An asymmetrical tonic neck reflex rating scale

Although the asymmetrical tonic neck reflex (ATNR) is commonly used as one clinical assessment when evaluating children with suspected sensory integration deficits, maturational lags, or behavioral dysfunctions, observations are limited on the degree of this reflex in normal children at different age levels. A quantitative rating scale that indicates the degree of integration of the ATNR in normal first and third grade children is presented for purposes of comparison with the "suspect" child. A procedure for testing this reflex is described using the quadrupedal position, four sequences of lateral head rotation, and a rating scale consisting of four components. Using this ATNR rating scale, scores can be derived that could serve as a guide in determining whether the residual ATNR is comparable to that of normal subjects of the same age.