The Symmetrical Tonic Neck Reflex, or STNR is a primitive reflex that helps the body divide in half at the midline to assist in crawling. This reflex may also be referred to as the crawling reflex. Check out our primitive reflex article to learn more about the STNR, when it is present, what it’s purpose is, and what you may see if the STNR is retained.
Following are some exercises and movement patterns that you can perform to help with STNR integration. If your kiddo has difficulty performing these activities or has difficulty maintaining good symmetry and form, the STNR may be retained. If you have any further concerns regarding STNR integration, contact your local OT practitioner.
Cat/Cow movement
- Start in a quadruped position (hands & knees), maintaining throughout.
- Tilt the head down tucking the chin to chest while arching the back up to the ceiling with a slight pause at the top.
- Look up extending the neck back while the torso/tummy “sag” toward the floor, pausing at the bottom.
Perform 15-20 reps 2-3 times/day.
Cat/Cow Difficulty
Observations
- Difficulty staying in the quadruped position through the movement, rocking to the heels and over the hands.
- Difficulty keeping the arms straight.
- Difficulty arching the back up and tilting the hips forward to “sag” the tummy down.
- Provide visual and physical support as needed to guide them through the movement.
Childs Pose
Childs’s pose
- Start in quadruped
- Rock back to the feet with a 3-5 second hold.
- Return to upright.
- Perform 15-20, 2-3 times per day.
Wall walk ups
Provides input through the arms and upper body while coordinating the legs to crawl up the wall.
Perform 10 walk-ups 2-3 times per day.
Wall Walk-ups
Wheelbarrow walk
Incorporate these into an obstacle course or have relay races. Wheelbarrow walk from room to room.
Animal crawls and walks are also good STNR integration activities, such as crawling on hands and knees, hands and feet, or in a crab crawl position. Even if the STNR has been integrated, these exercises and movements can provide benefits such as improving upper body and core strength, as well as improving coordination. They can also be used to help with regulation. Remember, play is one of the main occupations for kids, so find ways to incorporate these STNR exercises and movement patterns into their day and have fun with it.
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