Autism and Other Conditions that Cause Toe Walking

Autism and Toe Walking

Autism is one of the most common conditions associated with toe walking. But wait mommas before you freak out and self diagnose your baby with autism or an autism spectrum disorder lets talk!

Every child when they take those first steps will start walking on their tip toes it’s normal! Our brains simply don’t know how to have a proper gait yet. Their brains haven’t developed a pattern of walking yet, so through trial and error their brains figure it out. Toe walking isn’t seen as abnormal until they are older than two. If your child is older than two years of age and toe walking it could be a sign of a developmental disorder, neurological conditions or other forms of developmental delays. Lets talk about a few of the different medical conditions and reasons behind toe walking.

Cerebral Palsy

This is the most common motor disability in childhood. CP is normally due to damage of the brain in the womb or at birth. The most common cause is reduced blood or oxygen supply which caused brain damage. The most common area damaged is the frontal lobe, which is responsible for your motor ability in the brain especially extension. This is why most people with CP will be in a flexed position including walking on their toes.

Idiopathic Toe Walking

This simply means your child is walking on their toes for an unknown cause. This means more than likely your child is 3 or older and they’ve tested for neurological conditions or other associated developmental disorders with no positive findings. While this is frustrating it’s actually a great thing. Most of these children have been tested for other underlying medical conditions and everything comes up negative. More than likely this means your childs frontal lobe just needs a little more input to help function. Physical therapy often times is great for these kiddos. I personally recommend chiropractic and functional neurology. Studies show the input from these types of therapy actually targets the frontal lobe. Often times these cases resolve themselves or resolve after a little outside help.

Muscular Dystrophy

This is a genetic disease that will cause progressive weakness and degeneration of skeletal muscle. As with most forms of degeneration it will hit your extensor muscles first, so they often get pointed out as toe walkers first and that leads in to testing which results in this diagnosis. Unfotunately with this disease their muscle tone continues to decrease over time. Physical therapy and early intervention can help maintain their mobility longer. There are a lot of research studies on MD and hopefully before much longer we’ll find a cure.  

Tight Calf Muscles

This typically is going to effect older children or adults more than it will your young children. In children often times this ends up being they spend too much time sitting down whether in school, in front of the TV, video games or whatever reason. When we sit too long especially in front of a screen our flexors become more dominant. When you sit your legs are bent which also causes shortening and lengthening of different muscles in your legs often times leaving the calves extremely tight. One of the best things to help this is movement, whether you do this on your own or through the help of a physical therapist is up to you. In adults or older children that the calves remain too tight and nothing is working some doctors will choose to do botox injections followed by physical therapy.

Short Achiles Tendon

This typically is a congenital condition. The achiles is the tendon that is formed by the calf muscles. The side that is shortened will have a tighter calf and will be the side that has the toe walking. Due to this being congenital the fix for this will require surgery to resolve the toe walking.

Dysfunctional Vestibular System

This means your body’s balance system is not functioning properly. Studies show that the ankles and hip have a bigger connection into your balance system areas (vestibular and cerebellum). If these areas in your brain aren’t functioning properly you tend to see hip and ankle problems. Early on this can be seen with toe walking or walking on the balls of their feet. Your doctor will need to perform a physical examination to determine the underlying cause of your dysfunction. Depenind on the cause often times they will refer out for vestibular therapy, occupational therapy or physical therapy. You can also look in to a Neuro-Ophthalmologist and see if prism lenses would help you.


Beautiful little girl with autism smiling as she is playing with a beach ball.

Autistic children or autistic people in general will often have toe walking as well as a lot of other symptoms.  Toe walking is just one sign of autism, and often times other signs before this have triggered you to think maybe your child has autism. One of the earliest signs in babies is actually muscle weakness. Their muscle tone is behind and so they don’t reach their developmental mile stones on time. Often times this can be seen in babies that fail to perform a pull to sit test. Over time your child’s development falls further behind.

