Needing Some Unbiased Input

[Aurora11]

Hey everyone!  I have a little boy that is almost 3.  I have a few concerns about his development and need an unbiased opinion.  My husband says I'm being ridiculous and I agree that I'm a worrier.  I also have a young infant so I'm more stressed than usual and therefore, even more prone to worry.

My main concern is that he frequently walks on his toes.  It started around 6 months ago (age 2.5) and coincided with the fall/winter so I at first I assumed he was just trying to avoid stepping on long pants after being used to shorts, but now it has become a habit.   I would say he walks on his toes 30-40% of the time when we are at home.  If we ask him to walk flat footed he will. 

As to his other areas of development:

Verbally:  Has some difficulty with "s" and "f" sounds, but otherwise speaks in 6-7 word sentences, has a large vocabulary and converses well with us (for an almost 3 year old).   He was a late babbler (didn't start truly babbling until 11 months and then started with words), but has hit all other language milestones right when he should.   He does sometimes repeat what we say.

Socially:  He is a bit shy, but once he warms up to people he is fine.  He likes to play with his cousins and little friends at preschool.   Loves cars, trucks, trains and animals.  He loves playing pretend.  Can be somewhat rough with his cousin when they play and also enjoys poking at his new little sibling, but teacher says he has no problems with being too rough at school. 

Physically:  He's been average to the late end of average with gross motor milestones (i.e. walked at 13.5 months), but I've attributed this to just being cautious when trying new things.  One thing he is not doing very well is jumping with two feet off the ground.   I'm wondering if this could have something to do with the toe walking?  His fine motor skills have always been ahead of scheudle.

Cognitively:  Knows his colors, shapes, letters, most of his letter sounds.  We are working on numbers, but he is not as interested in those as with letters, etc.   He has been potty trained since he was 26 months old. 

Behaviorly:  Seems pretty typical.  Listens ok when he wants to.  He is a great eater and great sleeper.   Some temper tantrums, but nothing out of control.  In the past few weeks we've seen less tantrums and more anger being expressed verbally (i.e. "Go Bye-Bye Daddy, Go down the basement stairs." or "You are not nice anymore Mama.")  Lovely.  He is definitely into asserting his independence these days and is driving me a bit crazy with needing to do EVERYTHING himself.   I'm not sure whether some of this is related to a new sibling though.

I know that toe walking can be a sign of being on the spectrum.  I've taken assessment tests and other than the toe walking and the late babbling, I'm not seeing much else.  Not repetitive behaviors, no lining up things.  He's smiley and makes good eye contact.    Maybe I'm missing something here though.  Has anyone had much experience with toe-walking?   Is it something that was your first sign something was wrong or just one sign of many?  Thanks SO much. 

Also, he has his 3 year appt in a few weeks so I will definitely bring up the toe walking with my dr. in case it is a physical issue. 

[bonamarq]

He sounds totally normal to me! The toe walking is not that big of a deal - yes it is seen in many kids on the spectrum, but it's seen often enough int he general population that it's not something diagnosticians consider anymore (I think they did at one time, but the more we learn ...) Just keep reminding him to walk on his heels and yes, bring it up with dr.

I would say you can stop worrying but it's always good to watch their development...

[asraidevin]

The toe walking can become a problem because muscles won't develop properly. I had a chat with a friend of a friend whose daughter  had the habit.

But the rest all great. I would not worry at all . In fact I'd congratulate myself for raising a great little boy.

[MotherWhimsey]

He sounds very normal. Walking at 13.5 months is nowhere near late. Anything before 18 months is totally normal.

My son wears braces for toe walking but for him it wasn't so much the toe walking that was the main problem but that he toe walks to compensate for weak muscles. So his weak muscles got weaker and the other muscles got stronger and eventually he couldn't be flat footed comfortably. He walked tip toed probably over 95% of the time though and like I said, it was to compensate for another problem.

I'd say as long as your son walks flat footed a good bit, you know he can. I'd just remind him to walk flat footed whenever you see him tip toed and just leave it at that. But it sounds fine to me right now.

[PikkuMyy]

I do therapy with children with autism and your son sounds very typical.

I'd say that toe-walking is pretty low on my list for red flags and wouldn't make me thing of autism unless there are other symptoms as well. I even toe walk myself about 25% of the time at home.

[Emmeline II]

Toe walking alone is not a good indicator.

I think that his being able to function at school academically and socially, and his behavior at home is typical are signs that his development is fine.

[askew]

Sounds totally typical to me. I walk on my toes. So does my 4 year old. Some people are just toe walkers. 

[LynnS6]

Toe walking can be sensory in nature -- the bottoms of your feet are incredibly sensitive and if someone is hypersensitive to touch, they might toe walk to avoid feeling things on their feet.

However, toe walking alone isn't diagnostic of anything. Do you know if he does it while he's got shoes on or only without? If it's a 'habit', you might consider some soft-soled shoes for indoor wear to get him out of the habit. If he is still toe walking in 2  years, you can have him evaluated by a physical therapist. You should bring up your concerns about the toe walking and the jumping at his 3 year visit, but I wouldn't worry too much about it.

Everything else is on target or ahead for his age from what I know (the sounds he can't do are late developing sounds, he's got good language, typical emotional/social development (3 year olds were designed to drive us all mad, in my opinion).

[KCMichigan]

Originally Posted by askew 

Sounds totally typical to me. I walk on my toes. So does my 4 year old. Some people are just toe walkers. 

If you- as an adult toe walk and your 4 yr does as well. You should talk to your family dr.

Chronic toe walking (as in for a year+) can cause tightness in the tendons as well as knee/hip pain.

My DD's PT said it is developmentally normal for kids to experiment on toe walking, but chronic toe walking (and past age 3+) can be an indicator of weak core muscles and can cause underdeveloped tendons/musculature that long-term (were talking years+) can cause problems down the line w/ pain. DD has mild CP & SPD (hence the toe walking) she compensated for weak core muscles by toe walking (she toe walked exclusively for over year+), she still toe walks w/o shoes and has shortened tendons. We actively have to do stretches to help prevent problems.

They often have shoe inserts and therapudic taping to help.

Toe walking is different than pronation (walking on sides- inside oroutside) of the foot.

[sbgrace]

I don't see spectrum flags in your description. You might try this to see if you're missing something but nothing you said makes me think spectrum. http://www.childbrain.com/pddassess.html

However, I do think looking into the muscle tone/gross motor is a good idea. Not being able to jump at 3 generally would be a flag for muscle tone (low) issues and you've got the toe walking to boot. I would speak with his pediatrician about having a children's orthopedics look at the toe walking and a physical therapy consult to look at muscle tone and toe walking from that angle. It could certainly be sensory but combined with the jumping I would first think about physical causes. He may just need need orthotics (shoe inserts)--this isn't panic material but it is something you want checked out.