Retained Asymmetrical Tonic Neck Reflex (ATNR)

ATNR assists an infant to do their part of emergence through the birth canal, it also helps them to learn hand and eye control. You'll notice it in an infant as you gently turn their head to one side. The arm and leg on the same side with straighten, and the opposite limbs will flex.

This reflex should be integrated at 6 months. If not it can cause motor issues, reading, math, and other learning problems.


Test for Asymmetrical Tonic Neck Reflex

Have the child stand facing you with arms and hands straight out in front of them. Ask the child to keep that position while turning their head to one side and then to the other. They should be able to move their head only.

Alternately, you can also have them get down on their hands and knees like a “kitty” with their head straight out and face toward the floor. Ask them to look to one side then to the other side, keeping their neck and arms straight.

When standing, look for elbows to bend or shoulders to turn in the direction of the head.

When on their hands and knees, look for elbows to bend or the body to shift from one side to the other.

This can tell you if the child's head movement is still associated with their shoulders and that the reflex is still likely still present.


  • Reading Difficulties
  • Hand eye coordination problems
  • Awkward walk or gait
  • Difficulty in school
  • Immature handwriting
  • Difficulty in sports
  • Math and reading issues
  • Poor balance
  • Eye, ear, foot, and hand dominance will not be on the same side
  • Difficulty in things that require crossing over the midline of the body
  • Poor depth perception
  • Shoulder, neck and hip problems
  • Even if they don’t display any of these symptoms, it is a good idea to do the quick test on them, as there may be other functions that are affected by it that are still unknown.