Toe walking. A marker for language disorders in the developmentally disabled

Toe walking unassociated with an autistic disorder or cerebral palsy generally has been considered a normal infant gait. The incidence of toe walking in various diagnostic subgroups of 799 developmentally disabled children presenting to a tertiary-level multidisciplinary assessment clinic was reviewed to investigate the authors' clinical impression that toe walking may be a marker for language dysfunction. Toe walking was found to be more frequent in those diagnostic subgroups with more severe language disorders. Toe walking also correlated with lower IQ scores (p less than 0.0001). The sensitivities, specificities, predictive validities and odds ratios all supported the hypothesized association between toe walking and language disorders. Further prospective studies of the neurodevelopmental outcome of children with toe walking are needed to determine whether this behavior can identify children at risk for language disorders.