1/4 H Neuro #197 - Test and Integrate the ATNR

Introduction to the Asymmetrical Tonic Neck Reflex

Recently, I had the opportunity to assess an entire school of children using the INPP protocol developed by S. Godar. The results were positive regarding the asymmetrical tonic neck reflex. Often, when this reflex is not integrated, people immediately think of motor exercises, often derived from programs like Brain Gym. While these exercises have their utility, it is crucial not to overlook the sensory systems that are at the very core of this reflex.

What is the Asymmetrical Tonic Neck Reflex?

The asymmetrical tonic neck reflex (ATNR) manifests when an infant turns their head to one side: the arm and leg on the same side reflexively extend, while those on the opposite side flex. This behavior can be observed in children when they are lying in their crib or on the floor, adopting what is known as the fencing position. This reflex is supposed to integrate during the first months of life to allow for smooth motor development.

Skills Developed by the ATNR

The ATNR contributes to the development of several skills, including coordination and contralateral movements. This is particularly relevant in sports activities or daily life, where the ability to grasp objects or catch a ball is essential. Furthermore, this reflex is linked to many learning disorders. It is not uncommon to find children with reading or writing difficulties who exhibit an unintegrated ATNR.

INPP Testing and Its Importance

The tests established by the INPP are crucial for assessing the integration of primitive reflexes. The scoring ranges from 0 to 4, where 0 indicates that the reflex is fully integrated and 4 indicates poor integration. For example, if a child does not move their arms during the test, they receive a score of 0. This assessment allows for the detection of even weak reflexes and identifies vestibular issues that may influence ATNR integration.

Impact on Learning and Development

Children with coordination difficulties may face challenges in activities such as writing or following lines, which can also affect their concentration. Studies show that primitive reflexes, such as the ATNR, have a significant impact on cognition and cognitive development. This underscores the importance of an integrated approach that considers the sensory systems.

Approaches to Integrate the ATNR

To effectively integrate the ATNR, it is essential to work on the sensory systems prior to motor exercises. Movement-based exercises, often used in programs like Brain Gym, can be beneficial but must be tailored to meet children's sensory needs.

Importance of Sensory Stimulation

Motor exercises should be preceded by light vestibular stimulations, such as gentle rocking or head movements. This helps prepare the vestibular system and improve ATNR integration. A gradual sensory approach, followed by adapted motor exercises, is essential for harmonious development.

Conclusion

In conclusion, the asymmetrical tonic neck reflex, like many other primitive reflexes, relies on a solid sensory foundation. Any rehabilitation must begin with an assessment and stimulation of the sensory systems. By considering the environment and the individual needs of children, we can enhance the integration of this reflex and support their overall development.