Another sign can be sensory processing issues which means that the brain is processing sensory information differently. For autistic children their brains are flooded with sensory information and it becomes overwhelming, so you will start to see them act out or become anxious in over stimulating environments. Often times they will have language delays. This may mean they started talking later than they should or they struggle to put words together.

When your child actually starts walking, which was also probably delayed, you will notice they are doing persistent toe walking. This often becomes known as the autism walk, and often times for autistic children it’s actually a form of pleasure. When they walk on their toes it changes the amount of sensory information coming into the brain. At this point if you haven’t already you need to seek out a healthcare provider to have your child evaluated. The autism diagnosis often times doesn’t come as a surprise but it always helps to know what exactly is going on.

Toe Walking and The Brain

As you can see there are a lot of different reasons for your child to start toe walking. If they are not full toe walking, then most of these conditions will still change your child’s walking patterns in some form or fashion. The next question we should be asking ourselves is if there are so many different things that can cause a toe walking pattern what is the main reason for it?

You’ve heard me mention the frontal lobe a couple of times. Our frontal lobe is responsible for all of our conscious movement, our moods, and overall our personalities. In order to have healthy muscle tone you have to have healthy frontal lobes. Unfortunately, our world has become so technology based that kids are no longer being active or at least not as active as they need to be. One of the biggest things that drive our frontal lobes is movement. Getting your child up and moving and giving them positive reinforcement when they do is huge!

When you look at some of the conditions like CP, MD and Autism these kids often times have physical problems that don’t allow them to be active. Reaching out to a functional neurologist to help them get the sensory input into their frontal lobes will help your child greatly! For things like idiopathic toe-walking or tight calves being the cause of toe walking things like functional neurology or signing your child up in recreational activities can help and for some even get rid of the toe walking completely.

The Cerebellum

This area of the brain is another key factor in maintaining proper tone especially of our extensors. For years the cerebellum was really only thought to do balance but newer research shows that it has a major impact into our emotions as well. If your child has an unusual walking pattern due to toe walking or your child’s gait is off in other ways, it is very likely that the cerebellum is not getting the proper communication. Every piece of information coming in to the brain has to go to the cerebellum. If it is dysfunctional information coming in then it is dysfunctional going out. This is why it’s important to make sure each area of their brain is getting as much proper communication as possible.

Our cerebellum will maintain our posture or unconscious muscle which are for the most part extension muscles. If both the frontal lobes and the cerebellum play a key role in maintaining extension in the body you can now see if they aren’t functioning properly that the opposing muscles take over. Bring in the Flexors! In this case your calf muscles. This is why giving proper stimulus into the effected cerebellum and frontal lobe can have a dramatic impact on your child’s gait.

Making sure both sides of the cerebellum and frontal lobes are functioning properly will help with your child’s mood, balance, spatial orientation muscle tone, their social interactions, processing sensory information and so much more! If your child only has a sensory processing disorder and nothing else, then these two areas of the brain are 100% necessary to evaluate to help their brain learn to handle the environment around them.


As you can see there are a lot of different reasons your child may be toe walking. If you’re just now looking in to causes and you notice that your child has a few different symptoms that fall into the autism category then the next step would be making an appointment with your child’s doctor to have them evaluated. The amazing thing is regardless of the cause of toe walking chiropractic, functional neurology, physical therapy and physical activity have shown to make a significant difference in these children’s lives. Even neurotypical children that meet all their mile stones on time should be evaluated for proper muscle tone.

Unfortunately this type of care can be expensive, and not everyone can afford it. A great resource is a book called Disconnected Kids by Dr. Robert Melillo. It talks about the importance of these different areas of the brain and some at home work you can do to help your child even more. An even smaller step is to decrease your child’s screen time and increase their physical exercises. You should see a change in a lot of different areas of their life. I have witnessed a lot of children get rid of their toe walking and decrease a lot of the other symptoms stated above. Often times we look at a diagnosis and lose hope, but don’t forget that the diagnosis is just a name.

There are a ton of different things you can do to help your child have a better quality of life. You can also take a look at the Best Essential Oils that Help Children with Autism for a few more tools to help your child.

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