There are multiple etiologies for toe walking, ranging from idiosyncratic habit to profound neuromuscular disease. The most commonly observed type of toe walking is idiopathic toe walking (ITW), whose true cause and prevalence is still unknown.
Having worked with a large population of toe-walking cases over the course of the last 50 years, many of these idiopathic cases were not actually “hard-ware” or muscular problems, but rather adaptations to distorted perception and kinesthetic need for orientation to gravity—a “software” problem. Approximately 75% of the time, ambient prism lenses will lead to an immediate change.
Persistent toe walking may impact a child’s safety or risk of falling, therefore, if a child over the age of 2 years old is still walking on their toes, they should receive a comprehensive and perceptual examination to rule in or rule out a visual processing component.
Treatment of Toe Walking
When a visual perceptual problem is detected the utilization of prism lenses and a visual management program to realter processing stimulus and organization can be extremely beneficial to an individual with idiopathic toe walking. As they begin to trust visual feedback, they’ll rely on the kinesthetic need less.
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