On our courses we get a large variety of people – from novices to expert – clinicians and academics.

One question we always get is “how do you document the assessment of the reflex”?

As can be seen in the figure, there are several types of rating scales. I recommend starting with 0: absent and 1: present. You can just document what you saw (e.g., 1cm leg shortening on the ATNR). As you get more familiar with the assessment you can use a 3 point scale (0: absent; 1: mild; 2: marked). Obviously, as you use more variables to the scale, the harder it is to get reliability. I used a 5 point scale when I did a reliability study.

If you want to learn more about primitive reflexes and how they can be used in rehabilitation get in touch

Gibbons SGT 2009 Neurological soft signs are present more often and to a greater extent in adults with chronic low back pain with cognitive learning deficits. Manual Therapy. 14 (S1): S20
(PDF) Neurological Soft Signs are Present More Often and to a Greater Extent in Adults with Chronic Low Back Pain with Cognitive Learning Deficits. Available from: https://www.researchgate.net/publication/382615497_Neurological_Soft_Signs_are_Present_More_Often_and_to_a_Greater_Extent_in_Adults_with_Chronic_Low_Back_Pain_with_Cognitive_Learning_Deficits [accessed Oct 25 2026].