TOE WALKING: Doctor Attributes Toe Walking to Signs of Poor Vestibular Development

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular

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A little girl balances on her tip-toes. Given this simple sentence, most people will envision a little girl in a tutu, standing before a mirror and grasping a wooden bar. It’s common to find a ballerina on her toes. It’s also common to see very small children walking around on their tippy-toes, up until the age of three. But sometimes this is a tendency we see in kids over five and when that’s the case, it’s a sign that there may be something wrong.

Surprisingly, toe walking is not only a sign of a developmental delay in children; it is also a sign of a poor vestibular system, which is tied to a child’s balance and coordination. You may be asking yourself why balance and coordination is important and why it has anything to do with learning. If a child’s vestibular system isn’t working properly, we begin to see symptoms, like toe walking, poor behavior or learning challenges in the classroom. These signs mean that your child may have a disconnection in the brain preventing them from learning. We often see some of these symptoms in children with Autism, ADHD, Dyslexia, Dysgraphia, and Asperger’s. However, there are several mainstream children that may struggle with toe walking and vestibular issues as well.

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular | ilslearningcorner.com

Dr. Stephen M. Edelson, Ph.D., recently posted an article about toe walking that said, “Toe walking may be directly or indirectly related to a visual-vestibular problem.”

If toe walking is an issue in your home or with your students, it’s an instant trigger that tells us to look into larger learning issues with your child.

So now that we know toe walking could be a sign of a poor vestibular system, how do we know when it begins having an impact on our child’s learning? Here are some of the signs you may find in the classroom:

  • Needs glasses at a young age, typically between the ages of 3-6 (appears to be a vision problem).
  • Often says “huh?” or “what?” as if they didn’t hear the instructions the teacher is giving.
  • Struggles to copy information from the chalkboard to their paper.
  • Has trouble tracking words for reading and may have to blink to refocus their eyes on the page.
  • Often feels unbalanced, is uncoordinated or runs into furniture or desks at school.

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular | ilslearningcorner.com

What Causes it?

Toe walking has a wide range of causes from the serious side all the way down to virtually harmless. Here are a few of the common causes for toe walking.

Dysfunctional Balance System

For some children who walk on their toes, their inner ear may be to blame. The vestibular system in the inner ear is responsible for feeding the brain information on position and movement. If the information this system is providing isn’t correct, the brain may not even be aware that the feet aren’t walking in the most effective way. These children can be helped with a range of movement therapies.

Sensory Processing Issues

A Sensory Processing Disorder (SPD) can also be to blame for walking on tip-toes. If your child is oversensitive to touch, they maybe avoiding placing their heels down to avoid uncomfortable textures or discomfort they experience at their weight against their heels. These kids will also show aversion to socks, shoes or bare feet. Tactile therapy is usually helpful for the kids in this group.

Habit

We’ll leave off with one of the least alarming causes. Habit. If you have a tot that spend a lot of time on their toes, they may continue to walk that way simply because they’re used to walking that way.

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular | ilslearningcorner.com

How can we help toe walking?

While many doctors and professionals recommend surgery for this particular type of issue, we are still not focused on the real “toe walking problem.” The real issue we should be correcting is the child’s vestibular to help calm the symptoms of toe walking while helping them improve the learning challenges associated with the signs. Surgery or prism lenses may still be needed, however, using activities at home and in school can improve your child’s vestibular used for higher learning.

Dr. Edelson, also said, “The vestibular system provides the brain with feedback regarding body motion and position. It may be possible to reduce or eliminate toe walking by providing the person with therapeutic vestibular stimulation (e.g., being swung on a glider swing).”

If your child is prone to toe walking, there are exercises to do in your home that can help. These exercises will not only help them walk on their heels, they will also improve your child’s vestibular system.

Flippers

I recently talked with a mom who bought her child some scuba flippers and used them with her child at home. She said it was amazing how it was next to impossible for her child to toe-walk because flippers were created for walking heel to toe. It improved her child’s toe walking symptoms immensely.

Marching

Marching and stomping are actions that require the entire foot to make contact with the ground. They also can be made into a game. You can play music or sing songs to the beat of their marching. They can be in their own marching band or stomping trolls. They never need to know their working on their walking habits.

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular | ilslearningcorner.com

Climbing Hills

Running up hill stretches the tendon and muscle by keeping the toes pointed up. Once they’re at the top they can let loose and run back to the bottom, or my kids favorite, roll. With a little spotting they can also get the same exercise walking up slides or other inclines. These are also great activities that help them work out the toe-walking without them being any the wiser. You can just be the cool parent that encourages them to go up the slide instead of telling them no.

Shoes

You can purchase shoes with squeakers or wheels in the heels. For those that like the squeaky noises, they’re an incentive to get their heel to the ground. For those who aren’t swayed by the noise, the wheeled shoes are a good alternative. These shoes require kids to pick their toes up off the ground in order to roll. This gets them accustomed to the pressure on their heels as well as stretching that tendon.

Exposure

For the kids with SPD, you can encourage them to walk around barefoot on a variety of surfaces to expose them to different textures. Or you can make games. Have them walk through a gauntlet of textures from soft blankets to squishy shaving cream. They can also do art with their feet with a little paint and paper.

Driving

It’s never too early to teach them how to drive, right? Teaching them how to hold their feet while pretending to drive is another stretching exercise. They think they’re playing a fun game and they have your attention and you’re doing your part to help them out without a fight to complete special exercises.

Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular | ilslearningcorner.com


Integrated Learning Strategies is a Utah-based center dedicated to helping mainstream children and children with learning disabilities achieve academic success. Our services provide kids with non-traditional tutoring programs within the Davis County, Kaysville, Layton, Syracuse, Farmington, and Centerville areas. Areas to find Integrated Learning Strategies include: Reading tutors in Kaysville, Math tutors in Kaysville, Common Core Tutors in Kaysville, Tutors in Utah, Utah Tutoring Programs


Comments

  1. Wow I found this article to be very interesting. My 4 year old always used to walk on her toes, she does it rarely now. But she is very uncoordinated and clumsy and we recently found out she is far sighted and needs glasses.
    reesa recently posted…Rock the Holidays with Music FreedomMy Profile

    • That is very interesting! If she struggles with balance and coordination, that is usually a sign with our students that they need some extra help. I would definitely get the help she needs with the glasses, however, it sounds like she may have some trouble with vestibular, which typically manifests itself in vision. I’m sure the eye doctor is saying that it is a vision issue, but it could be more than that. As a parent, I would not only look into how glasses can help, but also how movement therapy can help that vestibular system as well. It will help improve her vision so she can track words on a page as well as her vision perception. For our students, they typically need a mixture of both. Let me know if you have any other questions!

  2. This post kind of alarmed me and also confused me at the same time. My girl used to do that a lot when she started walking which was at the age of 9 months. I never made her walk {against to my mom’s advises, she was certain that she should walk early and even bought her that stuff to help babies walk}, I have always sure that babies and kids have their own time and pace so I don’t need to push her. And Em always proved me right. She just stood up one day. She was sitting playing with toys and watching some baby shows and our of the blue she just stood up. Using only her legs, no hands, I was like WTH!!!! the she realized she was standing up and she let herself sit on her diapers LOL. After that she just started standing up and doing some steps. By next day she was already walking around. Short after that she started doing the toe walking until about the age of 2 maybe more but with really good balance. The one thing I never noticed on her is any symptom of something going wrong. She kept going so fats. She started talking at the aye of 1, I mean, communicating. water, mommy, daddy, names of her favorite shows, bottle, cereal. According to her pediatrician, she had way more vocabulary than regular. AT the age of 2 she already spoke like a 3 YO and right now we need to shut her up LOL {just kidding but she speaks non stop with a really fancy vocabulary} Her teachers say they need to double her class activities, because she finishes way faster than the rest and get bored while others finish. Not sure if that is a good thing. I just want her to be happy. At this point after reading this I got a little scared since I don’t know if there might be something hidden. I never thought of to walking as a sign of anything wrong, just a habit since that’s the position of toes in babies. I giggle when you say we we imagine the kids with tutu, she actually dance ballet and she’s the only one actually doing the tip tow walking. Her teacher thought he had done ballet before. Being a mom is so confusing! Thank you for this article.
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    • That is so cute! She sounds so adorable. I can picture her in that ballet tutu. Everything you have said seems like a normal development pattern. If she toe walked a little when she was a baby then that is normal. As long as she doesn’t show signs of toe walking now or learning delays, it sounds like she’s well on her way to developing as a strong student. It’s a good sign she is talking a lot and the teacher is giving her extra activities to keep up with her learning progress. I wouldn’t be alarmed. I think by now you would start seeing a lot of behavior that probably isn’t normal with speech, language, retention of letters/sounds, etc. if she had any trouble. How is her balance and coordination? That may help to know if she is good or struggles in those areas. From what you have said above, it doesn’t sound like she struggles with any of the issues we see at our center so I think she should be good. I’m always happy to answer any questions you have or help in any way I can.

  3. […] It being a holiday week I’m doing a ton of reevaluating and planning to start off the new year. This is on the top of my list to correct. So how perfect when I found this wonderful article!  […]

  4. […] Toe Walking: Doctor Attributes Toe Walking to Signs of Poor Vestibular […]

  5. […] Toe walking […]

  6. This article was very interesting. My daughter is 7 and I have noticed her toe-walking becoming a regular habit for at least 6 months. She has achieved milestones at a ‘normal’ or even early age, and is doing very well in school. She doesn’t seem to have too much trouble with balance or being clumsy. She’s fine in shoes, but when at home, she will usually walk around on her tip-toes unless she is reminded to walk on her heels. As a teacher with some experience with ASD students, she doesn’t appear to have any of those tendencies. I’m curious to hear your thoughts if you have the time. 🙂

    • Hi Lisa, great feedback! If she seems to have pretty good balance and auditory then she could have a retained primitive reflex (Plantar Reflex). You may want to try testing her for that to see if it stayed with her after birth. There are some exercises you can do at home to integrate the reflex so she no longer walks on her toes. It’s hard to know for sure without seeing her in person, but there are a few things on our website you can try to see if that might be the case. If you need more details, let me know and I’m happy to help.

  7. […] It’s true that sometimes it does just become habit. Can you click on sensory basics in the menu bar? Or any of the links to other sensory posts in this article? Is anything else ringing a bell for you in terms of more going on with sensory? Sometimes, which I didn’t mention here, walking on toes can be linked to vestibular. See this post for more on that and toe walking in general actually: http://ilslearningcorner.com/2015-12-toe-walking-doctor-attributes-toe-walking-signs-of-poor-vestibu… […]

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