What does toe-walking look like?
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| Mon, 08-01-2005 - 2:53pm |
Hi, I know it should be obvious, but I can't tell if Calvin is doing it. first of all, he has foot orthotics because of his low tone (his feet were the worst) so he was a late walker and still has a rather unsteady gait -- he's only been walking for seven months (He turned 2 in May). He can walk without his orthotics just as well, but gets tired more quickly. A few months ago I noticed that he's been going up on his tip toes to see things, which is good 'cause it means he's getting stronger. But every now and then he will try to walk on his toes for a few steps then stop, then start again, then stop. He only does this in his orthotics and walks normally when he's barefoot. It just looks kind of weird and it's freaking me out because during his evaluation last month the doctor asked if he walked on his toes and we said no because at the time he wasn't. She seemed relieved and said that was a good thing for whatever reason, but now I'm worried he's doing it and it means something bad. That is, if he's really doing it. Argh -- sorry to ramble, but it's so hard to see clearly when I try to look at him. I think he's the most perfect little boy, but I tend to overscrutinize and completely freak out. Can anyone stop the madness? Thanks ....
Kellie

Most people walk heel-toe heel-toe
Toe walkers walk toe-toe-toe
They don't put their heels on the ground. Some raise their heel just a fraction. Some raise the heel so high, they almost look like a prima ballerina. Most kids don't do it *all* the time. They are *generally* more likely to toe-walk if barefoot. For kids who do it all the time, there is a very real danger that the ligament at back of the heel will shorten and cause problems.
Most people think it's a sensory issue. As a toe walker, I can verify that. I hate the feel of the shock through my heel to my knee. By toe walking, I am using my foot for shock absorption. Also (Being the ballerina vaiety) I like the stretch on the instep.
HTH
-Paula
visit my blog at www.onesickmother.com
So that begs the question, what are the implications of toe walking? I'm just curious because my daugther does it quite a bit around the house. I hadn't really filed that in the 'out of the norm' category yet because she can, and does, walk flat footed, but seems to like the ballerina walk a lot.
Mary
Mary,
Implications how? To the feet and legs or as part of the whole "autistic spectrum" thing? I am guessing the latter, as I explained the physical implications earlier.
There could be none. Someone correct me if I'm wrong, but I imagine most kids try toe walking on for size at some point. If it becomes a more ingrained thing, that probably indicates sensory processing issues. Where there are sensory processing issues, there is often (not always) another disorder present, and the disorder most often linked with SID is an ASD, altough I can tell you as former CL of the SID board, that is is definitely not the only disorder which could be linked to it.
I toe walk, and I do not have an ASD (that I know of).
Does that answer the question?
-Paula
visit my blog at www.onesickmother.com
Thank you. That did answer my question. My daughter does other things that seem to point to sensory itegration issues, so I'm not surprised. I was just curious because I'd seen other parents mention toe-walking as a potential problem, but hadn't noticed it on lists of things to be concerned about. Either that or I didn't register it, because my dd doesn't always walk on her toes...
I seem to be having a little trouble with the vocabulary of these disorders. There often seems to be a subtle difference in how words are used to describe non-standard behaviors, and the already totally alien behaviors, of an almost 3 year old. So, I wa wondering if maybe you can answer another question that I haven't found a satisfactory answer to. What is the difference between obsessive behaviors and repetitive behaviors? I was skimming a yahoo group and one mother mentioned that her son had repetitive, but not obsessive behaviors. For example, if a child always insists on taking the same path through the zoo; is that considered obsessive or repetitive? Or, when my daughter and I play together she will often want to act out a scene from a video she saw. It's always a short thing (5 or 6 lines long) but she wants to repeat it over and over in the exact same way for 40 or 50 minutes. If I deviate from the script there are problems. Which word describes that sort of thing. Or is that something else?
And! One more. Echolalia. I'm not sure if I'm understanding how that differs from the sort of language imitation that is supposed to be done in toddlerhood. My daughter tends to do two different things that make me wonder if she's echolalic. First, when we are playing together, or I'm trying to get her to pay attention to directions she tends to repeat the last word or two I've said whenever there's a break. The other thing, is that she tends to repeat a word or phrase over and over and over to herself in (what seems to me to be) a self-stimulating way. I don't think she's attempting to communicate. Generally when she does it she seems to be talking to a toy, or something (like she's playing), and often she's singing the word or phrase. Is that considered echolalia? Or something else. Or nothing. (She has an advanced vocabularly and syntax for her age, so I didn't really start thinking about communication problems until I realized recently that she can't seem to answer questions that don't have simple fact based answer...e.g., what color are your shorts?).
