom.

Difficulties like:

  • Problems with eye-hand coordination- especially for fine motor skills.
  • Poor handwriting ability
  • Awkward or contorted writing positions
  • Holding a pen or pencil too tightly
  • Poor eye tracking (following words left to right)
  • Reduced reading fluency which could impact reading comprehension
  • Drifting of left margin space on paper or writing that slopes down
  • Difficulty with bilateral skills such as tying shoes.

Teachers, parents- any of these things sound familiar? Can you see the connection as to why I think teachers should be made aware of this important primitive reflex?

Let me tell you a little bit more about this reflex. 

This reflex is also sometimes referred to as the “fencing reflex”. If you look at the picture below, you’ll probably understand why. It looks like the baby is in a fencing position, right?

This is the ATNR. When the head is turned to the side, the arm, fingers and leg on the same side extend while the opposite arm and leg bend. 

The ATNR serves several purposes:

  • While in utero, the head movement activates the reflex which provides continuous kicks. This develops muscle tone, stimulates the vestibular system and increases connections in the neural pathways. 
  • After birth, the reflex helps ensure the baby has a free passage of air while lying on their stomach. 
  • It is an introduction to laterality (the preference for one side of the body over the other) by training one side of the body at a time.
  • It serves as the first eye/hand coordination experience, setting up the visual system for near point focus.

Now you must remember, that this is a primitive reflex. An early motor pattern that happens automatically. 

So for a moment, picture this:

Suzie is a 2nd grade student. She is sitting at her desk at school writing a few sentences on her paper (using her right hand). Someone to her right drops his pencil on the floor and Suzie looks over to see what happened. If her ATNR isn’t full integrated- if it didn’t finish it’s job and give way to more voluntary movements of the arm- think about what happens. 

Suzie looks over to her right. This, in turn makes her right arm want to extend. But, she’s writing on the paper! At this point, one of two things could potentially happen. Suzie could (subconsciously) grip the pencil tighter because her body has build up “compensations” to fight what the reflex wants it to do. By gripping tighter and tensing her arm she might be able to keep that hand in place where she needs it- on her paper. 

OR the other thing that could potentially happen is that when Suzie turns her head, her arm actually does extend, knocking over whatever she has on her desk, or just moving her paper out from in front of her.

Either way, it’s not what we want to happen, correct? Suzie should be able to look in the direction of the noise while her hand remains casually placed on the paper where it was before the noise occurred. Look over at the noise, see it’s nothing to worry about, return gaze back to paper and continue. That’s what we want to happen, but it probably doesn’t with a child that has an unintegrated ATNR.

This is only one quick scenario. If you look over the list of potential difficulties above, you’ll probably be able to come up with a few of your own. 

I hope you are starting to get a better picture about why I think teachers and parents should know about this reflex. It’s tremendously important for school! And, perhaps even more importantly, teachers and parents should know and learn some things they can do to help children integrate the reflex!

And yes, don’t worry, I’m going to give you one thing you can do to help integrate the reflex. It’s called “Lazy Eights” and it’s from the Brain Gym® program. What you do is draw infinity signs (an 8 on its side). Like this:

Place your (or your child’s) body in the middle of the 8. Then, you draw (or trace) with one hand, then the other hand, and then with both hands together. 

And let me tell you- you can get mighty creative with this symbol! You can make it on an easel or whiteboard. You can use paper. You can use your finger with shaving cream or finger paint. You can make a big Lazy Eight on the driveway with sidewalk chalk and walk (or skip or hop!) the eight. You can make it on each other’s backs. There are so many ways to incorporate the Lazy Eight. And, among other benefits (which I won’t get into in this blog post) all those Lazy Eights can help to integrate that stubborn ATNR.

The Asymmetrical Tonic Neck Reflex. An important reflex to know. An important one to recognize in children. 

Take a look at your own children, or students, or even yourself! 

Think your ATNR might not be integrated? Go grab some paper and start on those Lazy Eights!!

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