No products in the cart.
What is a Sensory Tip Toe Walker? Causes, Connections to ASD & Treatment Options
Understanding Sensory Toe Walking
Sensory toe walking is not the same as idiopathic toe walking (which has no known cause) or toe walking caused by medical conditions like cerebral palsy or muscular dystrophy. When a child walks on their toes for sensory reasons, it’s because of how their brain processes sensory information from their body and the world around them.
What Makes Sensory Toe Walking Happen?
Sensory toe walking happens because of how a child’s nervous system takes in and reacts to sensory information. Sensory-based toe walking does not go away on its own like normal toe walking does because it serves a neurological purpose for the child. Here are the main reasons:
Different Ways of Processing Sensory Information
Children who have trouble processing sensory information may see the world in a different way. Their brains may have trouble correctly processing sensory information, which can cause them to do things like walk on their toes to make up for it. For some children, toe walking gives them more sensory feedback that makes them feel safer and more aware of where their body is.
Proprioceptive Seeking
Our sense of proprioception tells us where our bodies are and how they are moving. Walking on your toes puts more pressure on your joints and muscles, which gives you more proprioceptive input. When children want this kind of sensory information, walking on their toes gives them better feedback about where their body is in space.
Tactile Defensiveness
Some children are more sensitive to touch, especially on the bottoms of their feet. When you walk on your toes, you make less contact with the ground, which makes your feet feel less uncomfortable. This is why you might notice that you walk on your toes more on some surfaces or when you’re not wearing shoes.
Processing in the vestibular system
Our sense of balance and where we are in space is controlled by the vestibular system. Children who have trouble processing vestibular information might walk on their toes to get more stability and control over their movements, which makes them feel safer when they are moving around.
“I’ve learnt that a lot of children who toe walk are actually looking for certain kinds of sensory input or trying to avoid feelings that make them uncomfortable. To be able to help, it’s important to know what the sensory root causes are.”
Signs of Sensory Toe Walking
- Walking on your toes for a long time after age 2 or 3
- Can walk flat-footed when reminded but quickly goes back to tiptoes
- More toe walking on some surfaces or textures
- Walking on your toes gets worse when you’re excited, anxious, or overstimulated
- Other behaviours that seek out or avoid sensory input are present
- Ability to stand flat-footed when still but rise to toes when moving
Sensory Toe Walking in Autism Spectrum Disorder (ASD)
Children with autism spectrum disorder walk on their toes much more often than children who are neurotypical. Studies show that up to 45% of autistic children walk on their toes, while only 5% of children without ASD do. This connection isn’t random; it has to do with the way people with autism process sensory information differently.
| Aspect | Sensory Toe Walking in ASD | Typical Toe Walking |
| Prevalence | 20-45% of children with ASD | Less than 5% of neurotypical children |
| Duration | Often persists beyond age 3-5 | Usually resolves by age 2-3 |
| Response to Cues | Can walk flat-footed when reminded but quickly returns to toes | More consistently responds to correction |
| Situational Factors | Often increases with excitement, anxiety, or sensory overload | Less affected by emotional state |
Self-Regulation and Stimming Behaviour
For a lot of children with ASD, toe walking is a way to stim (self-stimulate). Toe walking can give your nervous system predictable, rhythmic sensory input, just like hand-flapping, rocking, or spinning. Walking on your toes can help calm and organise your brain because it puts consistent pressure on your feet and gives you proprioceptive feedback.
Effect on Daily Life
Although sensory toe walking is not immediately detrimental, chronic toe walking may result in various complications:
Benefits of Addressing Toe Walking
- Improved balance and coordination
- Reduced risk of muscle shortening
- Better posture and alignment
- Enhanced participation in physical activities
- Reduced fatigue during extended walking
Potential Issues If Untreated
- Shortened Achilles tendon and calf muscles
- Less movement in the ankle
- Increased risk of falls and balance issues
- Difficulty with sports and physical activities
- Possible pain in the foot, ankle, and leg
Helpful Tips for Walking on Sensory Toes
To help someone who is sensory toe walking, you need to look at both the sensory needs that are causing the behaviour and any physical changes that may have happened. The best treatments use both sensory integration strategies and physical therapy techniques.
