Why is my autistic child toe walking?

If your child continues toe walking after age 2 here are some important tips.


What is Toe Walking?

When children are learning to walk, it can be a time of excitement and joy for parents. However, if your child is walking on their toes rather than on their heel, you may have noticed it and have some questions. Toe walking in children is a condition where a child walks on their toes instead of a normal gait with the heal striking the ground first.

Toe walking in children is a common occurrence among toddlers, but for some children, it can persist past the age of two, leading parents to worry that something more might be going on. Although toe walking may be a sign of an underlying issue, it can also be a perfectly normal part of a child's development. In this blog post, we'll take a look at what toe walking is, why it may happen, and when it's time to talk to your doctor about it.

is walking on your tippy toes a sign of autism?

The short answer is - maybe.  Tip toe walking is not a symptom of autism used in the diagnosis, but autistic children are more likely to walk on their toes than children without a diagnosis.

Here's the way I look at it. If your child walks on their tippy toes for longer than is normal, seek some help. Helping your child with their toe walking will help their development.  It may be helpful to avoid an ASD diagnosis or change where they sit on the spectrum.

When seeking help, have an open mind.  Seek advice from various sources, such as a doctor, an occupational therapist and a specialist in primitive reflexes.

Causes and resolutions for toe walking in children.

Toe walking is common among young children with certain medical conditions such as cerebral palsy, spina bifida or muscular dystrophy. 

Toe walking is also quite common in children on the autism spectrum.  Children with Autism Spectrum Disorder are more likely to be toe walkers than undiagnosed children.

Considering there are conditions related to brain and neurological development that seem to be correlated with toe walking, the solution may be caused in some way by our child's neurology.  

Problems with the vestibular system (feedback system between the body and brain with relation to body motion and position) may be a contributing factor to toe walking.  Considering that children with autism often have a poorly functioning vestibular system, this is potentially a major factor in your child's poor gait.

Despite some evidence of a neurological link, tiptoe walking is often thought to be caused by muscle weakness or lack of coordination.  There's good reason for this.  If the doctor sees a child after some time of toe walking, there tends to be muscular issues.  Although the root cause may not have been muscular, it certainly looks that way to a doctor when they first assess the child.  If the child continues to use their muscles incorrectly, particularly the foot muscles while walking, this may lead to more challenges as time passes.

There are often cases where Doctors can't find a cause of toe walking. In these cases, the child is considered to have idiopathic toe walking.  Idiopathic toes walking is common in children as they begin to walk, however with normal development, this will not persist.  If it persists, the child is otherwise healthy and the doctor can't find any cause, idiopathic toe walking may be given as a diagnosis.  The doctor may recommend physical therapy, orthotics, surgery, or medication as a way to help the child.

Now I put on my Natural Autism Support hat and look at the causes from a slightly different angle.  If you have read some of my other posts, you will know that I like to widen the net, explore more ideas and be curious.  

For me, primitive reflexes tick some boxes.  Retained primitive reflexes are often found in children on the autism spectrum.  The symptoms that are observed will be different for each child, depending on the combination of reflexes that are retained.  Toe walking and low muscle tone can be some of those symptoms.  

Often the root cause of the autism related symptoms also affect a child's ability to normally and naturally resolve primitive reflexes.  Each primitive reflex is expected to resolve through natural development at fairly consistent age ranges.  There can be many reasons why this doesn't happen, often relating to inflammation of the brain and nervous system during the early years of a child's life.

I expect that having help from a practitioner skilled in resolving retained primitive reflexes will likely help many children.  Retained the Plantar or Babinski reflexes can be related to persistent toe walking.  Along with helping your child with toe walking, primitive reflex therapy will likely help other symptoms as well, such as sensory issues.  One of the benefits of primitive reflexes therapies are that they contribute to sensory integration.

I highly recommend combining help from a practitioner skilled in primitive reflexes, while implementing a diet designed to reduce inflammation at the same time.  This will likely produce better results.  Most common food sources of inflammation for children on the spectrum are gluten and dairy.  For other ideas, please read our post for healing autism and seek personalised advice from a professional trained in nutrition.

In some cases, surgery is the solution of choice.  When other causes can't be found, or there is an obvious need for surgery, doctors may recommend a surgical intervention.  Surgery can improve range of movement and correct some gait abnormalities.  I would however, hate to see surgical interventions tried before any primitive reflex work is performed, unless there is an obvious need for a surgical correction.

Why is my autistic child toe walking? 

There can be various reasons.  The key message that I want to convey in this post is the importance of taking a wider view to look at more than the traditional reasons.  Due to the common situation that children with autism that walk on their toes and doctors can't find the reason and therefore have trouble helping, I want to emphasise the importance of exploring primitive reflexes.

In short, there could be various reasons, but a common reason for toe walking in children with autism is likely to be retained primitive reflexes.

What to do if your child is a toe walker.

If your child is a toe-walker, the first decision is to either act or ignore it and hope it goes away.  In most cases of idiopathic toe walking, it simply resolves itself through normal development.  However if it persists after the age of two years old, or you are worried, you probably should act as soon as possible.

The first step is to seek advice from your doctor.  Your doctor will be able to assist you with tests and options for diagnosis.  There are possible medical reasons for toe walking, which your doctor can help you with.

I'm a strong believer in not putting all of your eggs in one basket.  Particularly with autism and conditions such as persistent toe walking, there is no one person with all of the answers and necessary skills.  If your doctor can't find any clear reason for toe walking after she has explored various paths for diagnosis, I recommend widening the net to seek advice from other professional.

Other areas to explore and seek advice are:
  • Occupational/physical therapist
  • A Practitioner that specialises in primitive reflexes
In addition to the above, it's wise to seek help in improving the health of your child the same time.  Particularly with autism, we know that inflammation is correlated with ASD symptoms, and may impair development.  I expect there are cases where poor health and inflammation slow the integration of primitive reflexes, resulting in various symptoms, including toe walking and other issue with a person gait.

For more information about improve health of your child, please read our other posts, including 4 Ways To Heal Autism Naturally at Home.  You may also want to explore more free and detailed information in our other blog posts.  Knowing more able health with help you ask the right questions when you seek help from doctors, nutritionists and other professionals that you use for assistance.


Warren Gouin
Warren Gouin

I'm a parent of a child that was diagnosed with autism. I'm an engineer and scientist with most of my career in the diagnostic pathology industry. I'm passionate about improve health and I want to help other parents of children with autism.

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