Autism and Toe Walking: What You Need to Know

Toe walking refers to a person’s preference to walk on their toes or on the balls of their feet as opposed to using the entire foot. This behavior is common in young children who are just learning to walk and is usually quickly outgrown.

However, children who continue to walk without touching their heels to the ground for more than three months after they’ve learned to walk may have a gross motor function deficit commonly known simply as “toe walking.” Toe walking is not always a symptom of this deficit, as some children simply do it out of habit, but it’s worth looking into the cause of the issue if you notice it happening. Toe walking could be a sign of autism, cerebral palsy, muscular dystrophy, or a short Achilles tendon.

Photo: Adobe Stock/Africa Studio
Photo: Adobe Stock/Africa Studio

Toe walking is not rare among people with autism spectrum disorder. Although it is a comorbid disorder with ASD rather than a symptom of ASD, it can often be used to help with the diagnosis process for autism. A recent survey of families attending autism clinics determined that the average age for a toe-walking child to be diagnosed with autism was 4.14, while non-toe-walking children were diagnosed at an average age of 8.69.

Parents are most commonly the people who notice their children’s toe walking first, making it important to spread the word about this deficit so that more people can help their children get earlier diagnoses and earlier intervention for their autism spectrum disorder.

Photo: Adobe Stock/Olesia Bilkei
Photo: Adobe Stock/Olesia Bilkei

Once diagnosed, it is important that toe walking be corrected, generally through physical therapy. While it may not seem like a big deal, over time it can cause pain and mobility impairment. If the condition persists for long enough, it can result in equinus contracture, which is the inability to return the foot to a neutral flat position due to the tightness of the muscles.

Toe walking can also cause an increased risk of falling, and children who do it may experience bullying or social stigma from their peers. Current physical therapy resources for toe walking are highly underutilized, so it’s important that more parents find out how critical it is that this condition be treated.

Right now, it isn’t fully understood why more than half of children with autism are also toe walkers. But we need more parents to be aware of this link so that more kids can get early intervention, both for their toe walking and for their autism spectrum disorders.

Want to learn more about the comorbid disorders associated with autism? Click “next” below to read about dyspraxia.


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