Possible indicators of a retained Tonic Labyrinthine Reflex:

- Poor balance and coordination
- Clumsy, poor spatial awareness, poor sense of their own body space
- Person leans forwards when they walk, or has otherwise unusual posture
- Sensory processing or integration problems
- Visual problems, particularly with eye tracking and visual perception
- Difficulty following a list of instructions
- Excessively rigid muscle tone, or distinct lack of muscle tone
- Lack of skill in sport
- Motion sickness or travel sickness
- Poor sequencing skills, difficulty following a list of instructions
- Poor reading or spelling

What is the Tonic Labyrinthine Reflex?

The Tonic Labyrinthine Reflex (TLR) is a primitive reflex found in babies, in which tilting the head forwards causes bending of all limbs, forward curvature of the spine, and hunching of the shoulders (TLR "forwards"), whereas tilting the head backwards causes straightening of all limbs, arching of the back, and retraction of the shoulders (TLR "backwards").
 
The TLR plays a major role in the development of important components of the vestibular system: this is the collection of mechanisms that we use to achieve balance.   Movement of the head stimulates the developing inner ear, which detects the motion.  The TLR then causes movement in the rest of the body in response, and so neural pathways from the inner ear to the skeletal muscles begin to develop and strengthen.  The TLR thus provides the first, automatic but very crude, movement of the body in response to a change in position detected by the inner ear.  If this foundation laid down by the TLR during early development is solid, a more refined muscular response to movement under the influence of gravity will develop later on, and the child achieves good balance. 

The TLR also plays a role both in the development and balance of muscle tone: the actions of the TLR mean that the baby is constantly obliged to use its developing muscles, which grow stronger as a result.  This is crucial if the baby is to develop sufficient muscle strength to support its weight against gravity.

What happens if the TLR is retained?

As one of a number of primitive reflexes, the TLR should not remain active into childhood.  The TLR forwards should be inhibited by the time the baby is roughly 4 months old.  The TLR backwards gradually inhibits between 6 weeks and 3 years of age. 

If the TLR is retained into childhood and beyond, the individual may suffer from a variety of issues related to underdevelopment of the vestibular system.  This may manifest simply as a lack of balance, as the child constantly struggles to determine their position and orientation with speed and accuracy.  This person may be observed to grip with their toes when standing in an attempt to achieve better security with the ground, or posture may be affected: they may have a tendency to stand or walk with their head poked forwards whilst their bottom sticks out, as they feel more stable in this position.  Movement may appear unusual and uncoordinated.

A compromised vestibular system may also cause poor proprioceptive skills: the person may struggle with their sense of physical self, and have a poor awareness of where the various bits of their body are in time and space.  They may therefore be clumsy, uncoordinated, and have bad spatial awareness, even if balance is adequate.

Since the vestibular system is strongly linked to other sensory systems, if it has never fully developed then the other senses, particularly vision and hearing, can also be affected, and the person can suffer from a range of sensory issues.  They may be overly sensitive to sensory input: for example, they perceive sound or light as far louder or brighter than most people would, or they may be very insensitive to sensory information: for example, they do not feel light touch or cannot distinguish similar tastes.  Vision may also be affected: for example, the child does not develop eye tracking skills properly, and so struggles with reading, or visual-perception may be poor.  A poorly developed vestibular system may also lead to sensory integration problems, whereby the brain has difficulty combining the information from our different senses.  Sequencing skills may also be compromised as auditory and visual systems simply cannot operate quickly enough.  This may also be related to the poor sense of time often observed in individuals with a retained TLR.

A person with a retained TLR may also suffer from a lack of muscle strength: they will often be observed to have either excessively floppy muscle tone, leading to poor stamina, or excessively rigid muscle tone, leading to body tension and jerky, awkward movements.  Simply standing may be very tiring, especially if balance is also compromised, as then constant muscular adjustments are necessary just to keep upright.  The individual may develop a tendency to lean on solid objects for support, or avoid physical exercise because it is just too tiring.