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Developmental implications of idiopathic toe walking
L H Shulman1, D A Sala, M L Chu
1Center for Neuromuscular and Developmental Disorders, Hospital for Joint Diseases, New York, NY 10003, USA.
Insights
Children with idiopathic toe walking often show speech and language delays. This condition may indicate broader developmental issues, warranting a full assessment.
Area of Science:
- Pediatric Orthopedics
- Developmental Pediatrics
- Speech-Language Pathology
Background:
- Persistent toe walking in children, without apparent neurological issues, is often evaluated in orthopedic clinics.
- The underlying developmental implications of idiopathic toe walking require comprehensive assessment.
Purpose of the Study:
- To investigate potential developmental delays in children with persistent toe walking.
- To assess language, motor, visuomotor, sensory integration, and behavioral development in this cohort.
Main Methods:
- A prospective study involving 13 children with idiopathic toe walking (mean age 3.9 years).
- Multidisciplinary evaluations included pediatric neurology, developmental pediatrics, speech/language pathology, occupational therapy, and physical therapy.
Main Results:
- Developmental screening revealed delays in 7/13 children and questionable delays in 3/13.
- Speech and language deficits were identified in 10/13 children (77%).
- Motor and visuomotor delays were noted in 27-40% of participants.
Conclusions:
- Idiopathic toe walking is frequently associated with speech/language delays.
- The condition may serve as an indicator for broader developmental challenges.
- Referral for developmental assessment is recommended for children with idiopathic toe walking.
Objective:
To determine whether children with persistent toe walking, without suspected developmental problems, and with normal results after neurologic examination, who were seen in an orthopedic clinic demonstrate delays in language development, gross or fine motor skills, visuomotor development, sensory integration function, or evidence of behavioral problems through a comprehensive multidisciplinary evaluation.
Study Design:
A prospective, descriptive study of 13 children (mean age = 3.9 years) referred for idiopathic toe walking. Each child was evaluated by a pediatric neurologist, developmental pediatrician, speech/language pathologist, occupational therapist, and physical therapist.
Results:
On developmental screening, 7 of 13 children demonstrated delays and 3 were questionably delayed; all 10 had speech/language deficits. Speech/language evaluation showed that 10 of 13 (77%) had receptive or expressive language delays or both. Occupational and physical therapy evaluations found 4 of 12 (33%) had fine motor delays, 4 of 10 (40%) had visuomotor delays, and 3 of 11 (27%) had gross motor delays.
Conclusions:
Idiopathic toe walking was most often associated with speech/language delays, but delays in other areas were also present. We suggest that idiopathic toe walking should be viewed as a marker for developmental problems and recommend that any child with this condition should be referred for a developmental assessment.