Thank you in advance.
Mary
First thing I would wonder is if the orthodics are bothering him if he only does it with those on? Is it possible he has outgrown them or that for some reason they are not comfortable now that he is walking better? My daughter had horrible sensory issues regarding shoes. Hated shoes. Still isn't a fan and one of her biggest issues so I tend to think something about that is bothering him.
That said, Paula gave a very good explanation about toe-walking. Though common in ASD kids it is not exclusive to ASD kids and not all ASD kids do it. The concern is in the severe toe-walker is the physical problems mentioned by Paula. Also, occasional toe walking can be pretty common in small kids who are trying it out. For instance, my NT nephew toe-walked alot at that age (2-3) and still does occasionally (5) but his autistic brother does not.
Neither of mine toe walk. Mike can have a bit of an odd gait and will kind of toe-walk but usually it is because he is concentrating on cracks or lines in the floor and by walking on his toes he has a smaller area to step and less likely to step on cracks.
Renee
Hmmm, I am not sure there is an exact definition between repetitive and obsessive behaviors because it would be hard to know the function of why the kid is doing a behavior? Could all repetitive behaviors be obessive? That being said, I think possibly what this person was referring to was repetitive behaviors as in self stimulatory behaviors. Like hand flapping, lip smacking, etc. And what you described sounds more obsessive. For instance, Cait will lip smack, play with her fingers in a certain way, or sniff things. She doesn't even really notice when she is doing it. More an absent minded habit usually. I would call that repetitive. But when she insists on things being a certain way. Her shoes fitting just right, then that would be obsessive. Mike does the lines over and over, and insists on things a certain way and his routines. that is more obsessive.
Echolalia for kids with ASD can often happen particularly at the beginning of learning language and for a number of reasons. My kids did all of what you talked about and thier echolalia is now tons better. In fact, Cait has no echolalia at all anymore (other than the group of them obsessing on saying the same stupid movie lines and laughing).
first, Echoing what you have said. For instance this happened alot with my guys when they were little. Q-"What do you want for lunch?" A-"Want for lunch". These usually were a processing problem for my kids. They didn't understand the question when younger, then as they got older it was a coping strategy. Repeating back what I said gave them a chance to process it again. Often what I would do to help this is provide visual choices. So instead of "what do you want for lunch?" I would hold up 2 choices like say a jar of peanut butter and a hot dog and would say "do you want peanut butter and jelly or a hot dog?". You can also make picture representations of common choices or common type questions to help her. Likely if she gets speech it will help. We actually even used PECS with Cait for this even though she was verbal. It helped her understand language better to use visuals.
Next, Echoing movie lines or lines after the fact. Also called delayed echolalia. This can be a couple reasons. First, just doing lines over and over without meaning or talking to anyone is usually a verbal stim. Mike does this, boy it can make me crazy sometimes. Usually when he is hyper or overstimulated. Other times, they may even use phrases and lines of echolalia to communicate. When kids with communication problems Like ASD are learning to communicate it can be hard for them to learn how to put together spontaneous communication. They will use these phrases and snipets for communicative reasons. Mike and Cait both did this. Mike still does but more rarely, usually when stressed. Often he will do it and we won't even realize it. He has been doing it again and I didn't know it until I heard his new pet phrase on TV the other day. I have some great funny lines from about a year or so ago at doctors when he would do this. He usually will use them appropriately. I will never forget the first line that he used most often "That's a great idea, Thanks!". he was probably 2 1/2. He did it with this same hand motion. We didn't realize it was from a mother goose video he saw at the sitters for about 6 months.
I think that covers all the questions. Ya know, Mike covered well for years too. We always thought he was advanced compared to his sister. But because of high IQ he was able to cover alot of deficits with echolalia and vocabulary. It only became obvious over the last couple years how far behind his comprehension really is. When tested at around 4, he came out within normal limits (6 months behind) but had these weird gaps like he didn't understand "no".
Renee
You know, that's a good point. We are taking him for an orthopedic evaluation next month (the fun never stops, huh?) because he is due for some new ones. I guess he didn't complain or change his gait much last time because he wasn't walking very well yet. I'm just freaking out, I guess. But I do wonder why the dev. ped. was relieved to hear he wasn't toe walking? Was it just the ligament issue? I know, I should've asked, but I was a bit numb at the time. Thanks for your input.
Kellie