Treatments For Toe Walking
Children who continue to walk on their toes do need help. Shortened tendons are painful, and they lock children into a walking pattern thats very hard to break. Therapy can make flat-footed walking possible.
Experts say toe-walking treatments include:
- Physical exercises. Parents can use passive stretching techniques to help loosen tense tendons and encourage a normal heel-to-toe relationship. Parents can also entice their children to drop their heels quickly. These exercises arent always helpful in young children with communication deficits, but some families find them useful.
- Visual interventions. Doctors find prism lenses helpful in some children. These devices look like glasses, but they correct the visual disturbances that can come along with autism. Children who use this therapy also have daily visual-motor exercises to perform to retrain the eyes. Eventually, these children no longer need their special glasses.
- Casting. Tendons stretch via this technique. Every two weeks, the child visits a doctor for a new cast that pushes the foot slowly into the proper position. The child wears the cast both day and night, and in time, the tendon loosens and the child learns to walk with their heels on the ground. This mode of treatment takes up to six weeks to complete.
Interventions like this work. For example, researchers say children who use casts improve their gait, and they maintain those improvements years later.
Why Does A Child Toe Walk
There are a few reasons why a child may walk on his or her toes past the toddler stage. First, toe walking may be due to underlying muscle weakness, neurological conditions such as cerebral palsy or balance difficulties. Ive also heard of toe walking running in families. Additionally, toe walking may be related to difficulties with sensory processing. This is likely going to be a reason behind toe walking in children on the autism spectrum.
Why Do Some Children With Autism Walk On Their Toes
There are a number of reasons a child with autism may walk on their toes. These include
Sensory difficulties. A child with autism could experience anxiety or discomfort feeling certain areas of their feet touching the ground.
Hyper-extended back posture . More commonly seen in children with low muscle tone / muscle weakness, this posture can shift the childs weight forward over their toes, encouraging toe walking.
Vestibular difficulties. Vestibular has to do with balance, movement and coordination. This difficulty can cause the child to move their weight forward over their toes, encouraging toe-walking.
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Toe Walking: Should You Be Concerned
Walking is such an important milestone in young children that anything that is not typical about it, causes parents a lot of anxiety. Add to that friends and relatives who casually mention that toe walking is usually a sign of Autism or a neurological problem, it can become a source of huge concern.
WHAT IS TOE WALKING?
Toe walking refers to a walking pattern in which a child walks on the balls of their feet and there is no contact between the heels and the ground. Most children begin walking at 12 to 15 months of age. When children start to learn walking, they try different foot positions, and walking on their toes may be part of this. By around 24 months, they should walk with their feet flat on the ground. By 3 years of age, children should walk with a heel-toe pattern.
IS IT JUST A DEVELOPMENTAL VARIATION?
Generally, until age 2, toe walking isnt something to be concerned about. Often, children who toe walk after that do so out of habit. More than half of young children who toe walk will stop doing so on their own by about age 5. Most children toe walk occasionally when theyre cruising around a room , especially if theyre on a bare floor. Some kids keep toe walking, off and on, just for fun. Toe walking out of habit, also known as idiopathic toe walking, sometimes runs in families. The cause of idiopathic toe walking is unknown.
SOME SPECIFIC CAUSES
WHEN SHOULD YOU BE CONCERNED?
Consult your doctor if your child is toe walking AND
COMPLICATIONS OF TOE WALKING
How To Stop Toe Walking
Toe walking may be a concern because if it continues past age 5, a person may have problems walking with their heels down later in life, though most with idiopathic toe-walking do not.
If you toe walk most of the time, you may have problems wearing shoes comfortably or engaging in recreational activities involving wearing special shoes, such as roller skates. You may also fall more easily.
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How Is Toe Walking Treated
Treatment depends on the childs age, how severe the toe walking problem is, and the underlying cause of the toe walking. The doctor may recommend nonsurgical treatments, including:
- Observation to see if the condition improves on its own
- Walking casts. These are worn for several weeks to stretch the calf muscles and tendons.
- Ankle-foot orthotics . A plastic leg brace keeps the foot at a 90-degree angle to stretch the muscles and tendons.
- Botulinum A toxin injection to weaken the calf muscle and make it easier to stretch
If the child is older than 5, the doctor may recommend surgery to loosen and lengthen the calf muscles and Achilles tendons, which attach the calf and heel.
Toddler Toe Walking: What To Know
Parents wait expectantly for the day their child toddles uneasily across the floor for the first time. Unfortunately the triumph and pride can turn to concern and worry when a toddler is moving in atypical ways like toe-walking. But a toddler walking on toes is not necessarily in-itself a reason for parents to be on red alert. There are a number of potential reasons for tip toe walking and only rarely do they relate to larger concerns like autism or cerebral palsy.
Heres what parents of toe walking toddlers need to know.
