Neurological assessment of the preterm infant in the special care nursery and the diagnostic significance of the asymmetrical tonic neck reflex.

Neurological assessment at preterm age of 105 infants born at < 34 weeks gestation is discussed. The development of the asymmetrical tonic neck reflex (ATNR) was studied. There was no consistent post-menstrual age at which the 7 allocated grades occurred. The diagnostic significance of the preterm ATNR response for motor development (until 2 years) was considered. The incidence of an imposable reflex dominating spontaneous movement was significantly different (p<0.001) in the normal (n = 89) versus the abnormal development group (n = 16;13 having spastic cerebral palsy). The inclusion of observation of the quality of movement for this reflex could provide useful information in neurological assessment of preterm infants.