integration of ATNR

integration of ATNR (Full Version)

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katieptatc -> integration of ATNR (July 11, 2005 3:58:00 PM)
I have recently stepped into the world of Pediatrics after a long absence. I am looking for different ways to assist with the intergration of ATNR reflex. Different positions, parent education, sucess stories, that may help guide me with my first little one. Thanks.

Andrew M. Ball PT PhD -> Re: integration of ATNR (July 12, 2005 12:12:00 PM)
That all depends on a couple of things. Could you give us more information? How old is the child? What is the gross motor develomental level of the child? What is the cognitive age of the child? Does the child ALWAYS ATNR, or only in times of physical or mental stress (e.g. ATNR collapse upon head turning while playing in quadruped). Drew

katieptatc -> Re: integration of ATNR (July 12, 2005 12:32:00 PM)
the child is 7 months old, and other gross motor skills are age appropriate, with the exception of rolling - which I am having a hard time facilitating at times. The child shows the reflex particularily in supine and while sleeping. in sitting his head appears midline although he perfers to look right, he has bilateral hand play at times but tends to reach for toys with his right in sitting, prone and supine. Thanks for any information you can supply

Andrew M. Ball PT PhD -> Re: integration of ATNR (July 12, 2005 4:16:00 PM)
It's REALLY hard to offer consultation without seeing the child, except to say this: Depending upon which expert you ask, the ATNR can "integrate" in as early as 4 months, or as late as 6. The fact that one persists at 7 months isn't such a big deal provided that it's not a constant ATNR and that he has bilateral hand play in independent sitting. If you place the child in prone and work on reaching for toys from prone elbows and runner's stetch --- in absense of any neurologic problem --- it's likely to go away in 4 weeks or so. Help facilitate prone to sit and sit to prone NDT style from the sternum (try Lois Bly's book if you need help, or I'd be happy to e-mail you a few pictures). Keep and eye on it though, late normal to early late integration can be suggestive of either inilateral malcontrol at the trunk, or future sensory processing difficulties. Finally, I can suggest several peds experts in Maryland if you like, and having grown up in Baltimore, I get back home from time to time and would be happy to take a look an offer suggestions. Drew

katieptatc -> Re: integration of ATNR (July 13, 2005 3:57:00 PM)
Thank you so much for your help. I understand how difficult it is to assist without seeing the child. I have ordered Lois Bly's book - but a few pictures would be great. I saw my little one today and his head appears more in midline and is showing signs of rolling. The ATNR is still present in supine however. Hopefully one day I can return the help to you. Thanks again Katie katieptatc@msn.com

interstella -> Re: integration of ATNR (July 14, 2005 3:52:00 AM)
Hi Katie, Sounds interesting - I have found theat children can 'use' the ATNR if they are 'looking' for stability, it enables them to fix- especially if their core stability is lacking. So Id do lots of work in prone over a wedge/roll to encourage weight bearing through the UL's and head/trunk contol. I would also work on changing positions - facilitated rolling, transfering from supported sitting to lying etc, moving in and around their base in sitting, encourage lots of playing with feet in supine to work the abdominals..... Best wishes

Andrew M. Ball PT PhD -> Re: integration of ATNR (July 12, 2005 12:12:00 PM)
That all depends on a couple of things. Could you give us more information? How old is the child? What is the gross motor develomental level of the child? What is the cognitive age of the child? Does the child ALWAYS ATNR, or only in times of physical or mental stress (e.g. ATNR collapse upon head turning while playing in quadruped). Drew

katieptatc -> Re: integration of ATNR (July 12, 2005 12:32:00 PM)
the child is 7 months old, and other gross motor skills are age appropriate, with the exception of rolling - which I am having a hard time facilitating at times. The child shows the reflex particularily in supine and while sleeping. in sitting his head appears midline although he perfers to look right, he has bilateral hand play at times but tends to reach for toys with his right in sitting, prone and supine. Thanks for any information you can supply

Andrew M. Ball PT PhD -> Re: integration of ATNR (July 12, 2005 4:16:00 PM)
It's REALLY hard to offer consultation without seeing the child, except to say this: Depending upon which expert you ask, the ATNR can "integrate" in as early as 4 months, or as late as 6. The fact that one persists at 7 months isn't such a big deal provided that it's not a constant ATNR and that he has bilateral hand play in independent sitting. If you place the child in prone and work on reaching for toys from prone elbows and runner's stetch --- in absense of any neurologic problem --- it's likely to go away in 4 weeks or so. Help facilitate prone to sit and sit to prone NDT style from the sternum (try Lois Bly's book if you need help, or I'd be happy to e-mail you a few pictures). Keep and eye on it though, late normal to early late integration can be suggestive of either inilateral malcontrol at the trunk, or future sensory processing difficulties. Finally, I can suggest several peds experts in Maryland if you like, and having grown up in Baltimore, I get back home from time to time and would be happy to take a look an offer suggestions. Drew

katieptatc -> Re: integration of ATNR (July 13, 2005 3:57:00 PM)
Thank you so much for your help. I understand how difficult it is to assist without seeing the child. I have ordered Lois Bly's book - but a few pictures would be great. I saw my little one today and his head appears more in midline and is showing signs of rolling. The ATNR is still present in supine however. Hopefully one day I can return the help to you. Thanks again Katie katieptatc@msn.com

interstella -> Re: integration of ATNR (July 14, 2005 3:52:00 AM)
Hi Katie, Sounds interesting - I have found theat children can 'use' the ATNR if they are 'looking' for stability, it enables them to fix- especially if their core stability is lacking. So Id do lots of work in prone over a wedge/roll to encourage weight bearing through the UL's and head/trunk contol. I would also work on changing positions - facilitated rolling, transfering from supported sitting to lying etc, moving in and around their base in sitting, encourage lots of playing with feet in supine to work the abdominals..... Best wishes

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