The Symmetrical Tonic Neck Reflex (STNR) is an automatic movement pattern present in infants, typically emerging around 6 to 9 months of age. It plays a role in a baby’s ability to transition onto their hands and knees, helping separate upper and lower body movements as a precursor to crawling. The STNR usually integrates by 9 to 12 months of life. If this reflex remains active beyond its typical integration period in an older child, it can contribute to various developmental or learning challenges.
Recognizing Signs of Retained STNR
A child with a retained STNR might exhibit several observable signs. Poor posture is a common indicator, often seen as slouching when sitting or adopting a “W-sitting” position on the floor. They may also display an “ape-like” walk.
Hand-eye coordination can be affected, leading to difficulties with tasks like catching a ball. Challenges with handwriting, such as poor pencil grip or trouble copying notes from a board, are also frequently observed. Some children might struggle with swimming, especially the breaststroke, due to the reflex’s influence on arm and leg coordination. Poor concentration, difficulty sitting still, or challenges with visual tracking and adjusting focus between near and far objects could also be present.
Performing the STNR Test at Home
To perform an STNR test at home, ask your child to get onto their hands and knees in a tabletop position. Ensure their hands are directly under their shoulders and their knees are under their hips, forming approximate 90-degree angles.
Once in this position, instruct your child to slowly look up towards the ceiling, extending their neck. Ask them to hold this position for about 10 seconds while you observe their arms and legs. Next, have them slowly tuck their chin towards their chest and look down at their belly button, flexing their neck, and hold this position for another 10 seconds. Repeat this sequence two or three times.
Interpreting Test Results
When the STNR is still present, specific involuntary movements or changes in muscle tone can be observed during the test. If your child’s head moves down towards their chest, their arms might bend and their legs straighten. Conversely, if their head moves up, their arms might straighten and their legs bend.
Other indications of a retained reflex include difficulty maintaining a flat back, an inability to keep their arms straight, or general swaying and instability during the movements. Observing these signs during a home test is not a diagnosis. It can indicate that further professional assessment might be beneficial to understand the child’s developmental profile.
Seeking Professional Guidance
If observations from home testing suggest a retained STNR, consulting with professionals is a logical next step. Pediatric occupational therapists assess primitive reflexes and design targeted intervention plans. Developmental optometrists can also offer insights, particularly if vision-related difficulties are noted. Pediatric neurologists may also be consulted for comprehensive evaluations.
Professional assessment is important for an accurate understanding of a child’s needs and to rule out other potential issues. These specialists can help develop a tailored intervention strategy, which may include reflex integration therapy or specific movement programs. These programs involve activities designed to encourage the integration of the reflex and promote improved motor control and coordination.