The Effects of Persistent Asymmetrical Tonic Neck Reflex (ATNR) on Reading Scores in First and Second Grade Children
Rebecca Montgomery,* Candise Nichols, Chelsey Ornburn, Amanda Rudd, Lindsey Williams
Faculty: Barbara Smith
Department of Physical Therapy, College of Health Professions
This study examined the relationship between a presence of a retained Asymmetrical Tonic Neck Reflex (ATNR) and its effect on reading scores of local first and second grade children. The ATNR, a primitive reflex seen in infants and normally integrated by 6 months, may be present in children up to age eight. ATNR’s retention is associated with certain learning disabilities, behavioral dysfunctions and motor maturation delay. These developmental deficits can also affect reading and motor skills including hand-eye coordination, left-right integration, visual tracking, and the ability to control the hand when writing.
A collection of standardized reading test scores was obtained from 66 first and second grade students. The student sample was additionally tested for ATNR retention level by a licensed school physical therapist. The school from which the participants were selected utilizes the AIMsWeb standardized test to assess student reading levels. This standardized test, at a basic level, measures the number of words a student can correctly read per minute. The AIMsWeb test efficiently and accurately measures a student’s progress because it is time efficient to administer and produces results that intuitively reflect increase in ability. A modified testing procedure was performed by the school physical therapist to obtain a score related with a gradation of ATNR retention level.
The findings showed that there was a significant relationship between total ATNR scores and reading in first grade participants. Those who demonstrated a more integrated reflex, or a higher ATNR score, showed fewer errors and a higher accuracy on the AIMsWeb reading test than those with a more persistent ATNR, or lower ATNR score.
The literature is equivocal as to the association between presence of the ATNR in first and second grades and their reading scores. The results support the findings of previous research demonstrating a link between ATNR retention and a lower reading score. These findings suggest that further research is needed in order to establish an effective integration program.
by Anna Pecuch 1, Ewa Gieysztor 1,*, Ewelina Wolańska 2, Marlena Telenga 1 and Małgorzata Paprocka-Borowicz 1
Physiotherapy Department, Faculty of Health Sciences, Wrocław Medical University, Grunwaldzka 2, 50-355 Wrocław, Poland
Department of Pediatrics, Division of Pediatrics and Rare Disorders, Wrocław Medical University, ul. Bartla 5, 51-618 Wroclaw, Poland
Author to whom correspondence should be addressed.
Academic Editors: Christian Collet and Geneviève Albouy
Brain Sci. 2021, 11(8), 967; https://doi.org/10.3390/brainsci11080967
Psychomotor development in the first year of life is possible due to activity and then integration of primitive (neonatal) reflexes. The presence of active primitive reflexes (APRs) in preschool and school-aged children indicates neuromotor immaturity. Studies show dependencies between the preserved activity of primary reflexes and developmental problems such as learning difficulties (problems with reading, writing, reduced mathematics skills, and dyslexia), difficulties with coordination, and attention deficit. The primary purpose of this study is to present the activity of three tonic reflexes in a sample of 112 Polish children aged 4–6 in relation to their motor skills. The children were examined for the presence of the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR). Motor performance was examined with the MOT 4–6. Statistical analysis shows an inverse correlation between the score in the test of reflexes and motor efficiency (MOT 4–6) at p < 0.05 (−0.33). Children with increased reflex activity presented a lower level of motor efficiency. The multiple regression model showed that with the older age of the child and the decrease in the level of reflex activity, the motor skills of children improve. Thus, there is a need for early screening of primitive reflexes in children. Properly selected exercises and therapeutic activities aimed at integrating APRs in children with developmental difficulties can improve their motor skills, perceptual abilities, and emotional behavior.
Vestibular stimulation and primitive reflex integration may drive multisensory processing: putative principles for a Targeted sensorimotor therapy (TSMT)
Csaba E More
Judit Zsuga ( firstname.lastname@example.org
University of Debrecen https://orcid.org/0000-0002-5350-8188
University of Canterbury
Grigg, Tessa Maude
The birth of a human is facilitated by primitive reflexes which assist with the infant’s survival. Once the reflexes have been engaged, they then integrate and cognition takes over the functions needed to survive and thrive. Typically this process is completed within the first year of life. However, for some people, the primitive reflex integration process is interrupted, varying degrees of immaturity may persist and this may be associated with delays in skill acquisition. Movement-based interventions have been developed to assist the integration process. This thesis focuses on the phenomenon of primitive reflexes and the use of one reflex integration programme: Rhythmic Movement Training, with an aim of addressing the research question ‘What influences does the use of Rhythmic Movement Training (RMT) have in a classroom?’ The mixed methods methodology allowed the complexity of the issue to be explored hermeneutically and statistically. Ninety-eight New Zealand children, divided into two groups, intervention and control, used the RMT movements for between five and ten months. Seven teachers and 26 parents were interviewed and test results relating to the children’s reflex profiles, Draw-A-Person Test, Reading, Writing, Mathematics and the Strengths and Difficulties Questionnaire were analysed. The findings and results of this thesis are organised around three emergent themes: the classroom, student achievement and student behavioural outcomes. The intervention’s focus on the ‘whole child’ was seen as a strength and recommendations for further research are made to extend what is known about how and why primitive reflex integration enhances children’s development. The teachers found the generic RMT programme easy to use with their children and they noticed positive changes in focus, achievement and self-worth. Statistically significant differences were detected in student reflex profiles, reading scores, social and emotional challenge scores when RMT was used four or more times each week for five months. This research also found that there were gains noted by teachers and parents, and improved results for children when they were engaged in this reflex integration programme using generic movements for five minutes per day, four or more times a week for five months.
