How Does Physical Therapy Help Children Who Toe Walk?

the feet of a child doing a therapy for toe walking

April is Autism Awareness Month, a time dedicated to shedding light on autism spectrum disorder (ASD) and promoting understanding and acceptance. Throughout this month, we've been exploring how MetroEHS, a pediatric neighborhood therapy company with locations across Metro Detroit, is making a difference in the lives of children on the autism spectrum through various forms of therapy.

Today, we delve into a common phenomenon observed in children—toe walking—and its potential significance, particularly in relation to autism. Toe walking, the act of walking on the toes, balls of the feet, or tippy toes, is a behavior that may raise concerns, especially when observed in children around the ages of two to three.

According to experts at MetroEHS, including Kelly Johns, the Director of Physical Therapy, toe walking can be an indicator of potential developmental issues, including autism spectrum disorder. Children on the spectrum often exhibit sensory-seeking behaviors, and toe walking can be one manifestation of this sensory-seeking behavior, providing them with additional sensory input.

While occasional toe walking in toddlers who are still learning to walk may not be alarming, persistent toe walking, especially beyond the age of two or three, warrants attention. If a child is consistently toe walking more than 50% of the time, it is advisable for parents to seek evaluation and possible intervention, such as physical or occupational therapy.

Toe walking can have various implications for a child's physical development and overall well-being. It can lead to issues such as pelvic misalignment, muscular imbalances, and even the shortening of the Achilles tendon over time. Addressing toe walking early through therapy and interventions can mitigate potential future problems and promote proper musculoskeletal development.

MetroEHS offers a range of therapies, including physical and occupational therapy, to address toe walking and other developmental concerns in children. Additionally, parents can play an active role in helping their children at home by incorporating simple exercises and activities aimed at stretching the calf muscles and promoting proper walking mechanics.

Simple interventions like stretching exercises and using swim flippers can aid in correcting toe walking tendencies and promoting a more natural gait pattern in children. By combining professional therapy with at-home practices, parents can support their children's physical development and overall well-being.

MetroEHS has 14 locations across Metro Detroit, with three more on the way, ensuring accessibility for families seeking therapy services for various developmental needs, including autism spectrum disorder. Find the nearest MetroEHS location to you on the Locations Page!

As we wrap up Autism Awareness Month, let's continue to spread awareness, understanding, and support for individuals on the autism spectrum and their families, empowering them to thrive and lead fulfilling lives.

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September 26, 2025

Why Does Play-Based Therapy Work? 3 Reasons It Helps Children Thrive

How Play Unlocks Potential

Play isn’t just fun; it’s how kids learn best. It gives them the freedom to explore their abilities while feeling safe and supported. Imagine a young hero practicing teamwork by pretending to save the world with their peers or strengthening fine motor skills while building a block tower taller than a skyscraper. These playful missions help kids grow in ways that traditional methods simply can’t.

The BIG THREE Additions to Heroes’ tool belts.

  1. Improved Social Powers: Group games teach kids how to share, collaborate, and communicate—turning them into master team players.
  2. Problem-Solving Super Skills: Puzzles and pretend play help young heroes learn to think critically and creatively.
  3. Emotional Resilience: Role-playing scenarios give kids the tools to navigate their feelings and build confidence.

The Power of Play

In the world of superheroes, a child’s business is play. Through play-based therapy, skilled therapists use games, toys, and imaginative scenarios to help kids develop essential skills. Whether it’s building social connections, improving motor abilities, or boosting communication skills, every playful moment is designed with purpose—turning fun into progress.

For children, play is more than just a pastime; it’s the key to unlocking their unique powers. At MetroEHS, play-based therapy ensures every child has the chance to soar, grow, and shine—because every superhero deserves to feel unstoppable.

May 18, 2026

Questions to Ask Before My Clinical Fellowship Year

Starting your Clinical Fellowship year is exciting—but it can also feel overwhelming. Before you jump in, take a little time to reflect. Asking yourself the right questions now can help you find the best fit and start your career with confidence.

1. Who will my clients be?

Do you see yourself in pediatrics (schools, outpatient, hospital?) or working with adult patients (in the hospital, SNF, outpatient, or specializing?),? What areas draw you in? Articulation, AAC, literacy, language, or feeding? You don’t have to have it all figured out—but having a general direction helps.

