Skip to main content

ATNR & STNR: The Learning Reflexes

The Developing Child

Insights and Developments in Therapeutic Treatment Approaches for Pediatric Conditions

July 2020 | Issue 5

ATNR & STNR : The Learning reflexes

ATNR & STNR are two reflexes that are critical for a child's learning and development. Non-integration of these reflexes can lead to difficulties concentrating, difficulties with auditory processing and coordination issues.


ATNR stands for the Asymmetrical Tonic Neck Reflex. The reflex is present in utero and typically integrates by 6-7 months of age. It is important for separating head and arm movements (1). A child with an unintegrated ATNR will rest their head on their non-dominant hand and straighten the leg on their dominant side when writing. The head often tilts to one side when writing.


STNR stands for the Symmetrical Tonic Neck Reflex. This reflex is present in utero and typically integrates by 10 months of age. It is important for separating arm and leg movement, balance, and postural control for sitting upright. A child with an unintegrated STNR will wrap their feet around the legs of the chair, or the child will stretch both legs straight out and slouch down in the chair. Children with unintegrated STNR may prefer to sit on the floor or will move around at mealtime due to the discomfort of sitting upright in a standard chair (2). 

Reflexes vs ADHD

Children with unintegrated reflexes can appear to be similar to children with ADHD. These children have difficulty sitting in a normal, upright seated posture. They often slouch, fidget in their seats, and have decreased attention to tabletop tasks. These children are "fighting against a perpetual invisible force" (3).

The source of a child's discomfort sitting in a chair is the STNR reflex pattern working against their ability to maintain the intended upright posture. The child moves and adopts abnormal sitting postures because normal sitting positions are uncomfortable. This affects the child's ability to focus and participate in home and school (2).

Children with unintegrated ATNR experience difficulty with eye tracking problems, reading, spelling, mathematics, crossing midline and auditory processing (1). It requires effort for these children to hold and manipulate writing instruments. When a child is sitting at his desk writing, and he turns his head to see the board or the teacher, his writing arm will extend slightly and he will lose his spot on the page. The child will often compensate with an immature grip on pencils or heavy pencil pressure. When riding a bike, the child may turn their head and involuntarily the handle bars will follow the direction of the head turn.

We hope you've enjoyed this newsletter on the ATNR & STNR reflexes. If you're interested in having your child's reflexes tested, please contact us to set up an evaluation.

(1) Masgutova, S. & Akhmatova, N. (2007). Neuro-senso-motor reflex integration – Children with developmental challenge facilitation approach. S. Masgutova and International Dr. Svetlana Masgutova Institute (Poland).
(2) O'Dell, N. E. & Cook, P. A. (2004). Stopping ADHD: A unique and proven drug-free program for treating ADHD in children and adults. Avery, a member of Penguin Group (USA) Inc.
(3) Goddard, S. (2005). Reflexes, learning, and behavior: A window into the child’s mind. Fern Ridge Press.

You Might Also Enjoy...

The Developing Child | January 2022

The causal relation between exploration and cognitive development has been proposed in both directions: smarter, more behaviorally flexible species are more likely to play, and play may support the acquisitions of motor, cognitive, and social skills. (1)

The Developing Child | September 2021

In this issue, we start a conversation about cognition, the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.