What is the Tonic Labyrinthine Reflex (TLR)?

The TLR is a reflex that happens with head movement. It helps babies learn how to move their bodies against gravity. It supports muscle tone, posture, balance and position in space.

TLR has two patterns:

• When a baby looks down (forward), the arms and legs bend or curl in.
• When a baby looks up (backward), the arms and legs straighten out.

The TLR is there when your baby is born.  As your baby begins to have head control, the TLR and startle reflex will slowly fade or integrate.  The forward pattern usually fades or integrates by 4 months and the backwards pattern by 3 years. This helps movements become easier to control and coordinate.

As the reflex fades or integrates, your baby will progress through the following milestones:

• 0-6 months: lifting the head and pushing up on arms when on tummy.
• 6-12 months: sitting and crawling.
• 12-24 months: walking and climbing.
• 2-3 years: better balance and posture.

What Does it look like if the TLR Does Not Integrate or Fade?

Your child may have some of these difficulties:

• Trouble paying attention
• Trouble moving their eyes smoothly and working both eyes together
• Difficulty navigating their environment
• Weak posture or trouble sitting up
• Poor balance
• Fear of movement
• Motion sickness
• Trouble using all their senses together
• Muscles seem weak or floppy
• Walking on their toes

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 TLR reflex fade over time.