@Davesrose: I did an experiment with a DD+ with Atmos test track, using my A16 as a Atmos-enabled decoder and my Yamaha RX-V771 AV Receiver which supports Dolby Digital+ but no Atmos.
The test track places sound on all individual speaker positions - one at a time - of a 9.1.6 speaker layout.
When a sound is played that is intended for example for the left top middle position then the Atmos decoder of the A16 directs that sound 100% to the left top middle speaker, and nothing to any of the other speakers.
My non-atmos receiver directs that same sound 100% to the left side surround, and nothing to any of the other speakers.
That suggests to me that the sound is simply present in the left side surround channel of the basic 5.1 DD+ stream (it has to be, how else can the DD+ non-atmos receiver play it when it doesn't know what to do with Atmos information in additional streams?), and that the Atmos decoder substracts it from the left side surround channel (how else can the left side surround speaker be silent in this case?) to redirect it to the left top middle speaker.