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Consult Your Child’s Doctor
Dr. Lock shares, “I can’t say this enough, start with an appointment with the child’s primary care physician.” If you are seeing toe-walking, you need to consider all the other issues that can accompany it. Your primary care physician can help you work through whether the behavior is part of a larger concern, where and how you can find appropriate resources, and what you can do at home to help your child.
Clinical Research: Toe Walking In Toddlers Signals Autism
by Jessica Wright / 1 March 2011
Toeing the line: Many children with autism cannot easily flex their ankles past 90 degrees, causing them to walk on tiptoes.
Children who walk on their toes are more likely to have autism than other forms of developmental delay, according to a study published in January in The Journal of Child Neurology.
Many studies of children with autism report problems with gait, or alignment while walking. Of these, one of the most commonly described is persistent toe walking for longer than three months after learning to walk and tight heel cords, which restrict ankles to a 90 degree angle.
Of 954 children referred to a developmental pediatrics clinic, 115 had at one time shown persistent toe walking and 75 still had tight heel cords.
The ratios are higher in the subset of children diagnosed with an autism spectrum disorder: of 324 children with autism, 65 had shown toe walking and 39 had tight heel cords.
The results suggest that children who persistently walk on their toes should be tested for autism. Likewise, children with autism should have their gait examined and be referred to physical therapy when appropriate.
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Is Walking On Tip Toes A Sign Of Adhd
The researchers concluded that children with ADHD have an increase in idiopathic toe walking and Achilles shortening, especially if they presented with a social communication disorder or a family history of toe walking. It is helpful when idiopathic toe walking is diagnosed early in order to begin effective treatments.
Is Toe Walking A Sign Of Autism
Many infants typically begin walking between the age of 12 to 15 months. Early on, toddlers tend to have variations in their gait patterns or positions one such pattern is walking on their toes. When the child reaches the age of 24 months, the child naturally walks flat-footed.
Research shows that children with autism represent 20% of children with idiopathic toe walkinghowever, a study shows that 9% of the sampled population represent ASD children diagnosed with toe walking. Yet, 0.5% represents children who walk on their toes but are not on the autism spectrum. This suggests that although a greater percentage of children who toe walk are diagnosed with autism the habit of on its own is not a symptom of autism.
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Why Is Walking On Tip Toes Bad
Long-term effects of toe walking, if left untreated Many children who consistently walk on their tip-toes since establishing independent ambulation, may develop foot deformities as early as the age of four. These children may demonstrate ankle range of motion restrictions, impaired balance and poor postural alignment.
Autism And Toe Walking: What You Need To Know
Toe walking refers to a persons preference to walk on their toes or on the balls of their feet as opposed to using the entire foot. This behavior is common in young children who are just learning to walk and is usually quickly outgrown.
However, children who continue to walk without touching their heels to the ground for more than three months after theyve learned to walk may have a gross motor function deficit commonly known simply as toe walking. Toe walking is not always a symptom of this deficit, as some children simply do it out of habit, but its worth looking into the cause of the issue if you notice it happening. Toe walking could be a sign of autism, cerebral palsy, muscular dystrophy, or a short Achilles tendon.
Toe walking is not rare among people with autism spectrum disorder. Although it is a comorbid disorder with ASD rather than a symptom of ASD, it can often be used to help with the diagnosis process for autism. A recent survey of families attending autism clinics determined that the average age for a toe-walking child to be diagnosed with autism was 4.14, while non-toe-walking children were diagnosed at an average age of 8.69.
Parents are most commonly the people who notice their childrens toe walking first, making it important to spread the word about this deficit so that more people can help their children get earlier diagnoses and earlier intervention for their autism spectrum disorder.
Children Walking On Tiptoes: Causes Treatment And When To Worry
Is your child walking on tiptoes out of habit or because of an underlying cause? Read on to find out.
You’ve got to admit that the sight of children walking on tiptoesis pretty cute. Parents don’t usually think too much of it and assume it’s just the way they learn to walk. Asians also believe in an old wives’ tale that children who walk on tiptoes are mischievous! But is there more to it?
If a child walks on tiptoes before the age of three, you don’t have to worry too much just yet. At that stage it probably is part of the mechanism from when they were learning to walk. If they keep walking on tiptoes past this stage, it could be a red flag for problems with coordination, muscles and development. In more serious cases, it can also be a sign of a neurological problem.
Hand Flapping: Should I Be Worried Does It Only Happen With Autism
As a parent, you have an Eagle eye for any new behavior that your child starts doing. If that behavior is hand flapping, youve come to the right place.
Hand flapping is a form of stimming that kids do to calm down, self-soothe, or regulate their bodies. Its common when kids are excited, nervous, anxious, or having any other type of high emotion state. It can also become a habit.
Hand flapping or, arm flapping, has become one of the more popularly recognized signs of autism. As with any concept that becomes well known, we have to deal with both the positives and negatives of it.
We also have to deal with the confusion.
