July 9, 2015

Newborn Baby - Muscle Tone and Reflex ExaminationWhen a child is born, they display numerous primitive reflexes that allow them to interact with their environment. These reflexes are automatic, and in a typical child they will integrate in the first year of life as the central nervous system develops. This means that the child will not demonstrate the reflex pattern anymore because high level processing has taken over. Sometimes, these reflexes can be retained, which can affect how a child develops. Many times, retention can cause difficulty in school and learning.

Some reasons why a reflex may be retained include:

  • Breech position, forceps, suction, C-section
  • Prolonged or premature birth
  • Lack of tummy time
  • Too much time in walker/bouncer which restricts developing movement patterns
  • Too much time in car seat, stroller, crib, with decreased ability to explore environment
  • Not crawling
  • Illness, trauma, injury, stress

The ATNR and STNR reflexes are common ones that can be retained.

ATNR Reflex

This reflex links head and neck movement to one-sided movement. When a baby turns his head to the right he will extend both the right arm and leg, and he will flex the left arm and leg. Before birth, it helps with the development of muscle tone. Once a child is born it helps with the development of balance, hand-eye coordination, and rolling. It should be integrated by 6 months.

ATNR Reflex

When the ATNR does not integrate it can cause the following problems:

  • Difficulty crossing the middle with hands and eyes
  • Difficulty with hand-eye coordination (ex: writing)
  • Visual perception difficulties (ex: tracking required for reading and writing, dyslexia)
  • Poor organization
  • One leg left behind during crawling
  • Turning body while drawing or writing
  • Handedness confusion

How to test for a retained ATNR:

Have your child get into a crawling position with elbows straight, fingers pointing forward, and the head looking at the floor. With their weight over their hands, rotate the child’s head left or right. If the child bends their elbow on the opposite side of head rotation or the child shifts their weight backward, then the reflex may be retained.

STNR Reflex

This reflex emerges at 6-9 months and allows a child to prepare for crawling. Neck flexion is linked to arm flexion and leg extension. Likewise, neck extension is linked to arm extension and leg flexion.  This reflex should be integrated by 11 months or once a child is an active crawler.

STNR Reflex

When the STNR does not integrate it can cause the following problems:

  • Poor posture such as slouching
  • Muscle tension headaches from neck position being linked to arm position
  • Squirming, fidgeting, difficulty sitting still or staying on task
  • Difficulty copying from board because when child looks up to copy their arms will extend and when child looks down to write the arms will flex
  • Difficulty reading and writing
  • Walking with a wide base
  •  W-sitting

How to test for a retained STNR:

Have your child in a crawling position with their weight over their hands, flex their neck all the way and hold for 5 seconds, then carefully extend their neck so they are looking up and hold for 5 seconds. Repeat 3 times. If your child shifts backward, arches their back, or bends their arms, the reflex is probably retained.

When To Look Into Pediatric Therapy

If your child has retention of reflexes, pediatric therapy may be helpful in allowing these reflexes to be integrated. Pediatric therapy for retained reflexes consists of a child working through the various reflex patterns in order for their body and nervous system to learn how to manage these patterns. Through consistent practice, these reflexes can be integrated, and this may improve how a child learns at school and interacts with the environment.

For more information about how Epic Pediatric Therapy can help your child work through retention of reflexes or other concerns, please contact us today. Epic Pediatric Therapy offers in-home and clinic-based services across the state of Texas.