Children's Therapy leaflets - Toe Walking in ASD

Toe walking is when children walk or stand predominantly on their tip toes. 

Children who have Autism (ASD) and/or Attention Deficit Hyperactivity Disorder (ADHD) are often seen to walk on their toes.

How common is toe talking in children with ASD/ADHD?

It is reported that around 1 in 5 children with ASD/ADHD toe walk.

Does my child need to see their doctor or a health visitor about toe walking?

You should consult a healthcare professional IF:

• toe walking is linked with pain, falling over or difficulties with physical activities that used to be fine
• the toe walking is only on one leg
• your child can't get their heels to the ground when standing or walking (with or without being asked to)
• getting heels down makes standing or walking look awkward

What would a health care professional do if we contact them about my child's toe walking?

They will:

• ask some questions including how frequently your child walks on their tip toes each day
• look at your child’s walking and legs
• consider if your child needs further assessment

What happens if your child is referred to a children's physiotherapist?

They will ask further questions about the symptoms your child is experiencing and c

arry out a physical examination.

What will a physiotherapy examination involve?

A physiotherapist will look at the appearance and feeling of the child's legs and feet, and consider their physical skills and ability.

What might the physiotherapist find and suggest as next steps?

If following an examination the physiotherapist considers the child to have good flexibility in the joints and muscles, and good physical skills when balancing, jumping, kneeling and walking, then we will discharge you and provide advice.

If we find tightness or stiffness in the joints or muscles, or some difficulties with physical skills we will consider a number of options, including:

• Discharging you with advice which may include exercises to do at home
• Exercises to do at home to relieve tightness, stiffness and improve physical skills
• Arranging a follow-up appointment
• Making a referral to an alternative service.

If your child toe walks these activities can help with flexibility while they are still growing.

• Heels down stepping
• Heels down standing
• Squatting
• Bear crawling
• Standing stretches
• Floor stretches