Toe walking is a common developmental variation in toddlers that usually resolves over time. However, it can also be a sign of an underlying condition. This article will discuss what toe walking is, whether or not it is a sign of autism, possible treatment options, and when to see a healthcare provider.
Toe walking is a common condition in toddlers and is usually not cause for concern.
After the age of three, toe walking could be a sign of a developmental disorder, including autism, cerebral palsy, or muscular dystrophy.
Signs of toe walking include walking on the toes or balls of the feet, decreased coordination, frequent falls, problems wearing shoes, and foot pain.
Treatments for toe walking may include physical therapy, leg braces or splints, serial castings, or surgery.
If you have concerns about your child’s behavior or developmental milestones, reach out to your healthcare provider immediately.
What is toe walking?
Toe walking, also known as tiptoeing, refers to a type of walking in which the heel of the foot does not touch the ground. Before the age of three, toe walking is a normal developmental variation when children are learning how to walk and is usually not cause for concern. However, if toe walking persists after the age of three, it could be a sign of an underlying developmental issue.
Is toe walking a sign of autism?
The short answer is yes and no. Toe walking in general is a fairly common condition among children under two years of age. However, studies have indicated that by age 5, only 2% of typically developing children still toe-walk. That number jumps up to 41% for children with developmental disorders or delays.
Regarding autism specifically, a 2019 study confirmed that children with autism demonstrate toe walking much more frequently than children without autism. Why the prevalence of toe walking is so much higher in children with autism remains unclear.
However, it is important to remember that autism spectrum disorder (ASD) is a complicated condition that manifests differently in each child. Thus, toe-walking alone is not a guaranteed indicator of autism. Toe walking can also be a sign of other developmental disorders, such as cerebral palsy, muscular dystrophy, or short Achilles tendons. Alternatively, depending on your child’s age, it could simply be a normal part of their development that they will eventually grow out of.
Toe walking – notice the signs:
The most obvious sign of toe walking is if you notice your child walking on their toes and the balls of their feet. However, you may also notice:
- Decreased balance and coordination.
- Frequent falls.
- Problems wearing shoes.
- Complaints of foot pain.
- Difficulty running or playing sports.
Toe walking treatment options
Whether the toe walking is caused by autism or not, there are treatment options available. The most common method of treatment is physical therapy. A physical therapist can help your child stretch the leg and foot muscles, releasing tension and increasing their range of motion over time.
If physical therapy is unsuccessful, a healthcare provider may recommend leg braces or splints to promote contact between the child’s heel and the ground. A method called serial casting is sometimes used, where a series of casts are placed on the lower leg to gradually move the foot back to a normal position.
Finally, surgery to lengthen the muscles or tendons in the back of the lower leg may be recommended, but it is generally considered a last resort when all other corrective methods have failed.
When should you be concerned?
If your child is toe walking, it does not necessarily mean they have autism, especially if they are under three years of age. Remember, autism typically manifests in multiple ways, and children with autism have a variety of symptoms. Therefore, if you are ever concerned about the way your child is behaving or if they are not meeting their developmental milestones, it is best to reach out to your child’s healthcare provider for a thorough evaluation and proper diagnosis.
- Autism Research Institute. What is Toe Walking?
- Cleveland Clinic. Toe walking.
- Journal of Children's Orthopaedics. Autism and toe-walking: are they related? Trends and treatment patterns between 2005 and 2016.