The prevalence of persistent tonic neck reflex (TNR) and motor difficulties was assessed in three groups of 41 children (aged 9-10 years) attending primary schools in N Ireland and correlated with reading difficulties, at Queen’s University, Belfast. The relative persistence of the Asymmetrical TNR was compared in 3 groups of children selected from the bottom, middle and top 10% of readers. The lowest reading group had a significantly higher mean persistence of ATNR (17% affected) compared with the middle and top reading groups (0%). A standardized test of motor ability also showed a significant difference between the lowest and top reading groups. Boys were particularly at risk for persistence of an ATNR but not for impaired motor ability. [1]

COMMENT. The tonic neck reflex generally disappears by age 3 to 4 months and is infrequently imposable through 5 months (Paine and Oppe, 1966). The persistence of the TNR is abnormal and often indicative of lesions in the upper brain stem or more diffuse locations. The reflex is asymmetrical in spastic hemiplegia and may contribute to the associated movements such as mirror movements. Clumsiness and subtle neurologic abnormalities are described in children with learning disabilities and attention deficits (Huttenlocher et al, 1990; Millichap JG, 1974).