Why does He Walk Like That? Point Gait and Sensory Profile
DOI:
https://doi.org/10.25759/spmfr.422Keywords:
Autism Spectrum Disorder, Child, Movement Disorders, Toes, WalkingAbstract
Toe walking (TW) is the absence of normal heel-to-floor contact during the initial phase of the gait. It can be normal during the motor learning, associated with different pathologies or it can be idiopathic (ITW). The therapeutic approaches are either conservative or interventive.
TW is commonly observed in children with autism spectrum disorder and it can be possibly related to sensory processing disorders (SPD).
This article describes a clinical case of a child diagnosed with ASD, TW and SPD, preceded by a literature review on the topic.
It has been described by some authors that children with TW seem to have subtle sensory disorders, such as vestibular and proprioceptive input seeking and tactile hypersensivity.
The clinical case describes a 4 years and 9 months old boy, diagnosed with ASD and TW. The SPM-P results showed a tactile over-responsivity, a proprioceptive and vestibular input seeking, associated with difficulties with ideation and motor planning (praxis).
Although it seems to be an association between TW and SPD, data is scarce, with many limitations. If a consistent association was found, conservative management could be a reliable option, namely Occupational Therapy with sensory integration.
Downloads
References
Morozova M, Chang, F, Brown, E. Toe Walking: When Do We Need to Worry?. Curr Probl Pediatr Adolesc Health Care. 2017; 47: 156-60. doi:10.1016/ j.cppeds.2017.06.004.
Pomarino D, Ramírez Llamas J, Pomarino A. Idiopathic Toe Walking: Family Predisposition and Gender Distribution. Foot Ankle Specialist. 2016; 9: 417– 22. doi:10.1177/1938640016656780.
Leyden J, Fung L, Frick S. Autism and toe-walking: Are they related? Trends and treatment patterns between 2005 and 2016. J Child Orthop. 2019; 13: 340-5. doi:10.1302/1863-2548.13.180160.
Williams M, Tinley P, Curtin M, Wakefield S, Nielsen S. Is Idiopathic Toe Walking Really Idiopathic? The Motor Skills and Sensory Processing Abilities Associated With Idiopathic Toe Walking Gait. J Child Neurol. 2013; 29: 71-8. doi:10.1177/0883073812470001.
Accardo J, Barrow W. Toe walking in autism: further observations. J Child Neurol. 2015; 30: 606–9.
Roley SS, Schaaf RC. Evaluating sensory integration function and dysfunction. In: Schaaf RC, Roley SS, editors. Sensory Integration: Applying Clinical Reasoning to Practice with Diverse Populations. Austin: TX: Pro-ed; 2008.
Caserta AJ, Pacey V, Fahey M, Gray K, Engelbert RH, Williams CM. Interventions for idiopathic toe walking. Cochrane Database Syst Rev. 2019;1:CD012363. doi:10.1002/14651858.CD012363.
Dietz F, Khunsree S. Idiopathic toe walking: to treat or not to treat, that is the question. Iowa OrthoJ. 2012; 32: 184–8.
Jorquera-Cabrera S, Romero-Ayuso D, Rodriguez-Gil G, Triviño-Juárez JM. Assessment of Sensory Processing Characteristics in Children between 3 and 11 Years Old: A Systematic Review. Front Pediatr. 2017;5:57. doi:10.3389/fped.2017.00057.
Montgomery P, Gauger J. Sensory Dysfunction in Children Who Toe Walk. Phys Ther. 1978; 58: 1195-204. doi:10.1093/ptj/58.10.1195.
Ganley J, Behnke C. Distal Vibration Perception Threshold in Children Who Toe Walk. Pediatric Phys Ther. 2016; 28: 187-91. doi:10.1097/pep. 0000000000000241.
Williams CM, Tinley P, Curtin M. Idiopathic toe walking and sensory processing dysfunction. J Foot Ankle Res. 2010;3:16. doi: 10.1186/1757- 1146-3-16.
ZERO TO THREE. DC:0–5 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. Chicago: ZT; 2016.
Icdl.com [homepage na Internet]. ICDL - DIR Floortime. [Acesso Julho 2020] Disponível em: http://www.icdl.com.
Karim, E, Mohammed H. Effectiveness of sensory integration program in motor skills in children with autism. Egypt J Med Hum Genet. 2015; 16: 375- 80. doi:10.1016/j.ejmhg.2014.12.008.
Downloads
Published
How to Cite
Issue
Section
License
Copyright statement
Authors must also submit a copyright statement (as seen below) on article submission.
To the Editor-in-chief of the SPMFR Journal:
The below signed author(s) hereby state that the article
________________________________________ (ref. MFR_________) is
an original unpublished work and all facts stated are a product of the author(s) investigation. This article does not violate any copyright laws or privacy statements. The author(s) also hereby confirm that there is no conflict of interest's issues in this article.
By submitting this article the author(s) agree that after publication all copyrights belong to the SPMFR Journal.
Signed by all authors
Date:
Names (capital letters):
Signatures:
The SPMFR Journal’s contents are follow a Creative Commons licence. After publication the authors can hand out the articles as long as the SPMFR Journal is credited.