Toe Walking & Autism

Tiptoe walking may be done by children for more reasons than trying not to make a sound while going to the kitchen.

For some, walking on toes could be a sign of autism, especially if it persists past the age of two.

However, there are many other reasons why children may walk on their toes.

What is Toe Walking?

Toe walking is the act of walking on the balls of the feet. There’s no contact between the heels and the ground.

Many children perform this act as they are just learning to walk, as it helps them gain better balance and control over the muscles in their feet and surrounding areas.

However, many children outgrow consistent toe walking after the age of two.

They soon develop the pattern of the heel-to-toe pattern.

Again, it could merely be a habit that needs to be broken, but parents should take note of any unusual behavior.

Toe walking is one example of stimming for people with autism.

Is Walking on Tip Toes a Sign of Autism?

Toe walking can be a sign of autism.

‍One study looked at toe-walking data among over 2 million children.

5,739 children with autism spectrum disorder (ASD) also had a diagnosis of toe walking.

Less than 10% of children with autism display persistent toe walking. It’s not exactly a common symptom, but when combined with other factors, it could lead to an autism diagnosis.

This is in comparison to only 0.47% of typically-developing children.

However, a 2-year-old walking on toes may not necessarily have autism.

How Common is Toe Walking in Autism?

The study mentioned above provides the following statement concerning toe walking and autism: “Our results demonstrate that roughly 9% of patients with ASD have a diagnosis of toe-walking as compared with less than 0.5% of children with no ASD diagnosis.”

5,739 children with autism spectrum disorder (ASD) also had a diagnosis of toe walking.

Why Autistic People Walk on their Toes

There are three typical reasons why children with autism may walk on their toes.

1) Vestibular Problems:

The body’s vestibular system handles muscle coordination, posture, and bodily movements.

Children with autism may have difficulties with this system, meaning they push their weight forward, promoting toe walking.

2) Hyper-Extended Back Problems:

It can also be common for kids with autism to have weaknesses in the muscles or decreased muscle tone.

Due to this, their bodies tend to push forward, meaning they place greater weight on their toes.

3) Sensory Problems:

Many children with autism experience sensory difficulties.

The bottom of their feet may feel sensitive touching the ground, so they decide to walk on their toes, reducing the overall amount of surface area.

Toe Walking Autism Treatment

Most children may outgrow toe walking after the age of two, but if your child persists, there are ways to encourage them to walk heel-to-toe.

There are physical exercises parents can perform under the tutelage of a doctor to stretch out the tendon to make heel-to-toe walking feel more comfortable, but this has had varying degrees of success.

Some doctors may recommend the child to wear prism lenses.

Most children should outgrow toe walking after the age of two, but if your child persists, there are ways to encourage them to walk heel-to-toe.

These lenses displace an individual’s field of vision in a certain direction. It’s part of a “vision training” program that can last up to one year where the child performs daily visual-motor exercises.

Through this, the child may become more adept at walking heel-to-toe and no longer feeling reliant on toe walking.

When to Seek Help

Toe walking is can be common and normal for children becoming more aware of their environments until they are 2 years old.

The underlying source may not be autism at all but something like excessive stiffness in the Achilles tendon or another cause may be present.

Persistent toe walking will often be accompanied by other symptoms if the underlying cause is autism.

Such symptoms include avoidant eye contact, delayed language skills, lack of imaginative play, inability to perform simple gestures, and many others.

Don’t hesitate to speak with your doctor if anything appears out of the ordinary.

References:

https://autism.org/toe-walking-and-asd/

https://www.mayoclinic.org/diseases-conditions/toe-walking/symptoms-causes/syc-20378410