In one sense, its great that the potential signs of autism are becoming more widely known.
Three cheers for autism awareness!
In another sense, assuming that hand flapping=autism is too simplistic and ignores the nuances behind the behavior. In all the confusion, the #1 question becomes when should I worry?
So, youre a parent of a child and you see them starting to flap their hands. Given everything youve heard about hand flapping from the media and greater society, you start to panic.
What does this mean?
Lets dig in to what hand flapping is and whether your should be worried.
As we move forward, please keep in mind that this is general information and is not specific to your own kiddo. If you have any concerns or questions about your childs unique situation, please reach out to their pediatrician or occupational therapist.
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How Do I Know If My Childs Toe Walking Is A Sign Of Something More Serious
Toe walking on its own is usually not a cause for concern, especially if a child is otherwise growing and developing normally.
If toe walking occurs in addition to any of the following, consult a pediatrician:
- Muscle stiffness, especially in the legs or ankles
- Frequent stumbling or general incoordination
- Poor development of fine motor skills
- Inability to bear weight on a flat foot
- Avoiding eye contact
- Repetitive behaviors like spinning or rocking
- Other symptoms of autism, muscular dystrophy, or other neurological or muscular disorders
Waving Goodbye And Other Simple Gestures
Not reaching these milestones does not indicate your child has symptoms of autism or Asperger’s syndrome, as many children may be late developers and catch up at a later point. However it pays to look out for possible early symptoms as early intervention therapies can make a big difference if a diagnosis is reached in the years ahead. Children are usually not diagnosed until the second year at least but there are moves toward making earlier diagnoses to allow earlier intervention therapies.
Toward the end of the first year, the child may not appear to react normally to certain objects and activities. They may have an extreme reaction, or none at all. They may begin to show the first signs of repetitive behaviors such as rocking, or fixating on objects with their eyes. A lack of eye contact with other people is very common at later stages but often does not show in the first year.
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Diagnosing The Cause Of Toe Walking
If you or your child continues toe walking, youll want to see your doctor who will evaluate for potential causes. This usually begins with taking a medical history. Examples of questions a doctor may ask include:
- whether a child was born full term or if the mother had pregnancy complications
- whether a child reached developmental milestones, such as sitting and walking
- if they toe walk on both feet or one
- if there is a family history of toe walking
- if they can walk heel to toe when asked
- if they have other leg- or foot-related symptoms, such as pain or weakness in the legs
Your doctor will also perform a physical examination. This will usually include asking to see you or your child walk. They will also examine the feet and legs for development and range of motion.
Other exams may include those for neurological function and muscle strength. If theres nothing in your childs medical history to indicate a cause of toe walking, your doctor wont usually recommend imaging or nerve function tests. Thats because for a lot of people, toe walking is idiopathic and doesnt have a known cause.
Exercises For Children Under The Age Of Six
1. Calf stretch
- Get your child to lay on his back. Ensure that the surface is firm.
- Keeping his knee straight, bend his foot up to point towards the knee. Bend it upwards at the ankle joint. Do this for as much as possible without causing pain to your child.
- Return his foot to resting position.
- Repeat this for up to 10 times on each side.
2. Achilles tendon stretch
- Get your child to lay on his back. Ensure that the surface is firm.
- Bend your child’s knee and point his toe upwards in the direction of his knee. Do this gently.
- Hold this position for 15 to 30 seconds, or for as long as possible without causing him pain.
- Return his foot to resting position.
- Repeat this up to 10 times.
3. Sit to stand
- Get your child to sit on a chair that is small enough for his feet to touch the ground.
- Hold both his legs and push his feet flat to the ground. Get your child to stand while doing this.
- Make this more fun by blowing bubbles and singing.
Kids always need the element of fun so try to make the exercises enjoyable.
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Can Toe Walking Help To Diagnose Autism
Researchers say many children with autism walk on their toes. In a 2011 study, for example, researchers said 20% of children with autism walked on their toes. This is a strikingly high proportion, but it’s important to understand that toe walking alone isn’t enough for doctors to consider an autism diagnosis.
Children with autism have a variety of signs and symptoms in early childhood, including:
- An inability to speak.
- An ability to speak one or two words, but an inability to string these words together.
- Lack of response to a parent calling the child by name.
- Lack of interest in repeating words or sounds.
- Reluctance to babble or make pre-language noises.
If toe walking combines with language delays, experts explain, autism can be suspected.
But children can walk on their toes for all sorts of reasons. They may have genetic malformations in their legs, heels, or feet that keep them from walking flat-footed. Or they may have another medical condition that attacks the bones or tendons.
If your doctor suspects autism, behavioral screening is the next step. No blood test, x-ray, or brain scan can aid in an autism spectrum disorder diagnosis. Instead, doctors make observations about how their patients are developing, and they ask parents to complete behavior questionnaires. Using that data, doctors can make a diagnosis of autism.