The birth of a child in itself begins an exciting journey for parents. Additionally, every milestone crossed by their little one brings in added excitement and a sense of achievement for the parents also.
When the child starts walking it is almost like winning a Nobel prize! This is one of the earliest awaited and the most awaited milestone in child’s life. Walking is usually attained in children at approximately 1 year of age. A normal child starts walking with both heel and toes touching the floor. At times child start walking on toes. Toe walking is quite common and a normal finding in young children upto 3 years of age. But toe walking persisting beyond 3 years is often associated with neurological immaturity. And if it is persisting beyond 3 years, your child needs evaluation by a paediatrician.
Dr. Jyoti Chawla, Sr. Consultant – Pediatrics, Paras Bliss Hospital says, “It can be a sign of neurological disorder like Autism in children. Autism spectrum disorder (ASD) is the name for a group of developmental disorders in which child has difficulty in communication, & social interaction and has characteristic repetitive behaviours. A dysfunctional vestibular system may be responsible for toe walking in them. Autism needs early diagnosis and management.”
· Limited interests.
· Repetitive body movements such as hand flapping.
· Sticking to routines such as doing things in exactly the same order every time.
· Sniffing objects or staring intently at moving objects.
· Avoidance loud sounds.
· Limited use and understanding of non-verbal communication such as eye gaze, facial expression and gesture.
· Difficulties forming and sustaining friendships.
· Don’t share enjoyment, interests and activities with other people.
· Delayed speech.
· Difficulties initiating and sustaining conversations.
· Repetitive use of language such as repeating phrases from television or repeating the being question asked.
Commenting on the management of Autism, Dr. Jyoti adds, “Autism requires team approach involving paediatrician, child psychologist and occupational therapist and speech therapist. Structured, educational and communication interventions are effective for many children with ASD. Several approaches are available with similar efficacy. Most important step in management of autistic child is schooling with normal children with individualised attention.”
Management of Tip Toe walking:
· Physical exercises are sometimes used to stretch out the tendon in order to reduce toe walking, but this treatment has had minimal success.
· Therapeutic vestibular stimulation (e.g. being swung on a glider swing).
· Visual problems to be assessed and rectify them with glasses.
· Plaster casting to stretch out the tendon. In most cases, the cast is applied every two weeks for a total of 6 to 8 weeks.
· Surgery in very few cases may be needed to release the tight tendon.