What is the Symmetrical Tonic Neck Reflex (STNR)?

The STNR is a natural reflex that helps babies learn how to crawl and use different parts of their body together. It helps babies use the upper and lower parts of their body separately, which is an important step before crawling. This is why it is often called the crawling reflex.

The reflex usually follows a pattern of arm and leg movements that are a response to head movement.

When a baby's head moves:

• Forward (chin toward chest), the arms bend and legs straighten.
• To look up (neck extends), the arms straighten and legs bend.

STNR helps babies develop skills to:

• Get into the hands-and-knees position.
• Rock back and forth before crawling.
• Build strength in shoulders, arms, core, and hips.
• Move the upper body and lower body separately.
• Learn how to use both sides of the body together.

The STNR typically appears around 6-9 months of age. As babies grow, they gain better control of their movements. The STNR typically fades, or integrates, between 9 and 11 months of age.

What Does It Look Like if the STNR Does Not Integrate or Fade?

If the STNR does not fully fade, it can make some skills harder. It may affect posture, balance, coordination, and sitting still.

Here are some common signs:

Movement and posture

• Trouble pushing up on hands during tummy time.
• Arms and legs move together instead of separately.
• Hard time getting into a hands-and-knees position.
• Difficulty learning to rock or crawl.
• Sitting in a “w” position (knees forward and feet out to the side.

Sitting and body control

• Trouble sitting up straight.
• May slouch or lean a lot.
• Trouble keeping the head and body steady. This can make reading and writing harder.

Eye and hand skills

• Trouble following objects with their eyes.
• Trouble using eyes and hands together like when catching a ball or stringing beads.
• Looking up or down may make their body move too much.
• Poor handwriting.

Balance and Body awareness

• Poor Balance.
• Clumsy or unsteady.
• Trouble with knowing where their body is in space.

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 activities to do at home. Practice is important. Doing these activities regularly can help your child get stronger and improve their STNR.