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The Autistic Toe Walking: A Narrative Review for Interventions and Comparison with Idiopathic Toe Walking
Luiz Renato Agrizzi de Angeli1,2, Bárbara Lívia Corrêa Serafim2, Julio Javier Masquijo3
1Department of Orthopedics and Traumatology, Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil.
Children (Basel, Switzerland)
|September 27, 2025
Summary
Interventions for Autistic Toe Walking (ATW) are limited, differing from Idiopathic Toe Walking (ITW). More research is needed to guide treatment for children with ASD and toe walking.
Area of Science:
- Pediatric Orthopedics
- Neurodevelopmental Disorders
- Gait Analysis
Background:
- Idiopathic toe walking (ITW) is a diagnosis of exclusion.
- Autistic toe walking (ATW) in children with Autism Spectrum Disorder (ASD) is debated as a distinct entity.
- ATW presents unique challenges with higher prevalence and resistance to conventional treatments.
Purpose of the Study:
- To review interventions for ATW.
- To highlight differences between ATW and ITW.
- To discuss clinical practice implications for ATW management.
Main Methods:
- A literature search was conducted.
- Included articles focused on interventions for toe walking in children with ASD.
Main Results:
- Limited and heterogeneous literature on ATW interventions.
- Interventions include physiotherapy, orthoses, botulinum toxin, casting, and surgery.
- Evidence of effectiveness is scarce; ATW differs from ITW in pathophysiology and presentation.
Conclusions:
- Evidence for managing ATW is limited.
- ATW has distinct characteristics compared to ITW.
- Future research requires standardized definitions and controlled trials.
