During normal childhood development, Tonic Labyrinthine Reflex (TLR) is the baby's first response to gravity. There are two components of this reflex:

• The forward TLR is present in utero and is integrated at around 4 months old.
• The backward TLR is present at birth and gradually becomes integrated as higher-level reflexes develop, from 6 months up to 3 years old.

The TLR determines the tone throughout the body, helping the newborn straighten out from the flexed or curled up posture at birth. The Moro and TLR are related because both are stimulated with head movements, which then stimulate the vestibular system (the balance system in the inner ear).

When the TLR is retained, when these children move their heads, their muscle tone changes in response. Thus, their balance is greatly affected. Since balance and vision are connected on the same loop, information from where the body is in space then goes to the brain (vestibular nuclei) and next to the eyes. The information then also returns from the eyes back through the brain and to the body so the adjustments can be made in the body's position.

Additionally, bending their head backward, causes their legs to straighten out. This will affect a baby's development of creeping and crawling on hands and knees. (This will also affect their ability to copy from the board without losing their place on their paper). This may lead to a retained symmetric tonic neck reflex (STNR). If the baby is unable to crawl, this will further impede the development of eye-tracking, using two eyes together, and focusing, later affecting the child's academic abilities and coordination.

Because a retained TLR sends faulty messages back and forth between the brain and the receptors, this determines where the body is in space (proprioceptors), the function of the eyes is impaired. These children do not have a stationary reference point, so their judgment of space, distance, depth, and speed will be affected.

Not only does this affect the child's vision, but also affects his/her sense of where their body is in space, which subsequently affects their sense of direction, such as up vs. down, right vs. left.

We have determined that when a miscommunication of information between the eyes and the vestibular system occurs, children with a retained TLR do not know where their head is in space. This can also greatly affect their feeling of security with respect to gravity. When they move their head, they might feel dizzy or have a feeling of falling, which can lead to a fear of heights.

Symptoms of a Retained Forward Tonic Labyrinthine Reflex (TLR)

• Problems with Vestibular System
• Motion sickness
• Poor coordination
• Poor balance
• High muscle tone, resulting in stiff, jerky movements
• Poor posture, shoulders too far back
• Walking on toes
• Poor sequencing skills
• Poor organizational skills
• Poor sense of rhythm
• Problems with vision
• Eye movement and visual perception problems
• Problems with depth perception - difficulty estimating distances and catching balls
• Difficulty with figure/ground discrimination, which is the ability to distinguish the order of objects closest to the observer. This is seen in difficulty walking upstairs with open risers.
• Difficulty changing visual focus from near to far
• Poor Development of self identity, shy, tendency to be easily influenced by others