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Toe Walking in Autism

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Comprehensive Guide to Autism

Abstract

Persistent toe walking (PTW) not due to a neurological or orthopedic disorder is often characterized as idiopathic toe walking (ITW). PTW has been associated with language disorders and autism. Toe walking accompanied by a language delay might be considered as an early sign of autism. The reason behind this association remains unknown but may relate to either the persistence of an infantile primitive reflex pattern or to sensory modulation difficulties. Persistence of the toe walking for a long time might give rise to a fixed orthopedic deformity in need of physical treatment.

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References

  • Accardo PJ. On one’s toes about developmental language disorders. J Pediatr. 1997;130:509–10.

    Article  PubMed  Google Scholar 

  • Accardo PJ. Screening and diagnosis for autistic spectrum disorders. In: Gupta B, editor. Autistic spectrum disorders in children. New York: Marcel Dekker; 2004. p. 125–48.

    Google Scholar 

  • Accardo PJ. Autistic spectrum disorders. In: Shapiro BK, Accardo PJ, editors. Autism frontiers: clinical issues and innovations. Baltimore: Paul H. Brookes; 2008. p. 207–20.

    Google Scholar 

  • Accardo PJ, Capute AJ. The capute scales: cognitive adaptive test/clinical linguistic & auditory milestone scale. Baltimore: Paul H. Brookes; 2005.

    Google Scholar 

  • Accardo PJ, Whitman BY. Toe walking: a marker for language disorders in the developmentally disabled. Clin Pediatr. 1989;28:347–50.

    Article  Google Scholar 

  • Accardo PJ, Morrow J, Heaney MS, Whitman BY, Tomazic T. Toe walking and language development. Clin Pediatr. 1992;31:158–60.

    Article  Google Scholar 

  • Armand SP, Watelain E, Mercier MS, Lensel G, Lepoutre F-X. Identification and classification of toe walkers based on ankle kinematics using a data mining method. Gait Posture. 2006;23:240–8.

    Article  PubMed  Google Scholar 

  • Asperger H. Autistic sociopathy in childhood. In: Firth, editor. Autism and asperger syndrome. New York: Cambridge University Press; 1991 [1944]. p. 37–92.

    Google Scholar 

  • Barrow W, Jaworski M, Accardo PJ. Persistent toe walking in autism. J Child Neurol. 2011;26:619–21.

    Article  PubMed  Google Scholar 

  • Brunt D, Woo R, Kim H. Effect of botulinum toxin type A on gait of children who are idiopathic toe walkers. J Surg Orthop Adv. 2004;13:149–55.

    PubMed  Google Scholar 

  • Capute AJ, Accardo PJ, Vining EPG, Rubenstein JE, Harryman S. Primitive reflex profile. Baltimore: University Park Press; 1979.

    Google Scholar 

  • Capute AJ, Accardo PJ. The infant neurodevelopmental assessment: a clinical interpretive manual for CAT-CLAMS in the first two years of life. Curr Prob Pediatr. Part 1; 26:238–57. Part 2; 1996;26:279–306.

    Google Scholar 

  • Crenna P, Federissi E, Andreucci E, Frigo C, Bono R. The heel-contact gait pattern of habitual toe walkers. Gait Posture. 2005;21:311–7.

    Article  PubMed  Google Scholar 

  • Downey R, Rapport MJK. Motor activity in children with autism: a review of the current literature. Pediatr Phys Ther. 2012;24:2–20.

    Article  PubMed  Google Scholar 

  • Eiff MP, Steiner E. What is the appropriate evaluation and treatment of children who are “toe-walkers”? J Fam Practice. 2006;55:447–50.

    Google Scholar 

  • Engström P, Gutierrez-Farewell EM, Bartonek A, Tedroff K, Orefelt C, Haglund-Ǻkerlind Y. Does botulinum toxin A improve the walking pattern in children with idiopathic toe-walking? J Child Orthoped. 2010;4:301–8. Epub 12 May 2010.

    Article  Google Scholar 

  • Gilliam JE. Gillaim autism rating scale. Austin: Pro-Ed; 1995.

    Google Scholar 

  • Gilliam JE. Gillaim Asperger’s disorder scale. Austin: Pro-Ed; 2001.

    Google Scholar 

  • Hemo Y, Macdessi SJ, Pierce RA, Aiona MD, Sussman MD. Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking. J Ped Orthop. 2006;26:336–40.

    Article  Google Scholar 

  • Hirsh G, Wagner B. Natural history of idiopathic toe walking: a long term follow up of fourteen conservatively treated children. Acta Paediatr. 2004;93:196–9.

    Article  Google Scholar 

  • Jacks JK, Michels DM, Smith BP, Koman LA, Shilt J. Clinical usefulness of botulinum toxin in the lower extremity. Foot Ankle. 2004;9:339–48.

    Article  Google Scholar 

  • Jansiewicz EM, Newschaffer CJ, Denckla MB, Landa R, Mostofsky SH. Motor signs distinguish children with high functioning autism and Asperger syndrome from controls. J Autism Dev Disord. 2006;36:613–21.

    Article  PubMed  Google Scholar 

  • Kohen-Raz R, Volkmar FR, Cohen DI. Postural control in children with autism. J Autism Dev Disord. 1992;22:419–32.

    Article  PubMed  Google Scholar 

  • Krug DA, Arick J. Krug Asperger’s disorder index. Austin: Pro-Ed; 2003.

    Google Scholar 

  • Krug DA, Arick J, Almond P. The autism screening instrument for educational planning, 2nd edition, ASIEP-2. Austin: Pro-Ed; 1993.

