Walking on your toes could be a sign of autism or another developmental issue. However, toe walking is also common in very young children. Even persistent toe walking is not always a sign of an underlying condition.

Autism spectrum disorder (ASD) is a group of neurodevelopmental conditions that affect a person’s ability to communicate and interact socially. In addition to other symptoms, it’s not uncommon for an autistic person to walk on their toes.

Toe walking is a type of walking pattern where the heel does not connect with the ground. While common in very young children, walking on your toes could be an early symptom of autism if it persists beyond age 3.

Yes, toe walking can be one sign of autism. But toe walking is also typical in children just learning to walk, and most will outgrow it by age 2.

For some, persistent toe walking continuing beyond age 2 could be a sign of an underlying developmental condition, such as autism. Toe walking might also mean your child has tight Achilles tendons, or it could possibly signal cerebral palsy or muscular dystrophy. However, persistent toe walking is not always a sign of an underlying condition.

Toe walking could be a sign of autism if:

The reason why autistic children sometimes walk on their toes is still unknown, but it may be connected to the underlying differences in sensory responses experts often see in autistic people.

Is toe walking bad?

Autistic people may experience a great deal of social stigma and shame over the differences between themselves and neurotypical people. So it can be helpful to stay away from giving body processes moral labels, like “good” or “bad.”

However, if toe walking becomes someone’s primary way of moving around, it can lead to long-term balance issues, muscle weakness, and joint problems.

Unusual movement patterns are common in autistic people. In addition to toe walking, autistic children often have a wide stance and varied stride lengths in their walking pattern.

Autistic children and some adults may develop a unique gait pattern, which can be identified by:

  • a reduced stride length
  • an increased walking cadence or a bouncy pace
  • an increased variation in stride width

This movement strategy may be used to compensate for weaker muscles in the knees of autistic people. These gait differences can lead to less stability while standing or walking and an increased risk of fall-related injuries.

Occupational therapy helps people work on physical, social, cognitive, and motor skills needed in everyday tasks. The goal of occupational therapy is to help people become more independent and able to participate in different activities.

Occupational therapy can help develop motor skills and improve balance and coordination. Occupational therapists may use several different approaches to help improve autistic gait issues, including:

  • Exercise programs: The goal of these programs is to improve gait patterns and coordination. This can include lower limb strengthening, gait reeducation, balance, and proprioceptive training.
  • Sensory integration techniques: These strategies can help regulate sensory input and encourage more efficient movement. They may include activities like deep pressure touch, vestibular stimulation, and proprioceptive activities.
  • Behavioral interventions: Occupational therapists can use visual prompts, verbal cues, and positive reinforcements to promote a desired walking behavior.

Certain exercises may encourage stability and improve posture for autistic people. A few exercises to try at home are:

  • Bear crawls: These can develop body awareness, build trunk strength, and improve shoulder stability. To do them, start on all fours, then extend the hands and knees slightly and crawl forward. If this is too difficult, the yoga position downward facing dog is another alternative.
  • Heel walking: This can increase balance and coordination of the lower limbs. This exercise can be done on a gymnastics bench or any narrow plank. Walk slowly forward, placing one foot in front of the other, heel to toe.
  • Star jumps: Jumping exercises can improve body awareness and strengthen the legs and core. To do this exercise, begin in a crouched, squatting position, with the knees and arms tucked in. Then, jump up, extending all your limbs into an X shape, and then return to your starting position. If this is too difficult, try jumping laterally from one leg to another.
  • Stork stands: These can improve balance and coordination. To do this, stand on one leg for about 10 seconds per leg. To make it more challenging, try slowly moving the free leg to the front, to the side, and then behind the body without touching the ground.

Several other types of exercises can benefit autistic people and improve their posture and body awareness. Full-body exercises are best for autistic kids to increase strength and body awareness. Try to find exercises your child can do regularly and without stress.

Toe walking could be an early sign of autism, but it is also common in very young children still learning how to walk. If toe walking persists beyond age 2 or 3, it could be a sign of a neurodevelopmental condition. Persistent toe walking is not always a sign of an underlying condition, but it does warrant a professional evaluation.

When walking on toes and autism are connected, it is usually in combination with other symptoms of autism. Occupational therapy and various at-home exercises can improve gait and posture in autistic children or adults.