Mapping here is provisional, but this taxon does appear to be usually distinct and concentrated from the upper midwest to the southern Ridge-and-Valley and Piedmont (W; Spaulding et al. 2018; D. Estes, pers. comm.). The status of reflexum remains controversial, as either a variant of the more northeastern canadense (FNA 3; Kelly 2001) or as a full species (Sm, W). A. reflexum differs from typical canadense and var. acuminatum as follows (F, W; Spaulding et al. 2018); calyx lobes 5-12 mm long (versus 10-35 mm), usually shorter than the tube and broadly triangular (versus almost as long and narrowly triangular), strongly reflexed and often more or less appressed back against the calyx tube (versus spreading to ascending from the base), the margins convex to the base of the tubular tips (versus concave), the apex acute or acuminate with 0-4 mm tips (versus acuminate with caudale inrolling tips 4-20 mm long). Petioles and peduncles may be more hairy (S. Namestnik, pers. comm.). Also, leaves are more kidney-shaped, with broad lobes and a blunt apex (versus more acute to acuminate). Somewhat intermediate plants, sometimes known as var. ambiguum (Bickn.) Farw., occur mostly at intermediate elevations in the Southern Appalachians, and they are suspected in sw. Va. (Lee Co.), s. Ind. (S. Namestni, pers. comm.) and perhaps elsewhere (D. Estes, pers. comm.).