top of page

Tonic Labyrinthine Reflex (TLR)


If a child has a residual TLR it can affect muscle tone and posture. The TLR is triggered by head movement in flexion or extension (looking up or down), so when the head moves, the arms and legs also move. The vestibular system plays a key factor in this reflex. The TLR is not always obvious in a child beyond 3 1/2 years. The effects of a residual TLR can cause a mismatch between the balance mechanism and the body, causing the system to get inaccurate information. The TLR can interfere with other stages of motor development, causing interruptions in some higher-level brain functioning.  

toe walking sensory strategies

Symptoms Of A Retained TLR Include:


  • Insecure Balance

    • May become upset if bumped​

    • Clumsy

    • Uncoordinated

  • Poor Posture

    • Slumped over​

    • Slouchy

  • Low Muscle Tone

    • Poor endurance​

    • "Floppy"

  • High Muscle Tone

    • Can demonstrate tongue thrust​

    • Toe walker

    • Rigid in movement

  • Motion Sickness, Vertigo

    • Yawns frequently with movement​

    • Falls asleep in the vehicle

  • Visual Problems​​

  • Lack of Near-Point Convergence

  • Figure Ground Effect

    • Overwhelmed by busy worksheet​

    • Afraid of heights

    • Fearful of playground equipment

  • Difficulty with Sequencing & Time

  • Toe Walking

  • Articulation Problems

    • Low tone- may mumble, slur words

    • High tone- tongue thrust

reflex integration for toe walking
tlr reflex in babies

The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, or diagnosis.

bottom of page