Symmetrical Tonic Neck Reflex (STNR)
This is one of the most prevalent reflexes in children with learning disabilities, as much as 75% of these children have a retained STNR. A retained STNR is often accompanied with ADHD symptoms and causes problems with copying from the board and vertical tracking (Goddard Blythe, 2007). In this reflex, as the infant’s head is raised, the arms straighten and the legs bend. This helps her sit up. If this reflex is active too long, it can prevent the development of other skills, and they will have trouble maintaining certain positions because the upper and lower sections of the body are at odds with each other (Kokot, 2010). The STNR is often active in children who have not crawled.
Some of the signs of a retained STNR is slumping while sitting or sitting like a “sack of potatoes,” a clumsy child, difficulties with binocular vision, sitting in a “W” position, difficulty swimming and having messy eating habits. Because it is hard to keep their legs bent and while their head is down and arms are bent, many children have to wrap their feet around the legs of their chair. Therefore, elastic bands may be tied around the legs of chairs to counteract the STNR. If the child has difficulty with finishing homework tends to avoid it, then it would be prudent to check the presence of the STNR.
Effect on Mathematics
Children with a retained STNR often have their work sprawled over the entire page with columns running diagonally down the paper (O’Dell & Cook, 2004). Number reversals (12 vs 21) is also a problem. To help support mathematics in children with STNR, we need to allow students to position themselves in a comfortable position, whether that be standing or laying on the floor. We need to place few problems on a page so that they have more room to write, and it does not overwhelm as much as when they see many problems at once. Graph paper can be helpful to keep the columns straight. If copying from the book or board is necessary, allow fellow students to do this task so that the effected children are concentrated on solving the problems.
Knowing if the STNR is unintegrated
You may suspect that your child has an unintegrated STNR if you have observed any of the above behaviors. Have your child on his hands and knees in a table position, hands directly under the shoulders. Invite him to look down at his knees and then up to the ceiling. Note if while looking down the back arches upward or if his elbows bend. Also notice if he is not able to keep his feet flat on the floor or if he moves forward or backwards. These are signs of the presence of the STNR.
Exercise to Integrate the STNR
a) Crawling against a force. For example, the child is crawling on a mat forward with hands pointed in the forward position while the opposite hand and foot is moving forward at the same time. The adult facilitator is facing the child on her knees with hands on the shoulders of the child to provide slight resistance while crawling.
b) In a table position with hands directly under the shoulders, have students look straight ahead, lean forward and hold for a count of 7 seconds while exhaling and then resume to the resting position.
c) In a table position, with feet flat on the floor, hands under the shoulders and knees under hips, have child arch back up as high as he can while exhaling then returning to a flat back position. Note that many children with unintegrated STNR have an over flexible spine and can easily sag the spine down in the return position. Try to have the child stop when the back is in a flat position. These movements should be slow and intentional.
Other Integration Methods
There are other ways to integrate the STNR that requires special training in methods such as Blomberg's Rhythmic Movment Training (BRMT) and the Masgutova Method. Information on Blomberg Rhythmic Movement Training and can be found here. If interested, you can purchase Masgutova manuals and DVD's online as well as access as instructional videos for integrating reflexes for a fee. Bonnie Brandes has developed a protocol to integrate the reflexes with use of a cold laser, which has proven to be quite promising. Information about the use of her protocol is found here and youtube videos posted by Bonnie can be found here.
Works Cited
Goddard Blythe, S. (2007). The well Balanced Child: Movement and learning. Gloucesterschire, UK: Hawthorn Press.
Kokot, S. Integrated Learning Therapy: Unraavelling causes of Learning and Behaviour difficulties –online video: www.ilt.co.za/video-gallery retrieved on 8/21/13.
O’Dell, N. E. & P. A. Cook. (2004). Stopping ADHD. New York: Penguin Group.
Some of the signs of a retained STNR is slumping while sitting or sitting like a “sack of potatoes,” a clumsy child, difficulties with binocular vision, sitting in a “W” position, difficulty swimming and having messy eating habits. Because it is hard to keep their legs bent and while their head is down and arms are bent, many children have to wrap their feet around the legs of their chair. Therefore, elastic bands may be tied around the legs of chairs to counteract the STNR. If the child has difficulty with finishing homework tends to avoid it, then it would be prudent to check the presence of the STNR.
Effect on Mathematics
Children with a retained STNR often have their work sprawled over the entire page with columns running diagonally down the paper (O’Dell & Cook, 2004). Number reversals (12 vs 21) is also a problem. To help support mathematics in children with STNR, we need to allow students to position themselves in a comfortable position, whether that be standing or laying on the floor. We need to place few problems on a page so that they have more room to write, and it does not overwhelm as much as when they see many problems at once. Graph paper can be helpful to keep the columns straight. If copying from the book or board is necessary, allow fellow students to do this task so that the effected children are concentrated on solving the problems.
Knowing if the STNR is unintegrated
You may suspect that your child has an unintegrated STNR if you have observed any of the above behaviors. Have your child on his hands and knees in a table position, hands directly under the shoulders. Invite him to look down at his knees and then up to the ceiling. Note if while looking down the back arches upward or if his elbows bend. Also notice if he is not able to keep his feet flat on the floor or if he moves forward or backwards. These are signs of the presence of the STNR.
Exercise to Integrate the STNR
a) Crawling against a force. For example, the child is crawling on a mat forward with hands pointed in the forward position while the opposite hand and foot is moving forward at the same time. The adult facilitator is facing the child on her knees with hands on the shoulders of the child to provide slight resistance while crawling.
b) In a table position with hands directly under the shoulders, have students look straight ahead, lean forward and hold for a count of 7 seconds while exhaling and then resume to the resting position.
c) In a table position, with feet flat on the floor, hands under the shoulders and knees under hips, have child arch back up as high as he can while exhaling then returning to a flat back position. Note that many children with unintegrated STNR have an over flexible spine and can easily sag the spine down in the return position. Try to have the child stop when the back is in a flat position. These movements should be slow and intentional.
Other Integration Methods
There are other ways to integrate the STNR that requires special training in methods such as Blomberg's Rhythmic Movment Training (BRMT) and the Masgutova Method. Information on Blomberg Rhythmic Movement Training and can be found here. If interested, you can purchase Masgutova manuals and DVD's online as well as access as instructional videos for integrating reflexes for a fee. Bonnie Brandes has developed a protocol to integrate the reflexes with use of a cold laser, which has proven to be quite promising. Information about the use of her protocol is found here and youtube videos posted by Bonnie can be found here.
Works Cited
Goddard Blythe, S. (2007). The well Balanced Child: Movement and learning. Gloucesterschire, UK: Hawthorn Press.
Kokot, S. Integrated Learning Therapy: Unraavelling causes of Learning and Behaviour difficulties –online video: www.ilt.co.za/video-gallery retrieved on 8/21/13.
O’Dell, N. E. & P. A. Cook. (2004). Stopping ADHD. New York: Penguin Group.