    Google Scholar 

  • Lord C, Rutter M, DiLavore P, Risi S. Autism diagnostic observation schedule (ADOS). Los Angeles: Western Psychological Services; 1999.

    Google Scholar 

  • Mandell DS, Novak MM, Zubritsky CD. Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics. 2005;116:1480–6.

    Article  PubMed  Google Scholar 

  • McMulkin ML, Baird GO, Caskey PM, Ferguson RI. Comprehensive outcome of surgically treated idiopathic toe walkers. J Pediatr Orthop. 2006;26:606–11.

    Article  PubMed  Google Scholar 

  • McPartland J, Klim A. Asperger syndrome. Adolesc Med. 2006;17:771–8.

    Google Scholar 

  • Ming X, Brimacombe M, Wagner GC. Prevalence of motor impairment in autism spectrum disorders. Brain Dev. 2007;29:565–70.

    Article  PubMed  Google Scholar 

  • Myles BS, Bock SJ, Simpson RL. Asperger syndrome diagnostic scale (ASDS). Austin: Pro-Ed; 2001.

    Google Scholar 

  • O’Dell NE, Cook PA. Stopping ADHD. New York: Avery/Penguin; 2004.

    Google Scholar 

  • Oetgen ME, Peden S. Idiopathic toe walking. J Amer Acad Orthop Surg. 2012;20:292–300.

    Article  Google Scholar 

  • Rimland B. Diagnostic checklist form E-2. San Diego: Autism Research Institute. http://www.autism.com/pdf/providers/diagnostic_cl_e2.pdf. Accessed 5 Mar 2012.

  • Robbins DL, Fein D, Barton ML, Green JA. The modified checklist for autism in toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord. 2001;31:131–43.

    Article  Google Scholar 

  • Rutter M, Bailey A, Lord C. Manual for the social communication questionnaire. Los Angeles: Western Psychological Services; 2003a.

    Google Scholar 

  • Rutter M, Le Couteur A, Lord C. Autism diagnostic interview – revised (ADI-R). Los Angeles: Western Psychological Services; 2003b.

    Google Scholar 

  • Sala DA, Shulman DH, Grant AD, Chu MLY. Idiopathic toe-walking. Dev Med Child Neurol. 1999;41:846–8.

    Article  PubMed  Google Scholar 

  • Schopler E, Reichler RJ, Renner BR. The childhood autism rating scale (CARS). Los Angeles: Western Psychological Publications; 1986.

    Google Scholar 

  • Shulman LH, Sala DA, Chu MLY, McCaul PR, Sandler BJ. Developmental implications of idiopathic toe walking. J Pediatr. 1997;130:541–6.

    Article  PubMed  Google Scholar 

  • Siegel B. The pervasive developmental disorders screening test-II (PDDST-II). San Antonio: Pearson; 2004.

    Google Scholar 

  • Teitelbaum O, Teitelbaum P. Does your baby have autism? Detecting the earliest signs of autism. Garden City: Square One Publishers; 2008.

    Google Scholar 

  • Teitelbaum P, Teitelbaum OB, Nye J, Fryman J, Maurer R. Movement analysis in infancy may be useful for early diagnosis of autism. P Natl Acad Sci USA. 1998;95:13982–7.

    Article  Google Scholar 

  • Teitelbaum P, Teitelbaum OB, Fryman J, Maurer R. Reflexes gone astray. J Dev Learning Dis. 2002;6:15–20.

    Google Scholar 

  • Weber D. Toewalking in children. Z Kinder Jug-Psych. 1977;5:115–27.

    Google Scholar 

  • Weber D. “Toe-walking” in children with early childhood autism. Acta Paedopsychiatr. 1978;43:73–83.

    PubMed  Google Scholar 

  • Williams CM, Tinley P, Curtin M, Nielsen S. Vibration perception thresholds in children with idiopathic toe walking gait. J Child Neurol. 2012. doi:10.1177/o883073811432748. March 20.

    Google Scholar 

  • Winter H, editor. Gastrointestinal disorders in individuals with autism spectrum disorders. Pediatrics. 2010; 125: S1–29.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Developmental Research in Pediatrics, Virginia Commonwealth University, Virginia Commonwealth University Child Developmental Clinic, 3600 West Broadway, Richmond, VA, 32320, USA

    Pasquale J. Accardo

  2. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA

    Eugenio Monasterio

  3. Commonwealth Autism Service, Richmond, VA, USA

    Donald Oswald

Authors
  1. Pasquale J. Accardo
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  2. Eugenio Monasterio
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  3. Donald Oswald
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Corresponding author

Correspondence to Pasquale J. Accardo .

Editor information

Editors and Affiliations

  1. Department of Biomedical Sciences, University of Westminster, Faculty of Science & Technology, London, United Kingdom

    Vinood B. Patel

  2. Nutritional Sciences Division and Genomics Centre, King's College London, London, United Kingdom

    Victor R. Preedy

  3. Faculty of Society and Health, Buckinghamshire New University, Middlesex, United Kingdom

    Colin R. Martin

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Accardo, P.J., Monasterio, E., Oswald, D. (2014). Toe Walking in Autism. In: Patel, V., Preedy, V., Martin, C. (eds) Comprehensive Guide to Autism. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4788-7_24

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  • DOI: https://doi.org/10.1007/978-1-4614-4788-7_24

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4787-0

  • Online ISBN: 978-1-4614-4788-7

  • eBook Packages: Behavioral Science

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