The ATNR is stimulated during the birth process, assisting the baby through the canal and is typically present up until 4-6 months of age. A retained ATNR in a school-aged child may present as difficulty with writing and tracking (involving hand-eye coordination). These children may use their finger to follow the words on a page while they read. Sometimes they will skip letters/words/lines. The ATNR is also responsible for dividing the body vertically, into two halves. If this is not established a child may have difficulty with right and left. They may also experience difficulty with crossing the midline (whole body movements as well as when writing). They may have challenges with getting thoughts to paper.   

Additional concerns include:    

• Balance and co-ordination will be affected by head movement. 

• Difficulty crossing midline (from one side of the body to the other)  

• Homolateral patterns of movement. 

• Hand-eye co-ordination may be limited to one side of the body at a time; eyes may not easily cross the vertical midline

• Handwriting 

• Horizontal tracking (reading) 

• Laterality (may not have a dominant hand/foot/ear/eye)