Why Do Some Children With Autism Toe Walk—and What Can Parents Do?

a child's feet with little smily faces drawn on each toe

Are you concerned about your child’s toe walking habits? Toe walking, a common concern for parents, can sometimes be associated with autism spectrum disorder (ASD). Understanding the connection between toe walking and autism is crucial for early intervention and support.

What is Toe Walking?

Toe walking refers to a walking pattern where a person walks on their toes or the balls of their feet without their heels touching the ground. While occasional toe walking in toddlers is common, persistent toe walking beyond the age of two may indicate an underlying issue.

The Connection with Autism

Toe walking is often observed in children with autism spectrum disorder (ASD). While not all toe walkers have autism, studies suggest that many children with ASD exhibit toe walking behavior. Children with Autism often have higher sensory seeking behaviors, and being up on their toes gives them deep sensory input through their feet and in their contracted calf muscles. This connection can lead to more targeted interventions and support from therapists and parents.

How Can a MetroEHS Physical Therapist Help?

Physical therapy plays a crucial role in addressing toe walking in children, especially those with autism. A skilled physical therapist can:

  • ‍Assess the Underlying Causes: A physical therapist will conduct a comprehensive evaluation to identify any underlying factors contributing to toe walking, such as muscle tightness, sensory issues, muscle weakness, or lack of range of motion.‍
  • Develop Individualized Treatment Plans: Based on the assessment, the physical therapist will create a personalized treatment plan tailored to your child’s needs. This plan may include stretching exercises, strengthening activities, balance training, or different sensory inputs.‍
  • Educate and Empower Families: MetroEHS Physical Therapists work closely with families to educate them about toe walking and provide strategies for home exercises and activities to support their child’s progress.

Toe-walking can impact your child long-term if left untreated:

Toe walking will impact your child’s overall body positioning, posture, and muscles. With toe walking, because of these impacts, it will also change the load of the body’s joints and likely cause chronic pain as the individual ages. It is common for toe walkers to lose range of motion in their ankles, preventing them from being able to reach their heels to the ground and causing their Achilles tendon to shorten. In more severe cases, if the Achilles tendon shortens too much, the only way to regain that length is with a surgical lengthening.

Take the First Step Towards Support

If you’re concerned about your child’s toe walking or suspect they may have autism, early intervention is key. Schedule an evaluation with a qualified physical therapist who specializes in pediatric care. Together, we can help your child take confident steps towards improved mobility and independence.

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June 30, 2019

How do I Know if My Child has a Feeding Disorder?

Feeding disorders are very common. Though it is hard to quantify, “[a]pproximately 20-50% of normally developing children, and 70-89% of children with developmental disabilities” (1) have a feeding disorder. How does this happen so frequently?!

According to Dr. Kay Toomey’s research and reviews of other studies, of children who have feeding disorders, between 65-95% of cases are caused by both behavioral and natural, organic causes (2017) (2). In other words, more often than not, a feeding disorder is not just behavioral! For example, a child that has undiagnosed reflux or allergies has learned to refuse food, because they have learned that food causes them to have an upset stomach. They may continue to refuse food even after receiving treatment for the initial physiological problem. A child that has choked on some solids because of undiagnosed oral dysphagia will begin to only eat liquid and purees to avoid choking. A child that is refusing crunchy foods could have sensory processing disorder and benefit from desensitization. A child that is having a hard time breathing will refuse food in order to get enough oxygen to survive. The examples could go on and on. Every child is different, and needs to be diagnosed and treated holistically.

Some signs that may indicate your child could have a feeding disorder include:

  • If your child eats less than 20 foods
  • If mealtimes take more than 30 minutes
  • If they refuse all of food of a certain texture or color, or are they having difficulty transitioning to solids
  • If they are choking, coughing, or gagging while eating
  • If they are demonstrating a lot of negative behaviors during meal times
  • If they have difficulty with mealtime routines or have a hard time sitting at the table
  • If they have difficulty chewing or swallowing (example: food left in their mouth after they’ve finished eating)

If you think your child could have a feeding disorder, or you feel that you’ve exhausted your options at home and don’t know where else to go, your child could likely benefit from a feeding evaluation and possibly feeding therapy. A pediatric feeding specialist can help you determine the cause, if a cause is present, make appropriate referrals, and plan the best course of treatment. Slowly, your child will become an adventurous and independent eater!

Sources:

  1. 2013. June 13. Banchaun Benjasuwantep, Suthida Chaithirayanon, and  Monchutha Eiamudomkan. Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices. Published online 2013 Jun 13. doi: 10.4081/pr.2013.e10
  2. Toomey, Kay (2017). Top Ten Myths of Mealtime in America. SOS Approach to Feeding. https://sosapproach-conferences.com/resources/top-ten-myths-of-mealtime-in-america/

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April 22, 2024

Empowering Communication for Children with Autism: A Look at Therapy Interventions

In a recent airing of Live in the D, sponsored by MetroEHS Pediatric Therapy, the spotlight was on Autism Awareness Month, shedding light on how children on the autism spectrum can benefit from life-changing therapy. MetroEHS, a pediatric neighborhood therapy company with multiple locations across Metro Detroit, including expanding services, is dedicated to enhancing the quality of life for children with various therapy needs, including autism.

