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.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Accardo PJ. On one’s toes about developmental language disorders. J Pediatr. 1997;130:509–10.
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.
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.
Accardo PJ, Capute AJ. The capute scales: cognitive adaptive test/clinical linguistic & auditory milestone scale. Baltimore: Paul H. Brookes; 2005.
Accardo PJ, Whitman BY. Toe walking: a marker for language disorders in the developmentally disabled. Clin Pediatr. 1989;28:347–50.
Accardo PJ, Morrow J, Heaney MS, Whitman BY, Tomazic T. Toe walking and language development. Clin Pediatr. 1992;31:158–60.
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.
Asperger H. Autistic sociopathy in childhood. In: Firth, editor. Autism and asperger syndrome. New York: Cambridge University Press; 1991 [1944]. p. 37–92.
Barrow W, Jaworski M, Accardo PJ. Persistent toe walking in autism. J Child Neurol. 2011;26:619–21.
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.
Capute AJ, Accardo PJ, Vining EPG, Rubenstein JE, Harryman S. Primitive reflex profile. Baltimore: University Park Press; 1979.
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.
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.
Downey R, Rapport MJK. Motor activity in children with autism: a review of the current literature. Pediatr Phys Ther. 2012;24:2–20.
Eiff MP, Steiner E. What is the appropriate evaluation and treatment of children who are “toe-walkers”? J Fam Practice. 2006;55:447–50.
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.
Gilliam JE. Gillaim autism rating scale. Austin: Pro-Ed; 1995.
Gilliam JE. Gillaim Asperger’s disorder scale. Austin: Pro-Ed; 2001.
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.
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.
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.
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.
Kohen-Raz R, Volkmar FR, Cohen DI. Postural control in children with autism. J Autism Dev Disord. 1992;22:419–32.
Krug DA, Arick J. Krug Asperger’s disorder index. Austin: Pro-Ed; 2003.
Krug DA, Arick J, Almond P. The autism screening instrument for educational planning, 2nd edition, ASIEP-2. Austin: Pro-Ed; 1993.
Lord C, Rutter M, DiLavore P, Risi S. Autism diagnostic observation schedule (ADOS). Los Angeles: Western Psychological Services; 1999.
Mandell DS, Novak MM, Zubritsky CD. Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics. 2005;116:1480–6.
McMulkin ML, Baird GO, Caskey PM, Ferguson RI. Comprehensive outcome of surgically treated idiopathic toe walkers. J Pediatr Orthop. 2006;26:606–11.
McPartland J, Klim A. Asperger syndrome. Adolesc Med. 2006;17:771–8.
Ming X, Brimacombe M, Wagner GC. Prevalence of motor impairment in autism spectrum disorders. Brain Dev. 2007;29:565–70.
Myles BS, Bock SJ, Simpson RL. Asperger syndrome diagnostic scale (ASDS). Austin: Pro-Ed; 2001.
O’Dell NE, Cook PA. Stopping ADHD. New York: Avery/Penguin; 2004.
Oetgen ME, Peden S. Idiopathic toe walking. J Amer Acad Orthop Surg. 2012;20:292–300.
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.
Rutter M, Bailey A, Lord C. Manual for the social communication questionnaire. Los Angeles: Western Psychological Services; 2003a.
Rutter M, Le Couteur A, Lord C. Autism diagnostic interview – revised (ADI-R). Los Angeles: Western Psychological Services; 2003b.
Sala DA, Shulman DH, Grant AD, Chu MLY. Idiopathic toe-walking. Dev Med Child Neurol. 1999;41:846–8.
Schopler E, Reichler RJ, Renner BR. The childhood autism rating scale (CARS). Los Angeles: Western Psychological Publications; 1986.
Shulman LH, Sala DA, Chu MLY, McCaul PR, Sandler BJ. Developmental implications of idiopathic toe walking. J Pediatr. 1997;130:541–6.
Siegel B. The pervasive developmental disorders screening test-II (PDDST-II). San Antonio: Pearson; 2004.
Teitelbaum O, Teitelbaum P. Does your baby have autism? Detecting the earliest signs of autism. Garden City: Square One Publishers; 2008.
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.
Teitelbaum P, Teitelbaum OB, Fryman J, Maurer R. Reflexes gone astray. J Dev Learning Dis. 2002;6:15–20.
Weber D. Toewalking in children. Z Kinder Jug-Psych. 1977;5:115–27.
Weber D. “Toe-walking” in children with early childhood autism. Acta Paedopsychiatr. 1978;43:73–83.
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.
Winter H, editor. Gastrointestinal disorders in individuals with autism spectrum disorders. Pediatrics. 2010; 125: S1–29.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this entry
Cite this entry
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
Download citation
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 ScienceReference Module Humanities and Social SciencesReference Module Business, Economics and Social Sciences