What is the Asymmetrical Tonic Neck Reflex (ATNR)?

Asymmetrical Tonic Neck Reflex (ATNR) is a normal reflex that helps support a baby's development during the first few months of life. It is linked to the baby’s inner ear (balance system) and vision.

When a baby turns their head to one side:

• The arm and leg on that side naturally straighten.
• The opposite arm and leg bend.

This position is called the "fencing pose".

ATNR helps babies develop:

• Knowing where their body is in space (body awareness).
• Following objects with their eyes (visual tracking).
• Early hand-eye coordination.
• Movement during birth.
• Skills like rolling and crawling (motor skills).

As babies grow, they gain better control of their movements. The ATNR reflex typically fades, or integrates, between 4 and 6 months of age.

What Does It Look Like if ATNR Does Not Fade?

If the ATNR does not fully fade, it can make some skills harder. It may affect movement, coordination, and visual skills.

Your child may have trouble with some of the following skills:

• Bringing hands together in the middle of the body.
• Following objects from one side to the other or eyes fluttering.
• Hand-eye coordination.
• Balance.
• Using both sides of the body together.
• Knowing left from right.
• Reaching across their body.
• Fine motor skills like feeding or handwriting.

How Can You Help Your Child?

Work with your child’s Occupational Therapist (OT) to create a plan just for them. This plan will include simple exercises and activities to do at home. Practice is very important. Doing these activities regularly can help your child improve their skills. This will help the ATNR reflex fade over time.