Approaches to Sensory Integration
Because sensory toe walking is caused by how the brain processes sensory information, sensory integration therapy can be very helpful. These methods are all about helping the nervous system process and react to sensory input more quickly.
Activities that help you feel your body
- Pushing, pulling, and carrying things that are heavy
- Jumping on crash pads or trampolines
- Push-ups against a wall and animal walks
- Weighted vests or backpacks (with help from a professional)
- Clothes that compress to give consistent proprioceptive input
Desensitisation of touch
- Walking barefoot on different surfaces, like sand, grass, and carpet
- Mats and stepping stones with different textures
- Foot massage with different types of pressure and textures
- Sensory bins for foot exploration
- Vibrating foot massagers (with supervision)
Physiotherapy Treatments
If you have tight muscles or bad movement patterns because you’ve been walking on your toes for a long time, physical therapy is very important. A qualified physiotherapist can figure out what your child needs and make a plan for how to help them.
Stretching Exercises
Stretching the Achilles tendon and calf muscles on a regular basis helps keep them flexible and able to move. These could be standing calf stretches, towel stretches, and ankle movements with help.
Strengthening Activities
Building up the muscles in the front of your shins (the anterior tibialis) helps keep your calf muscles strong. Heel walking, picking up marbles with your toes, and doing the ankle alphabet are all good exercises.
Gait Training
Certain exercises that encourage walking on your heels and toes help the brain and muscles learn new things. These could be walking up and down hills, stepping over things, or using visual cues on the floor.
The StandSure Board Can Help Your Child’s Therapy
Designed by a physiotherapist, this portable sit-to-stand aid stabilizes feet, promotes symmetrical weight bearing and heel strike, and supports aligned posture during exercises. When used alongside a qualified physiotherapist, it facilitates quicker progress in balance, coordination, and muscle memory.
Grounding Techniques
Grounding exercises help children pay more attention to their feet and how they touch the ground. These methods can be very helpful for sensory toe walkers who need to learn more about their bodies.
- Walking Barefoot: Spending time barefoot on different safe surfaces on a regular basis helps you become more aware of your feet and how they process sensory information.
- Mindful Foot Placement: Games that make you step on certain targets make you pay attention to how you walk.
- Heavy Feet Games: Pretending that your feet are “heavy like elephant feet” can help you touch your heels.
- Sensory Pathways: Making textured paths for walking gives you both tactile input and helps you walk correctly.
When to Think About Extra Help
If sensory and physical therapy don’t work, your doctor may suggest other treatments:
- Orthotic Devices: Custom foot orthotics or ankle-foot orthoses (AFOs) can help keep your feet in the right position and give them structural support.
- Serial Casting: A series of casts slowly stretch tight muscles and tendons for children whose muscles are very short.
- Specialized Footwear: Shoes with strong heel counters and good arch support can help your feet stay in the right position.
Helping Your Child at Home
It’s important to get professional help, but there are many things you can do at home to help your child make progress. When therapy sessions and everyday life are the same, it helps reinforce new ways of moving and processing sensory information.
Daily Activities to Support Progress
- Calf Stretches: Gently stretch the Achilles tendon and calf muscles for 30 seconds, two to three times a day.
- Sensory Play: To help children get used to different textures, let them play barefoot in sand, grass, or on textured mats.
- Balance Games: Standing on one foot, walking on lines, or using balance boards help you learn how to feel your body.
- Heel-Walking Races: To strengthen the muscles in the front of your legs, make a game out of walking on your heels.
- Toe-Grabbing Games: Games that involve grabbing things with your toes, like marbles or small toys, make your foot muscles stronger.
