In this blog, “Toe Walking in Autism,” we will share some activities that you can try with your children that may prove beneficial. Toe walking is a symptom often observed in autism, where children walk on their toes without letting their heels touch the ground. This behavior may stem from sensory issues, muscle tightness, or a habitual pattern seen in autistic children.
Toe walking is also associated with other disorders such as Autism Spectrum Disorder (ASD), Cerebral Palsy, Muscular Dystrophy, Spinal Muscular Atrophy, Sensory Processing Disorder, Achilles Tendon Tightness, Tethered Spinal Cord Syndrome, Peripheral Neuropathy, Developmental Coordination Disorder (DCD), Genetic Syndromes (e.g., Rett Syndrome, Down Syndrome), Idiopathic Toe Walking, Motor Neuron Disorders (e.g., ALS, Polio), Traumatic Brain Injury, Hypotonia (Low Muscle Tone), and Dystonia or other Movement Disorders. However, some measures can help prevent or reduce toe walking.
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Massage Steps for Reducing Toe-Walking in Autism
The habit of walking on toes in autistic children can often be improved with regular foot massage. Massage helps to relax tense muscles, strengthen them, improve blood circulation, and increase sensory input. Here are some simple foot massage steps you can follow:
1. Warm-up massage
Apply light pressure with your hands on the child’s ankles for about 5 minutes daily. Gently hold the child’s feet and apply gentle pressure. Using gentle movements, rub the feet from top to bottom. This warm-up massage relaxes the muscles and improves blood flow.
2. Thumb pressure
With your thumbs, apply gentle pressure on the child’s sole. Press in a circular motion, focusing on the heel and arch area, where the tension is the highest.
3. Stretching the toes
One by one, gently press and stretch the toes. This step relaxes the toes and surrounding muscles and improves flexibility.
4. Heel and arch massage
Rub the kid’s heel and arch (curve of the sole) in a circular motion with your fingers or thumb. This step helps to relax tense muscles and improve sensory balance.
5. Ankle rotation
Hold your kid’s ankle and slowly rotate it clockwise and counterclockwise. This makes the ankle joint flexible and the calf muscles relaxed.
6. Deep pressure on the sole
Apply some gentle pressure on the sole with the palm of your hand. Focus on the middle region of the pair, where there is tightness.
7. Final step and sensory brush
End the massage with gentle stroking. Lightly rub the upper and lower region of the pair so that it feels relaxed. You should provide some pressure with a sensory brush and apply light pressure on the foot as autistic children have difficulty walking due to sensory issues.
Activities for Toe Walking in Autism
Here are some activities that strengthen the child’s foot muscles and help him maintain balance.
1. Balance Exercises
Ask the child to maintain balance on a line (such as a rope or lines drawn on the floor). Alternatively, stick a piece of cello tape on the floor and ask the child to walk on it. You can also take a piece of wood or cardboard, cut it to the size of a foot, and create a straight line or shape it like a number 5. These exercises help improve focus and attention in children along with toe walking.
2. Push-Pull Exercises Near the Wall
Place the child’s feet near the wall and perform push-pull exercises. This will apply pressure on the child’s ankles, and with consistent practice, it can lead to visible improvements in walking.
3. Weighted Cuffs for Ankle Pressure
To apply pressure on the ankles, tie a weighted cuff to the child’s ankles, you can purchase appropriate to their age. Use this while the child is engaged in activities at home or walking. Over time, this method can help improve their walking pattern. Ensure the weighted cuff is worn for 3-4 hours each day.
4. Foot Strengthening Physical Exercises
Encourage your child to do physical exercises to strengthen their feet. Activities like jumping on a trampoline, pushing and pulling a gym ball with their feet, climbing a ladder, moving up a slide and coming back down, and practicing climbing can be very helpful.
5. Foot Soaking in Water or Rice
Take a bucket, fill it with water, and sand, and have the child dip their feet into it, ensuring that the water covers their feet up to their knees. Ask the child to move their feet up and down. You can also repeat this activity using rice or beans. This helps children with sensory sensitivity by providing relief and improving toe walking. It also aids in reducing sensory issues, as moving the feet up and down in water or rice adds gentle pressure, strengthening the muscles and improving blood circulation.
6. Animal Walks
Encourage the child to walk like different animals, such as a Dog walking or crawling, jumping like a frog, walking like a bear using hands and legs, or running like a horse. This strengthens the child’s legs and increases muscle flexibility.
7. Walking on Different Surfaces
Encourage the child to walk on various surfaces such as a mattress, sand, or grass. This will place additional pressure on the feet, helping to strengthen the muscles.
8. Therapeutic Ball Activities
Ask the child to sit on a gym ball or lie down on their back, and then slowly roll the ball back and forth. This activity will help strengthen the leg muscles.
What does the inability to toe walk mean Neurologically?
Walking is a coordinated movement made possible by the proper balance and communication between the nervous system, muscles, and joints. If someone has difficulty walking or is unable to perform this movement, it could indicate an underlying neurological or muscular issue. Neurological causes may include muscle weakness or imbalance, conditions like Amyotrophic Lateral Sclerosis (ALS) or Poliomyelitis, sensory integration issues such as autism spectrum disorder, traumatic brain injury, or other neurodevelopmental conditions. It could also result from spinal cord injuries or abnormalities, peripheral nerve issues, cerebral palsy, muscular dystrophy, or spinal muscular atrophy.
Conclusion: Toe Walking in Autism
Before doing any of these activities, you should consult a doctor or therapist to ensure that the child’s progress happens under proper guidance. These are home-based activities that I have personally done with my child while staying at home. They do not have any side effects. However, it is important to discuss your child’s behavior with a doctor or therapist and explore additional activities that may benefit them.
Autism-related behaviors tend to fluctuate. There are some FDA-approved medications as well as non-labeled medications that doctors may prescribe to manage certain behaviors. Therefore, after consulting a neurologist, you can work on your child’s behavior by incorporating therapies such as occupational therapy, speech therapy, behavior therapy, applied behavior analysis (ABA) therapy, and sensory integration therapy. Always seek expert advice before starting any new activities or treatments with your child.
Frequently Asked Questions (FAQs)
Why do kids walk on their toes?
There can be many reasons for toe walking, but one major reason is sensory issues, where children are not able to get a proper sense of the ground, and they do it to seek sensory feedback. Muscle weakness can also be a major reason in some children, as they may use their calf muscles more, leading to toe walking. Autism is a neurodevelopmental disorder in which toe walking is commonly seen because of balance and coordination issues. Over time, this can also become a habit. Since this pattern is well-developed, it can be difficult to break. However, with continuous practice and the guidance of a proper therapist, toe walking can be reduced.
Is walking on tiptoes a sign of autism?
Yes, walking on tiptoes is a significant sign of autism, but it is not seen in every autistic child. Some autistic children have sensory processing issues, or they may struggle to get a proper sense of the ground. Tiptoe walking is mostly seen in such children. Sometimes, it can also be due to a lack of muscle tone or coordination. If the child is walking on tiptoes regularly, it could indicate issues with their developmental and motor skills. So, if it has become a habit, it is important to consult a doctor for therapy.
Shoes to prevent toe walking?
So, specially designed shoes are used to manage walking. The height of the shoes, which provides support to the ankle, helps keep the foot in a flat position and reduces toe walking. The shoes have weighted ends that provide sensory feedback, which helps improve the walking pattern of the child. An ankle-foot orthosis (AFO) is also an option that helps keep the ankle in the correct position, aiding in proper walking. Before using any shoes for your child, it is essential to consult a doctor or therapist who can recommend suitable footwear based on your child’s needs.