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Toe-Walking in Children Could be Sign of Developmental Delay

Update Date: Jul 24, 2012 10:37 AM EDT

The next time you see your toddler walking on toes, you may have reasons to worry, as a latest study claims that toe-walking could be a sign of a developmental delay or neuropsychiatric disorders in a child.

According to the study from Sweden, toe-walking could be caused by certain conditions like cerebral palsy. However, some healthy children could toe-walk habitually as well.

The Swedish study revealed that by the age of 5 and half years, 40 percent of children with either developmental delays or autism spectrum disorders are or were toe-walkers.

Although the number of children with "a neuropsychiatric disorder in this study is too small for conclusions," the authors reported, the study "confirms earlier findings that toe-walking has a high prevalence among children with a cognitive [or mental] disorder," reported Health Day.

The authors noted that healthy children who toe-walk, often stop doing so automatically. By age 5 and a half, more than half of toe-walkers stopped spontaneously.

For the study, Dr. Pahr Engstrom and Dr. Kristina Tedroff of the Karolinska Institute in Stockholm reviewed data on 5.5-year-old children living in Blekinge County, Sweden.

Around 1500 children participated in the study, 35 of whom were children with special needs and 17 of those children had developmental delays or neuropsychiatric disorders.

The study found that 30 children (2 percent) among all the participants were healthy and toe-walked currently. Another 40 (5 percent) children were toe-walkers previously.

While 11 children reportedly developed toe-walking during the first year of walking, it was found that out of the 17 children with developmental delays or neuropsychiatric disorders 7 boys (41 percent) had a history of toe-walking.

According to the study authors, toe-walking could pose a threat to the structures in the legs, ankles and heels if it is left untreated. Also, it can create a social stigma, they said.

"Although many of these cases are labeled idiopathic, which means without a known cause, as clinicians and parents, I think we have to consider whether there is an organic cause that may be so subtle it's not always evident," Dr. Pete Richel, chief of pediatrics at Northern Westchester Hospital in Mt. Kisco, N.Y. was quoted as saying by Health day.

Ritchel added that some children who toe-walk could have sensory issues which may be lower than the level of diagnosis of an autism spectrum disorder, but could still benefit from treatment.

"Every child is different and every treatment is different, but early intervention is key. The brain from zero to 3 years old is much more pliable," said occupational therapist Chantell D'Avignon, from Ft. Lauderdale, Fla.Children who walk on their toes, have their stomachs projected outwards and a part of the treatment focuses on moving that back. The treatment needs to be taken early because the longer the posture has been practiced, the longer the correction process will take.

Colleen Harper, a physical therapist and director of developmental, rehabilitative and child life services at La Rabida Children's Hospital in Chicago noted that in U.S., a child spending too much time on baby walker is a common cause of it toe-walking.

Experts advise parents to mention toe-walking in front of their child's pediatrician if the child practices the habit. Richel added that while children with developmental delays and neuropsychiatric disorders may have higher rates of toe-walking, toe-walking on its own is not an indication of a child having one of these conditions.

The study has only associated toe-walking and developmental delays and not established a cause and effect relationship.

The findings of the study were released online July 23, in advance of publication in the August print issue of Pediatrics.

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