Journal of Research in Special Educational Needs•
Blackwell Publishing, Ltd.
The effects of the Primary Movement programme
on the academic performance of children attending
ordinary primary school
Queen’s University, Belfast, Northern Ireland
The present study investigated the prevalence of a
primary reflex (the Asymmetrical Tonic Neck Reflex)
in children attending ordinary primary school and
how this related to attainments in a number of
academic areas. The effectiveness of a specific
movement intervention programme in reducing
primary reflex persistence and improving academic
attainment was also evaluated.
A comparative study of the progress of 683 children
over a two-year period from Years 3 and 5, who
completed an intervention programme known as
Primary Movement, was carried out using the
relative attainments of children at the same schools
and standardised scores as baseline and follow-up
measures. A second, quasi-experimental study
followed the progress of four parallel groups in each
of two large schools with the experimental side
completing the movement intervention programme
while the other side acted as the control.
It was found that ATNR persistence was significantly
associated with level of attainments in reading,
spelling and mathematics and that boys were more
at risk than girls for ATNR persistence. In both
studies, it was found that the movement intervention
programme had a very significant impact on
reducing the levels of ATNR persistence in children
and that this was associated with very significant
improvements in reading and mathematics, in
This research provides further evidence of a link
between the attainment of core educational skills
and the interference that may result from an
underlying developmental deficit. The effectiveness
of the intervention programme in reducing ATNR
persistence and in increasing academic attainments
suggests that this programme could be used to
complement other strategies that have been shown
to have a positive effect on children’s learning.
Are effects of the symmetric and asymmetric tonic neck reflexes still visible in healthy adults?
S.M. Bruijna,b,∗, F. Massaada, M.J. MacLellanc, L. Van Gestela, Y.P. Ivanenkoc, J. Duysensa,d
a Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Department of Kinesiology, K.U. Leuven, Belgiumb Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China
c Neuromotor Physiology Laboratory, Santa Lucia Foundation, Rome, Italy
d Department of Research, Development and Education, Sint Maartenskliniek, Nijmegen, The Netherlands
Trunk rotation due to persistence of primitive reflexes in early school-age children
Ewa Z. GieysztorA–D,F, Ludwika SadowskaA,E,F, Anna M. ChoińskaA,E,F, Małgorzata Paprocka-BorowiczE,F
Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland
Received 16 December 2015, Revised 26 January 2017, Accepted 26 January 2017, Available online 20 February 2017
To propose a phylogenetic significance to the Moro reflex which remains unexplained since its publication in 1918 because both hands are free at the end of the gesture.
Among the 75 videos of healthy term newborns we have filmed in a research project on antenatal education to parenthood, we describe a sequence that clearly showed the successive movements of the Moro reflex and we report the occurrence of this reflex in the videos that were recorded from Time 0 of birth defined as the moment that lies between the birth of the thorax and the pelvis of the infant.
This paper proposes for the first time a phylogenetic significance to the Moro reflex: a ritualized behavior of nonverbal communication. Professionals should avoid stimulating the newborns’ fear system by unnecessarily triggering Moro reflexes. Antenatal education should teach parents to respond to the Moro reflexes of their newborn infant by picking her up in their arms with mother talk.
Ewa Z. Gieysztor1, Anna M. Choińska2, Małgorzata Paprocka-Borow
Rehabilitation Developmental Laboratory, Department of Physiotherapy,
Faculty of Health Sciences, Medical University of Wroclaw, Wroclaw, Poland
2 Department of Physiotherapy, Faculty of Health Sciences, Medical University
of Wroclaw, Wroclaw, Poland
Submitted: 14 September 2015
Accepted: 24 December 2015
A b s t r a c t
Introduction: Retained primitive reflexes can disturb natural development
and involve difficulties in social and educational children’s life. They can
also impact on psychomotor development. Mature responses in a child’s
psychomotor progress can only occur if the central nervous system itself
has reached maturity. The process consist the transition made from brain
stem reflex response to cortically controlled response. This study define the
occurrence of primitive reflexes in healthy 4–6 years old children and analyze
the impact of survived primitive reflexes on psychomotor development.
Material and methods: The study involved 35 participants aged 4–6 years
healthy preschool children. The study tools were: primitive reflexes tests by
Sally Goddard for children and Motor Proficiency – Test (MOT 4–6 test) in
Results: Over a half (65%) preschool children had survived the primitive
reflexes on the residual level. Eleven percent of them had no retained primitive
reflexes. According to the psychomotor ability, 9% of the children were
in the category of “altered development”, 29% in “delayed development”,
59% in “normal” and 3% in “very good development”. The greater the severity
of the reflex, the motor efficiency was lower (p < 0.05).
Conclusions: It seems reasonable to introduce reflexes integration therapy
in children’s with low psychomotor skills. Primitive reflexes routinely tested,
can contribute to improved early psychomotor development in children with
needs, thus preventing many difficulties which children can encounter within
their social and school life.