In children with Autism, the vestibular system (which helps to control balance and body position) is under developed or dysfunctional. Toe walking can often then develop. Exercises targeting vestibular stimulation can assist in reducing toe walking.
Walking on the toes or the balls of the feet, also known as toe walking, is fairly common in children just beginning to walk, especially those with autism. A child cannot be able to make heel-to-ground contact when they are in the initial stages of the gait cycle, which is when children are learning how to walk.
Vestibular Difficulties
The vestibular system deals with the body's movements, posture, and muscle coordination. Children with autism often experience vestibular difficulties which again push their weight forward and end up encouraging toe walking.
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.
Relation to Autism
However, in 2019 a large-scale review of trends and treatment patterns found that 9% of children with ASD are diagnosed with persistent/idiopathic toe walking compared to less than 0.5% of children without an autism diagnosis (Leyden et al., 2019).
Toe walking is quite common in young children, age 3 and younger; but toe walking, especially in children 5 years and older, is often associated with neurological immaturity. Many parents and professionals are not aware of the various interventions used to treat toe walking.
Twirling of the feet isn't in itself a common sign that autism may be present, but in combination with other identifiable signs, such as twisting wrists and stiffening limbs, it should certainly be checked out with a family doctor.
Signs of autism in young children include: not responding to their name. avoiding eye contact. not smiling when you smile at them.
Kids might toe walk because: They're learning to walk. They have tight calf muscles. Their Achilles tendon is tight. They have neurologic disorder (such as cerebral palsy or autism).
About stimming and autism
Stimming – or self-stimulatory behaviour – is repetitive or unusual body movement or noises. Stimming might include: hand and finger mannerisms – for example, finger-flicking and hand-flapping. unusual body movements – for example, rocking back and forth while sitting or standing.
Children with ASD may have physical symptoms that range from difficulty with coordinating muscle movement to low muscle tone. Children with autism spectrum disorder are also less likely to participate in physical activity than their age- related peers.
Early signs of autism include atypical social and communication behaviour, repetitive behaviour or movements, and intense interests. Early signs of autism usually appear in the first 1-2 years of life.
People with autism walk even more slowly or are wobblier than usual, which suggests that problems with attention may also factor into their movement challenges.
Children with ASD tend to augment their walking stability with a reduced stride length, increased step width and therefore wider base of support, and increased time in the stance phase. Children with ASD have reduced range of motion at the ankle and knee during gait, with increased hip flexion.
A child with mild autism can ultimately lead a very “normal”, productive, and independent life. With early intervention, a child with autism can learn the skills needed for successful navigation in communication and social interaction with peers in school.
Sometimes, toe-walking can become purely habitual. A few potential factors that may contribute to the toe-walking include: difficulty with processing sensory information through their feet and/or legs, muscular tightness and/or weakness, poor bony alignment, or nervous system involvement.
The findings may point to a unique developmental trajectory for children who have both autism and intellectual disability. About 97 percent of children will have begun walking by 16 months of age, according to the World Health Organization2.
Children with ASD were less likely to exhibit delayed walking than those with non-ASD diagnoses, and this difference was larger at lower levels of NVIQ (P = . 002). For example, rates of delayed walking for ASD and non-ASD were 13% and 19%, respectively, in those with NVIQ >85 but 31% and 60% in children with NVIQ <70.
However, it is expected that typically developing children will only walk on their toes occasionally. If your child is walking on their toes more than 50% of the time, or is walking on their toes ALL the time, then you should probably have them assessed by a health professional.
While cognitive empathy can be lower in people with autism, affective empathy—which is based on instincts and involuntary responses to the emotions of others—can be strong and overwhelming. In fact, newer research suggests that some people with autism may actually feel other people's emotions more intensely.
In some cases, a child may appear to have clumsiness and awkwardness in doing normal activities like walking and running. Some children also have repetitive behaviors such as hand clapping, twisting, or twirling.
In the case of vocal stimming (or verbal stimming), the child might make noises such as groaning, grunting, high- pitched screeching, squealing, humming, or repeating random words, words to a familiar song, phrases, or lines from a movie.