When does toe walking become problematic in children?

Learning to walk is a major milestone in a young child’s life. Parents eagerly await this milestone, but then may quickly fret when toddlers become so fast on their feet that they become difficult to catch.

As children learn to walk, they may demonstrate a type of walking known was ‘toe walking.’ This is walking on the toes or the ball of the foot rather than having the heel and bottom of the foot touch the ground. Although toe walking can be an entirely natural way to develop normal walking patterns, sometimes it can be a sign of autism or other neurological conditions. Naturally, parents may grow concerned if they see their toddlers repeatedly walking around on their toes.

The Mayo Clinic reassures that walking on the toes or the balls of the feet is fairly common for initial walkers. Many children outgrow toe walking after age 3. However, some children continue to walk on their toes beyond toddlerhood. WebMD says that more than half of young children who toe walk will stop by age 5. Even these children may be completely healthy and developing normally. Toe walking may be a behavioral habit and nothing to be concerned about.

According to a study of 1,400 children in Sweden, nearly 5 percent of all young children had toe walked at some time. Former toe walkers did so for one to two years before walking normally. Children still walking on their toes after age 5 only did so about 25 percent of the time.

According to the Children’s National Medical Center, many children who toe walk do not have developmental or neuropsychiatric problems, especially when toe walking is an isolated abnormality. However, those who exhibit other developmental delays or symptoms of neurological immaturity may require further testing. Toe walking is sometimes a symptom of muscular dystrophy, cerebral palsy or autism.

According to the Autism Research Institute, toe walking may be a result of a dysfunctional vestibular system, which is quite common in autism. The vestibular system provides the brain with feedback regarding body motion and position. Children with autism may not be receiving the right body motion and positioning signals and begin compensating through toe walking.

With cerebral palsy, toe walking can be caused by abnormal development in the parts of the brain responsible for controlling muscle function. Toe walking with muscular dystrophy can occur when muscle fibers weaken over time.