Function and Midline

Turner Midline Assessment System

"If you want to measure function, assess the midline."

Why Midline?

Midline assessment offers:

• A unified diagnostic view across ages, abilities, and diagnoses

• A fast and non-invasive way to detect developmental deviation

• A practical entry point for restorative intervention

1. Midline in Rotation

• Check for: Oppositional movement around the center axis

• Deviations show: Loss of functional gravity use, poor vestibular organization

• Seen in: CP, autism, hypotonia, astronauts, aging adults

• Example: Can they rotate across the body during crawl or reach? Or do they “log roll” or avoid?
   

2. Midline in Linear Movement

• Check for: Crossing or aligning body parts in straight paths

• Deviations show: Compensation patterns, lack of weight transfer, and visual tracking gaps

• Seen in: Children with skipped crawling, toe-walking, and slouched posture

• Example: Can they come from lying to sitting in a smooth plane? Or do they twist and collapse?

3. Midline in Vision

• Check for: Convergence, tracking, crossing the center field of view

• Deviations show: Cortical visual impairment, oculomotor delays, spatial disorientation

• Seen in: Reading struggles, "clumsy" movement, balance issues

• Example: Can they smoothly track an object from left to right, or do they lose focus at midline?

4. Midline in Fine Motor

• Check for: Bilateral hand coordination and crossover

• Deviations show: Hand dominance conflict, lack of reflex maturity, poor tool use

• Seen in: Writing issues, feeding delays, cutting/scissor problems

• Example: Can they thread, grasp, and manipulate across body lines?

5. Midline in Primitive Reflexes

• Check for: Integration of reflexes like ATNR, STNR, Moro

• Deviations show: Retained reflexes blocking functional coordination

• Seen in: Emotional dysregulation, attention issues, delayed milestones

• Example: Does the head turn pull the body into a reflex pattern, or does it rotate independently?

Why It Works