Retained Reflexes & Midline Crossing: Why It Matters for Your Child’s Development

(and How Neurohealth Wellness Can Help)

At Neurohealth Wellness on Sydney’s Northern Beaches, we see many parents concerned about their child’s handwriting, coordination, school readiness, or difficulty choosing a dominant hand. One of the most overlooked—but incredibly important—contributors to these challenges is a child’s ability to cross the midline.

Crossing the midline is far more than a developmental milestone. It’s a neurological foundation for reading, writing, coordinated movement, attention, and the ability to use both sides of the body together.

When a child struggles to cross the midline, it often isn’t because they’re “lazy” or “behind”. More commonly, it reflects an underlying neurological factor — such as a retained primitive reflex, particularly the Asymmetrical Tonic Neck Reflex (ATNR).

At Neurohealth Wellness, our chiropractors take a whole-body, neurodevelopmental approach. We assess posture, sensory-motor patterns, retained reflexes, and functional mobility to understand root contributors — not just surface-level symptoms.

What Is Crossing the Midline in Child Development?

Your body’s “midline” is the invisible line running straight down the centre of your body — from your nose through your belly button.

Crossing the midline means using one hand, foot, or eye to perform a task on the opposite side of the body.

Everyday examples include:

• Writing across a page
• Reaching across to grab a toy
• Kicking a ball with the opposite foot
• Brushing your hair
• Tracking words from left to right while reading

This ability doesn’t appear all at once. It gradually develops between 6 months and 8–9 years of age, supported by early movement experiences such as rolling, crawling, reaching, and bilateral play.

Why Crossing the Midline Is Essential for Learning & Coordination

Crossing the midline plays a critical role in:

1. Hand Dominance

Children who struggle to cross the midline often switch hands during tasks, because neither side has established clear dominance. This can make handwriting, cutting, and dressing more difficult.

2. Reading and Writing

To read smoothly, the eyes must track across the page in a continuous left-to-right motion. Poor midline crossing often appears as losing place, skipping words, slow reading, or reading fatigue.

3. Coordination & Gross Motor Skills

Activities like skipping, kicking, throwing, and catching require integration of both sides of the body working together.

4. Core Strength & Postural Control

Crossing the midline relies on trunk rotation, stability, and efficient communication between the left and right sides of the body.

5. Cognitive & Emotional Development

Midline crossing supports:

• Attention
• Language development
• Processing speed
• Emotional regulation
• Executive functioning

This occurs because effective midline crossing strengthens communication between the brain’s hemispheres via the corpus callosum — the brain’s major information highway.

When Midline Crossing Is Difficult: The Role of Retained Primitive Reflexes

Primitive reflexes are automatic movement patterns babies are born with to support survival and early development. These reflexes are designed to integrate (fade away) in the first year of life as higher brain centres mature.

When a reflex does not integrate, it is referred to as a retained primitive reflex.

The reflex most commonly associated with difficulty crossing the midline is the:

Asymmetrical Tonic Neck Reflex (ATNR)

Often called the “fencer’s pose,” ATNR appears at birth and typically integrates by around 6 months of age.

ATNR works like this:
When a baby turns their head, the arm and leg on the same side extend, while the opposite arm and leg flex.

When ATNR is retained beyond infancy, children may experience difficulty with:

• Crossing the midline
• Eye tracking
• Reading endurance
• Handwriting (poor spacing, letter reversals, slow speed, fatigue)
• Establishing hand dominance
• Sitting still (as the reflex activates with head movement)
• Coordination in sport and play

A retained ATNR can effectively “lock” the body into left–right separation. When the head turns, the arm wants to extend rather than cross the body — making many classroom and daily tasks more effortful.

🔹 Unsure whether retained reflexes could be affecting your child?

Difficulties with handwriting, coordination, attention, or school readiness are often misunderstood — and they are rarely a motivation or effort issue.

A thorough neurodevelopmental assessment can help determine whether retained reflexes or sensory-motor patterns are contributing to your child’s challenges.

📍 Neurohealth Wellness – Allambie Heights (Northern Beaches)
📞 (02) 9905 9099
🔗 Book online: https://www.neurohealthwellness.com.au/booking

Gentle, child-centred care. No referral required.

