Now that you have a basic understanding behind why we test primitive reflexes, we’ll discuss how we test them at The Center for Vision Development! As stated in the previous post, primitive reflexes are one of the first things we test for during a patient’s initial evaluation. Most offices test for the same basic reflexes, but with a slight variation.
At The Center for Vision Development, we test for the Moro Reflex, Tonic Labyrinthine Reflex (TLR), Asymmetrical Tonic Neck Reflex (ATNR), Symmetrical Tonic Neck Reflex (STNR), Spinal Gallant, and the Duck and Pigeon. Some offices might test for these, in addition to a few others, and some may not test for all of these reflexes. If there is one you would like your child to be tested for that we don’t usually administer, let us know, and we will be happy to include it in your child’s plan!
When being tested, we are determining if the reflex is present or not present. We do this by looking for very specific body movements and based on how pronounced they are, we administer a score of 1-4 with 4 meaning that the reflex is completely present. I will walk you through how we assess each reflex, and what the presence of that specific reflex can look like in your child. If determined that the reflex is present, there are a variety of different exercises that can be assigned to inhibit the reflex. At the bottom of this post are YouTube videos which show some of these exercises.
Moro Reflex:
What is it? This is a baby’s primitive fight or flight reflex. Unlike when an adult gets startled by something, when a baby gets startled, they lose their postural control. This should no longer be present by (around) four months of age. If it is not developed out, the child may display signs of hypersensitivity to all types of sensory stimuli. This sensitivity can manifest itself through:
- Anxiety
- Physical timidity
- Poor balance
- Motion sickness
- Emotional and social immaturity
- Inability to ignore peripheral stimuli
- Poor coordination
- Poor impulse control and more of the like.
Tonic Labyrinthine Reflex (TLR):
What is it? The TLR is how an infant’s head management affects the rest of their body. When lying on their back, if their head is tucked in, then their limbs tuck in as well. If the head moves backward, their arms and legs extend straight out. This reflex helps a baby prepare for rolling over, crawling, standing and walking. It should be developed out of by around three years of age. If retained, it can result in:
- Poor balance
- Poor coordination
- Poor spatial awareness
- Poor sense of timing and rhythm
- Oculomotor and eye teaming dysfunction
- Low muscle tone
- Poor posture
Asymmetrical Tonic Neck Reflex (ATNR):
What is it? The ATNR occurs when an infant’s head is turned to one side causing their limbs on that side to extend, and their limbs on the opposite side to contract. This aids in the birthing process and should be inhibited by six months of age. If retained, it can result in:
- Poor hand-eye coordination
- Poor handwriting
- Poor visual tracking
- Poor visual perceptual skills
- Poor bilateral integration
- Difficulty crossing the midline.
Symmetrical Tonic Neck Reflex (STNR):
What is it? The STNR is a baby’s preparation for crawling. It should be inhibited by around 11 months of age. If a baby is on their stomach and they lift their head, their arms will straighten and their legs will bend. If they move their head down, their arms bend and their legs straighten. These automatic movements help babies support their upper body so they can learn to crawl and pull themselves up. If retained, it can result in:
- Clumsiness
- Poor posture when writing or reading
- Poor hand-eye coordination
- Poor muscle tone
- Difficulty copying from the board and changing focus from near to far and vice versa.
Spinal Gallant:
What is it? The Spinal Gallant Reflex occurs when a baby’s back is stroked causing their hips to rise to the touch and their body to swing toward the side that was stroked. This reflex aids in the birthing process as well as encourages hip movement which later helps with crawling and walking. It should be inhibited around nine months of age. If retained, it can affect the child’s ability to:
- Sit still
- Pay attention
- Concentrate
- Can sometimes even cause bed wetting
ADHD is also strongly linked to the retention of the spinal gallant reflex.
Duck and Pigeon:
What is it? The Duck and Pigeon is an exercise that assists in integrating the Moro reflex.
If you or your child are exhibiting some of the above symptoms, schedule an evaluation with Dr. Taddese today!
-Emily Thompson, Vision Therapist
