Symmetric tonic neck reflex

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Symmetric Tonic Neck Reflex (STNR) is a primitive reflex found in newborns and is an important aspect of a child's neurological development. It plays a crucial role in the coordination of the upper and lower parts of the body and is closely related to the development of postural control, crawling, and the ability to maintain a quadruped position. The presence and integration of the STNR can significantly influence a child's motor development, including their ability to perform tasks that require the coordination of their arms and legs.

Overview[edit | edit source]

The Symmetric Tonic Neck Reflex is elicited when the head of an infant is moved or tilted in a certain direction, causing a reflexive response in the limbs. Specifically, when the head is tilted upwards, the arms of the infant extend while the legs flex, and conversely, when the head is tilted downwards, the arms flex and the legs extend. This reflex begins to develop around 6 to 9 months of age and is typically integrated by the age of 11 to 12 months. The integration of the STNR is a critical milestone in a child's development, as it allows for the smooth transition from primitive reflex patterns to voluntary movements and more complex motor skills.

Significance in Development[edit | edit source]

The STNR is significant for several reasons:

  • It facilitates the transition from primitive reflexes to voluntary control over movements.
  • It is essential for the development of crawling, which is a key milestone in motor development.
  • It helps in developing postural control and balance, enabling the child to sit upright without support.
  • It is crucial for the coordination of the upper and lower parts of the body, which is necessary for activities such as walking, running, and climbing.

Clinical Implications[edit | edit source]

The persistence of the STNR beyond the typical age of integration can indicate neurological problems or developmental delays. It may interfere with a child's ability to perform certain motor tasks, affect their posture, and impact their ability to learn and perform in academic settings. Children with an unintegrated STNR may exhibit difficulties with tasks that require hand-eye coordination, balance, and fine motor skills. In such cases, intervention from healthcare professionals, including occupational therapy and physical therapy, may be necessary to help integrate the reflex and support the child's development.

Assessment and Intervention[edit | edit source]

Assessment of the STNR involves observing the child's response to head movements and evaluating their ability to perform tasks that require coordination of the arms and legs. If the reflex is found to be unintegrated, intervention may include exercises and activities designed to promote the development of voluntary motor control and facilitate the integration of the reflex. These interventions are tailored to the individual needs of the child and may involve a variety of therapeutic approaches.

Conclusion[edit | edit source]

The Symmetric Tonic Neck Reflex is a fundamental aspect of a child's early neurological development. Its timely integration is crucial for the development of motor skills, postural control, and coordination. Understanding the STNR and its implications for development can help parents, educators, and healthcare professionals support children in achieving their developmental milestones.


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Contributors: Prab R. Tumpati, MD