Signs Your Child May Be Struggling With Midline Crossing

Parents may notice:

• Switching hands when drawing or writing
• Using the left hand on the left side and right hand on the right side
• Difficulty cutting with scissors
• Fatigue or poor grip with writing
• Messy or slow handwriting
• Frequent letter reversals
• Difficulty visually tracking across a page
• Awkward or uncoordinated kicking, throwing, or catching
• Avoidance of fine-motor tasks
• Difficulty planning and sequencing movement

Early identification is helpful, as neuroplasticity is highest in childhood.

How Neurohealth Wellness Supports Child Neurodevelopment

Our chiropractors are trained to assess not only spinal and joint movement, but also broader neurological development, including:

• Primitive reflex integration
• Eye tracking and oculomotor control
• Balance and proprioception
• Postural patterns
• Core stability and integrated movement
• Sensory-motor development

We support families across the Northern Beaches — including Allambie Heights, Brookvale, and surrounding areas — using a gentle, holistic, nervous-system-centred approach.

1. Reflex Integration Exercises

If retained reflexes such as ATNR, STNR, or TLR are identified, we provide home-based neurodevelopmental movements designed to support reflex integration. These movements mirror early developmental patterns and help strengthen the neural pathways required for midline crossing.

2. Chiropractic Care for Nervous System Function

Gentle chiropractic care can support:

• Joint mobility
• Postural alignment
• Proprioceptive input
• Bilateral coordination
• Communication between brain and body

Improved sensory input helps the nervous system organise movement more efficiently.

3. Visual-Motor & Eye Tracking Support

Children who struggle to cross the midline often experience difficulty with smooth eye movements. Targeted activities can help improve visual tracking across the midline — essential for reading fluency.

4. Strengthening Core Stability

Midline crossing depends heavily on trunk stability and rotational control. We use child-friendly movements to improve balance, coordination, and postural control.

5. Parent Education & Home Programs

We empower parents with practical strategies to support development at home and school, including:

• Cross-crawl patterns
• Yoga for children
• Vertical “rainbow” drawing
• Streamer dancing
• Rock-wall climbing
• Large-scale art and bilateral play

Our focus is on prevention over reactive care, supporting long-term development rather than short-term fixes.

Midline Crossing Activities You Can Start at Home

Some Neurohealth-approved favourites include:

1. Cross-Crawl Movements
   Marching with the opposite elbow to knee to improve hemispheric integration.
2. Large-Scale Rainbow Drawing
   Using vertical surfaces to encourage trunk rotation and midline crossing.
3. Yoga and Animal Walks
   Many poses naturally promote rotation and bilateral coordination.
4. Sensory Bins with Scooping
   Place items on one side and the tool on the opposite side to encourage crossing.
5. Playful Games Like “Simon Says”
   Direct children to touch opposite shoulders, knees, or toes.

These activities are most effective when paired with individualised reflex-integration guidance.

Final Thoughts

Crossing the midline is not just a motor skill — it is a foundational neurological process that supports learning, behaviour, and coordinated movement.

When children struggle with midline activities, there is usually an underlying neurological or developmental reason. Retained primitive reflexes, particularly ATNR, are among the most common contributors.

At Neurohealth Wellness, we are committed to helping children move better, learn better, and build confidence through developmentally informed care.

🔹 You don’t have to navigate this alone

If you’re concerned about your child’s coordination, handwriting, reading, or school readiness, support is available.

Our team at Neurohealth Wellness provides gentle, whole-body, neurodevelopmental care to help children build strong foundations for growth.

📍 33–35 Kentwell Rd, Allambie Heights
📞 (02) 9905 9099
🔗 Book online: https://www.neurohealthwellness.com.au/booking

References

1. Bly, L. (1994). Motor Skills Acquisition in the First Year: An Illustrated Guide to Normal Development. Psychological Corp.
2. Forssberg, H. (1999). Neural control of human motor development. Pediatric Research, 46(6), 701–708.
3. Gieysztor, E. Z., Choińska, A. M., & Paprocka-Borowicz, M. (2018). Persistence of primitive reflexes and associated motor problems in healthy preschool children. Archives of Physiotherapy, 8(1).
3. Hadders-Algra, M. (2018). Early human motor development. Neuroscience & Biobehavioral Reviews, 90, 411–427.
4. Melillo, R. (2016). Neurobehavioral Disorders of Childhood. Springer.
5. Piek, J. P., et al. (2008). Early motor development and later cognitive ability. Human Movement Science, 27(5), 668–681.

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