2. What work environment fits me best?

Think about where you thrive! Do you prefer a fast-paced clinic , scheduling yourself in a school environment, or in home with your patients? Do you want to work closely with other professionals everyday or have more independence?

3. What kind of support do I need?

Your CF supervisor plays a huge role in your experience. Ask yourself: Do I want hands-on guidance? Frequent feedback? A team I can easily turn to with questions? An experienced mentor?

4. What do I want to learn this year?

Your CF isn’t just about completing hours—it’s about growing your skills. What do you want to feel confident in by the end of the year?

5. What are my non-negotiables?

Consider what matters most to you. Ask about caseload size (both appointments and number of patients/students whose cases you must manage), work-life balance, mentorship, or pay structure (W2 vs 1099). Knowing your priorities will help you make the right decision.

You can also ask about benefits! Some benefits make a big difference today like PTO, paid holidays (are they taken out of your PTO?), medical coverage, and more. Other will shape your future in a big way, like the retirement plan options.

6. How will I take care of myself?

This year can be demanding. Think about how you’ll manage stress, stay organized, and maintain balance so you can show up as your best self.

Your CF year is just the beginning. Taking time to reflect now can set you up for a more meaningful, supported, and successful start in the field. And if you can, find a mentor who will guide you through these sometimes-challenging questions.

October 31, 2023

Fostering Gratitude in the Family

Gratitude is a valuable life skill that can enrich the lives of all individuals, including children on the autism spectrum. Teaching children with autism about gratitude can help them develop a more positive outlook, build stronger relationships, and improve their overall well-being. However, because children on the autism spectrum often have unique learning needs, it’s important to use tailored strategies to teach them about gratitude. Here are a few ideas.

1. Visual Supports

Visual supports are powerful tools for children with autism, as they process information in a more concrete manner. Create visual schedules or charts that incorporate gratitude activities into their daily routines. For example, you can design a “gratitude journal” with pictures or symbols representing things they are thankful for. During the month of November, you could draw a tree on a large piece of paper and add a leaf of gratitude every day with a drawn picture of what you are thankful or writing down simply one word. This can be a simple way to encourage them to reflect on positive aspects of their lives. As they add items to their gratitude journal, reinforce the positive feelings associated with each entry.

2. Social Stories

Social stories are narratives that describe social situations and appropriate behavior. You can create social stories that revolve around gratitude. Tailor the stories to your child’s interests and communication style. For instance, you might develop a story about a character who learns to express gratitude when someone helps them. Reading and discussing these stories with your child can help them understand the concept of gratitude and its importance.

3. Visual Modeling

Children on the autism spectrum often benefit from visual modeling, where they observe someone demonstrating a behavior or skill. Create visual examples of gratitude by using pictures, drawings, or videos. Show them how to say “thank you” or how to express gratitude through simple gestures. Repeated exposure to these visuals can help them imitate and internalize these actions. Make sure you are expressing your appreciation with the people around you while your child is watching.

4. Use Concrete Reinforcers

For many children with autism, immediate reinforcement is key to learning new behaviors. Use concrete reinforcers to motivate your child to practice gratitude. This could be as simple as providing a favorite treat or activity when they express gratitude, whether by saying thank you or engaging in a small act of kindness. The more they associate gratitude with positive outcomes, the more likely they are to embrace it.

5. Practice Mindfulness and Reflection

Gratitude often goes hand in hand with mindfulness and reflection. Teach your child techniques for being present in the moment and focusing on positive aspects of their lives. Simple activities like mindful breathing, meditation, or keeping a gratitude jar can help them develop an appreciation for what they have. Encourage them to reflect at bedtime about their day and share what they are thankful for, fostering a sense of gratitude as part of their daily routine.

Teaching children about gratitude is not only possible but also incredibly beneficial. Gratitude helps improve their emotional well-being, enhance their social interactions, and promote a more positive outlook on life. The key is to tailor your approach to their specific learning needs, using visual supports, social stories, visual modeling, concrete reinforcers, and mindfulness and reflection techniques. Remember that patience and consistency are crucial in helping children with autism develop this valuable life skill. By embracing these strategies, you can help them grow into more thankful, empathetic, and content individuals.