Deanna Coker, a board-certified behavioral analyst, and Kris Krajewski, a speech therapist with MetroEHS, joined the show to discuss how therapy can significantly impact children’s communication skills.

Understanding Communication Challenges in Autism

Deanna explained that autism, as a developmental disability, often presents challenges in social interaction and communication. Unlike typically developing children who learn language by observing and imitating, children with autism struggle to find meaningful ways to communicate, despite their desire to do so.

The Role of Speech Therapy

Kris emphasized that speech therapy is essential for children with autism, given that communication difficulties are a hallmark characteristic of the condition. Speech therapists, like those at MetroEHS, work to identify barriers to communication and introduce alternative methods for expressing thoughts and needs.

Speech Therapy Interventions

Kris introduced an innovative tool called the AAC device (Alternative and Augmentative Communication), essentially an iPad loaded with specialized software designed exclusively for communication purposes. This device enables children to select words and icons to express themselves, giving them a voice and autonomy in their interactions.

Empowering Communication Through Tools

Deanna highlighted another communication aid, the PECS book (Picture Exchange Communication System), a low-tech solution that uses pictures to help children convey wants, needs, and preferences. By selecting and exchanging pictures, children can effectively communicate with caregivers, enhancing their independence and self-expression.

The conversation between Deanna, Kris, and the show’s host highlighted the importance of therapy in empowering children with autism to communicate effectively. Through innovative interventions and specialized tools, such as AAC devices and PECS books, children can overcome communication barriers and actively engage with the world around them.

For families seeking therapy services for their children, MetroEHS offers comprehensive support, including ABA, speech, occupational, feeding, and physical therapies. With multiple locations across Metro Detroit and additional centers on the way, MetroEHS aims to make therapy accessible and impactful for families in need.

March 26, 2025

Why Is Early Intervention Feeding Therapy So Important for Children?

In the grand battle of dinnertime, where broccoli becomes a villain and picky eaters stage epic showdowns, there exists a team of superheroes ready to save the day—Pediatric Feeding Therapists! These mighty champions use their super skills to help babies, toddlers, and children with feeding challenges, ensuring every little hero gets the nutrition they need to grow strong.

The Origin Story: What is Pediatric Feeding Therapy?

Pediatric feeding therapy unites speech therapists, occupational therapists, and sometimes behavior analysts (yes, ABA superheroes!) to help children overcome feeding struggles. Whether it’s a sensory issue, difficulty with chewing, swallowing, or just a deep-seated dislike for anything green, these experts use science, patience, and fun strategies to turn mealtime mayhem into moments of mastery.

Many young heroes-in-training face powerful foes:

The Texture Titan – That sneaky foe who makes certain foods feel ‘icky’ or unbearable.

The Gag Goblin – The reason some kids struggle with new foods and textures.

The Avoidance Avenger – The mastermind behind food refusals and dinnertime battles.

The Autism Anomaly – Children with autism often experience heightened sensory challenges that impact eating habits.

Fear not! Early intervention in feeding therapy provides the best chance to defeat these villains before they gain strength. The sooner a child receives support, the more likely they are to develop healthy eating habits that last a lifetime.

In all seriousness, some pediatric feeding disorders are complex and often require a comprehensive approach individualized for each child and family. MetroEHS provides scheduling options dependent upon the family schedule and the severity of the diagnosis. All evaluations are performed by a Team of Feeding/Swallowing Specialists. MetroEHS Speech-Language Pathologists, Occupational Therapists, and Physical Therapists work in tandem with Parents to improve feeding and swallowing disorders.

The Power of Breastfeeding Support

For the tiniest superheroes just starting their feeding journey, breastfeeding support and lactation therapy can make a world of difference. Some babies face challenges with latching, tongue ties, or milk transfer, which can make feeding difficult and stressful for both baby and parent. Lactation consultants and feeding therapists work together to provide guidance on positioning, improving latch techniques, and addressing any underlying oral-motor issues. Early support ensures that even the youngest heroes get the nourishment they need to thrive from day one!

The Superpower of Early Intervention in Feeding Therapy

Early intervention is like unlocking a hidden superhero ability—striking before the villains take full control! The benefits of starting pediatric feeding therapy as soon as you suspect an impending battle or villainous origin story:

Building Healthy Eating Habits: Introducing a variety of foods early makes for a well-rounded diet.

Improving Oral-Motor Skills: Strengthening those tiny mouth muscles for better latch or better chewing and swallowing.

Reducing Mealtime Stress: No more dinnertime showdowns! Parents and children both enjoy a more relaxed experience.

Enhancing Independence: Teaching kids to confidently try new foods and textures on their own.

Assembling Your Feeding League

If your baby, toddler, or child struggles with eating, picky eating, or sensory issues, it’s time to call in the feeding therapy superheroes. ABA techniques, occupational therapy, and speech therapy can all work together to build confidence at mealtime.

Remember, every great hero starts somewhere and learns new skills best when they are small. With early intervention and the right team behind them, your little one can transform from a mealtime sidekick into a fearless food explorer!

Is your child ready to join the Feeding League? The adventure begins now!