Toe Walking

[teacher2tx]

My nephews walk on thier toes constantly (ages 7 and 9).  I'm wondering if this is something that their parents should be concerned with.  I have ask if they have discussed this with their pediatrician and they said they never have and didn't seem very concerned about it at all.  Both of my nephews are very slow in developing their language skills also and I don't know if this is connected to the toe walking or not.  It's very hard to understand them when they talk and neither used complete sentences.  Is the toe walking something to be concerned about or am I over reacting.  I've heard that this can be a symptom of Autism.

[mgonzalezmd]

Toe walking can be seen in a variety of neurologic disorders, but I have seen it in normal children who have been thoroughly evaluated for it.  Cerbral Palsy is typcially at the top of the list of neurologic disorders that can cause this. In this case it is hard for the child not to toe walk due to increase muscle tone in his calf muscles.  So one thing to evaluate is whether the child can NOT toe walk.  The language delay also speaks to a more global neurologic problem.  A thorough evaluation by the pediatrician and possibly a pediatric neurologist and/or orthopedist,and possibly a genetics evaluation since 2 children are demonstrating similar abnormal finding.  

[mjcamps]

Autism makes up part of what is considered the Autism Umbrella.  There are many pervasive development disorders which make up this umbrella.  A child may have all or some and various degrees of symptoms.  My son is autistic and does not walk on his toes.  This in part led to the school misdiagnosing him as developmentally delayed.  It is awsome that you are aware of what is going on.  Suggest a CARS and GARS.  So that they can see his Autism Quotient.  Exe-  My son is 103 percent likely to be autistic.  There are treatments.  We use ABA (applied behavior analysis).  He can now ask and answer why questions.  This is something I did not think was possible.  
With the speech problem and toe walking autism or related disorders are extremely likely given their age.  If they have other issues not related to Autism.  It needs to be checked but toe walking could also be weak muscle disorders.

[Dazon50]

Your relatives are fortunate to have you looking out for your nephews.

What reasons did they give that they are not concerned enough to talk with the boy's Doctor?  At least they are aware of your concern. Maybe they are afraid to give voice to something they are not ready to face or maybe a family member was similar & grew out of it on the other side.

Do the boys receive any therapy for the language skill lag?  In diagnosing Autism or being on the spectrum, they do a thorough evaluation and look at many areas.
  http://www.cdc.gov/ncbddd/autism/hcp-dsm.html

It is interesting that the 2 are similar in those 2 specific areas but 2 yrs. apart.  Does the younger one look up to the older one?  What concerns me is that at their age, the language skills are behind.  My oldest was like that also, but she was diagnosed at 6 yrs. old.  She had someone to work with her on language development.

Social skills is a red flag for being on the spectrum.  Do they interact with each other and/or others in school/home?  If you find it hard to understand them, maybe others are if there is a social problem.  That may be your inroad when talking with your relatives to them re-thinking things over.

Thanks for sharing and please keep us posted.  I hope things work out.  Do you get to spend much time with your nephews?  

Just a suggestion:  if you are close and get to spend a lot of time with them, you could do some research on language skill development and look at the activities they have & adapt according to the preferences of your nephews (what they like to do).

I focused on language & speech with my oldest & now she is quite a verbal young lady...lol.  It took lots of work over the years.