Toe Walking in Autism

Accardo, Pasquale; Barrow, William J.

doi:10.1177/0883073814521298

Cited by 31 publications

(10 citation statements)

References 15 publications

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“…Infant fine motor skills in ASD-assessed via parent report and standardized assessment-have been linked to concurrent and future communication, especially to characteristics of language production (Gernsbacher et al, 2008;Hellendoorn et al, 2015;Leonard et al, 2015;MacDonald et al, 2013). A similar pattern is observed for gross motor ability: Better scores on gross motor assessments are associated with better communicative ability (Bedford, Pickles, & Lord, 2015;Leonard et al, 2015;MacDonald et al, 2013;Pusponegoro et al, 2016) albeit, with one exception (Accardo & Barrow, 2015). Notably, one study found that this relation held even after controlling for nonverbal IQ .…”

Section: Motor and Communication Developmentmentioning

confidence: 85%

Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta‐analysis

West

2018

Child Development

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Studies of infant motor development in autism spectrum disorder (ASD) have increased in recent years. This article synthesized this literature through meta-analysis to assess (a) whether infant motor ability differs in ASD relative to neurotypical controls; and (b) whether motor ability and communication are related in infants with ASD. Study 1 aggregated data from 1,953 infants with ASD (ages 3.0-42.0 months), and Study 2 included 890 infants with ASD (age 6.0-42.9 months). Study 1 revealed that infant motor ability differed significantly in ASD compared with neurotypical infants-this difference was robust to variation in measurement and design. Furthermore, this group difference amplified as age increased. Study 2 indicated that within ASD, infant motor ability and communication are related.

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Section: Motor and Communication Developmentmentioning

confidence: 85%

Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta‐analysis

West

2018

Child Development

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“…This could be a pragmatic way to monitor and describe TTB during daily living activities in ASD subjects. Moreover, it is known that persistent TW in children with autism may contribute to secondary motor deformity by producing a shortening of the Achilles's tendon [Accardo et al, ], but it is not clear why some TTB subjects develop heel muscle shortening and others do not. A possible contributing factor could be the time the children spend in TTB during the day when they remain in a standing position.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, in this study we found a directly proportional relationship between the presence of TTB and the severity of language delay in ASD children. Until recently, only a few authors suggested a possible relationship between these two elements [Accardo et al, ; Barrow et al, ], but systematic observations were never conducted, and no explanation has been provided. To our knowledge, this is the first study that analyzed, found and is able to confirm this relationship.…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, about 20% of individuals with ASD walk on their tiptoes [Barrow et al, ; Ming et al ] and this occurs in varying degrees of severity [Accardo & Barrow, ]. To be considered present, the duration of TW needs to be present for more than 6 months [Accardo, Monasterio, & Oswald, ]. Some authors describe TW as intermittent or persistent [Ming et al, ], while others grade TW using history and observation (e.g., as absent, present in the past, intermittently present, or persistent) [Accardo & Barrow, ].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of presentation patterns, clinical severity, and sensorial mechanism of tip‐toe behavior in severe ASD subjects with intellectual disability: A cohort observational study

Valagussa

Trentin²,

Balatti³

et al. 2017

Autism Research

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We assessed presentation patterns and characteristics of tip-toe behavior (TTB), more commonly known as toe walking, in a cohort of severe autism spectrum disorder (ASD) subjects with intellectual disability in two studies. The first study included 69 consecutive ASD subjects (57 males, mean age = 14 years-3.7 SD) under observation at our institute. A therapist assessed the presence of TTB during standing, walking, and running through direct observation and an interview with the subjects main caregiver. The prevalence of TTB was 32%. We found three clinical presentation patterns of TTB: (1) present when standing, walking and running (45.5%), (2) present when walking and running (18.4%), or (3) present only when running (36.4%). TTB subjects were more frequently nonverbal than those without TTB (72.7% vs. 44.6%-P = 0.03). On the other hand, no significant difference in ASD severity according to the ADOS scale was found between TTB and non-TTB subjects. In the second study, carried out in a subgroup of 14 ASD subjects (7 TTB and 7 non-TTB), we evidenced that a soft floor surface (foam mats) made a substantial difference in reducing the TTB phenomenon. TTB is frequently present in ASD individuals and may occur in three mutually exclusive modalities, which ultimately defines what is commonly known as toe walking. The presence of TTB seems correlated to the severity of language delay. Foot contact on soft surfaces reduces TTB both during static and/or dynamic tasks. Further evaluation is needed to clarify the potential pathophysiological implications of this phenomenon. Autism Res 2017, 10: 1547-1557. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

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“…Some researchers described TW as intermittent or persistent (Ming et al, ), while others graded TW using history and observation (e.g., as absent, present in the past, intermittently present, or persistent) (Accardo & Barrow, ). As it is known that persistent TW in people with autism may contribute to secondary motor deformity by producing a shortening of the Achilles's tendon (Accardo, Monasterio, & Oswald, ) it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative setting. Moreover, in a recent cohort study we observed that the condition is not necessarily related only to walking, since these children often also stand and run on their tiptoes.…”

Section: Introductionmentioning

confidence: 99%

Toe Walking Assessment in Autism Spectrum Disorder Subjects: A Systematic Review

Valagussa

Trentin²,

Signori

et al. 2018

Autism Research

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There is increasing evidence that autism spectrum disorder (ASD) subjects have also motor impairments. Toe walking (TW) is a phenomenon that can be found in ASD subjects during gait, even if this condition was found not to be necessarily related only to walking, since these children often also stand and run on their tiptoes. Since persistent TW in ASD subjects may contribute to secondary shortening of the Achilles's tendon, it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The aim of this systematic review is to critically evaluate and describe the methods employed to assess toe walking in ASD subjects. The systematic review protocol was previously registered on PROSPERO. We conducted an extensive literature search in PubMed, CINAHL, PsycINFO, The Cochrane Library, and Scopus databases. There were no restrictions on the types of study design eligible for inclusion. Ten studies were included in the systematic review. Risk of bias of the included studies was conducted using the following instruments depending on the study types: STROBE Statement, Cochrane risk of bias tool, and CARE checklist. Almost all the included studies (8/10) proposed a tip-toe behavior (TTB) assessment only during walking. Nine out of ten of the included studies assessed TTB using a qualitative methodology. The results evidenced the heterogeneity of qualitative methods and a lack of a structured quantitative test to assess toe walking in ASD subjects. Autism Res 2018, 11: 1404-1415. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY ABSTRACT: Toe walking (TW) is a phenomenon that can be found during ASD subject's gait. The persistence of this behavior may contribute to secondary Achilles's tendon shortening. In this perspective it becomes important to have an assessment tool and/or outcome measure for both the clinical and rehabilitative settings. The current systematic review aimed to describe the methods employed to assess TW. The results evidenced the lack and the need of a structured quantitative test to assess TW in ASD subjects.

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Toe Walking in Autism

Cited by 31 publications

References 15 publications

Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta‐analysis

Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta‐analysis

Assessment of presentation patterns, clinical severity, and sensorial mechanism of tip‐toe behavior in severe ASD subjects with intellectual disability: A cohort observational study

Toe Walking Assessment in Autism Spectrum Disorder Subjects: A Systematic Review

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