WIll my autistic child ever grow out of toe walking?

Will my autistic child ever grow out of toe walking?

The answer to the question: Will my autistic child every grow out of toe walking? is both yes and no.

Yes, as the autistic child grows taller and heavier, idiosyncratic toe walking (ITW) becomes more and more difficult. Unfortunately, what usually happens is that the toe walking evolves into a rigid gait, often characterized by some rigidity of the legs and leaning forward when walking.

We have not found any scientific studies that explain why children with autism toe walk and become adults with a particular gait.

Some have proposed that this gait pattern is linked to a sensory processing dysfunction (SPD), but no firm link has been found yet.

Walking is one of the last things that develop in a human. With autism, we see a lot of problems associated with the various steps involved in walking. We see poor sensory processing, poor self-awareness, poor balance and motor organization.

Can you do anything to help?

There is one strategy that has worked for us as we implement Sensory Enrichment techniques to help the brains of these children with autism.

This strategy addresses tactile processing in general and the information coming from the foot sole in particular. This is done by creating a multi-texture path for the child to walk on with bare feet, randomly, during the day, whenever he feels like it, without any direct request from you, the parent.

Here are some examples of textures to use: simple and inexpensive plastic door mats; rubber mats for the car; pillow cases filled with rice, corn or twigs; a piece of cardboard wrapped in tin foil. When these textures are placed on the floor in a line in a high-traffic area they will be walked on many times a day.

Using the foot sole tactile area as an entryway for interesting information, while the child is in full control of the routine and can take ownership of what he feels, is a very powerful means to improve tactile processing and self-awareness.

The multi-texture path combines two essential elements for recovery: interesting and novel tactile information and a very understimulated tactile area which can be trained to process accurately. The brain will prompt a full contact, thus a flat-footed walk, on the texture. This should progressively decrease the toe walking.


Additional Reading

Magn Reson Med. 2012 Jun 7. doi: 10.1002/mrm.24330. [Epub ahead of print]
Novel MRI-compatible tactile stimulator for cortical mapping of foot sole pressure stimuli with fMRI.
Hao Y, Manor B, Liu J, Zhang K, Chai Y, Lipsitz L, Peng CK, Novak V, Wang X, Zhang J, Fang J.

Gait Posture. 2012 Oct 11. pii: S0966-6362(12)00355-4. doi: 10.1016/j.gaitpost.2012.09.012. [Epub ahead of print]
The differential effects of foot sole sensory on plantar pressure distribution between balance and gait.
Zhang S, Li L.

Clin Biomech (Bristol, Avon). 2001 Nov;16(9):719-27.
The effect of changes in foot sensation on plantar pressure and muscle activity.
Nurse MA, Nigg BM.

J Electromyogr Kinesiol. 2002 Jun;12(3):213-7.
Afferent feedback in the control of human gait.
Nielsen JB, Sinkjaer T.

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