Creating a Sensory-Friendly Environment
Your home can either help or hurt your child’s ability to process sensory information. To make the space more helpful, think about making these changes:
Sensory Pathways
Make a sensory path with different textures, like foam tiles, carpet squares, and textured mats, to get children to explore and be aware of their feet as they move from one activity to the next.
Movement Breaks
To meet proprioceptive needs, plan regular breaks during the day for activities like jumping, climbing, and heavy work.
Visual Reminders
To help people become more aware, put friendly signs about “flat feet” or “heel walking” in places where toe walking happens a lot.
When to Get Help from a Professional
Some toe walking is normal in the early stages of development, but there are some signs that show you need to see a professional for help. Taking action now can help your child’s overall growth and keep problems from getting worse in the future.
Consult a healthcare professional if your child:
- Keeps walking on their toes after age 2–3
- More than half the time, Toe walks
- Shows toe walking that gets worse as you get older, not better
- Shows that the ankles are stiff or can’t move very much.
- Has pain or discomfort in their feet, ankles, or legs
- Has trouble with gross motor skills like balance, coordination, or others
- Shows other signs of having trouble processing sensory information or having developmental issues
What to Look Forward to at a Professional Assessment
A full sensory toe walking assessment usually involves a team of healthcare professionals working together to get a complete picture of your child’s needs:
- Pediatrician: Will check your child’s general health and may send them to specialists.
- Physiotherapist: Looks at muscle strength, flexibility, range of motion, and walking patterns.
- Occupational Therapist: Assesses how well you process sensory information, your motor skills, and how well you do everyday tasks.
- Developmental Pediatrician or Neurologist: May be involved if there are worries about neurological conditions that could be causing the problems.
The evaluation will probably include watching how your child walks, measuring how flexible their muscles and joints are, testing how well they process sensory information, and talking about their developmental history and daily activities.
Supporting Your Child’s Journey
The first step in helping your child move more evenly is to learn what a sensory tiptoe walker is. Keep in mind that sensory toe walking isn’t just a bad habit; it’s also a sign that your child has special sensory processing needs. Most children can make a lot of progress with the right mix of sensory integration strategies, physical therapy techniques, and helpful things they do at home.
The trip might take a while, and progress might not always be smooth. Be patient with problems and celebrate small wins. Children who walk on their toes with sensory issues can learn to move better, be more aware of their bodies, and feel more confident in their physical abilities with regular help and the right interventions.
Get Help from a Professional for Your Child
If you’re worried about your child’s toe walking, I suggest talking to a paediatric occupational therapist or physiotherapist who works with children who have trouble processing sensory information. The best results come from acting early. If you want to help your child with their therapy, the StandSure board is a excellent addition to a full treatment plan.
Common Questions About Walking on Your Toes Sensory
Is sensory toe walking always a sign of autism?
No, sensory toe walking is more common in children with autism (affecting 20-45% of children with ASD), but it can also happen in children with sensory processing disorder who don’t have autism. Some neurotypical children may also toe walk because of how they like to feel things. But if toe walking continues after age 3, a professional should look into it to find out why.
Can toe walking with sensory issues lead to long-term health problems?
If you don’t do anything about it, toe walking can cause shortened Achilles tendons and calf muscles, less range of motion in the ankles, balance problems, and pain in the feet, ankles, or legs. Early intervention helps avoid these physical problems while also meeting the person’s sensory needs.
How can physiotherapy help with toe walking that is caused by sensory issues?
Physiotherapy works on both the physical and sensory parts of toe walking. A physiotherapist can help with tight muscles by giving them stretching exercises, with weak muscles by giving them strengthening activities, with walking by teaching them how to walk with their heels and toes, and with sensory integration by addressing their underlying sensory needs. Adding tools like the StandSure board can help make therapy more effective.
What sets idiopathic toe walking apart from sensory toe walking?
Idiopathic toe walking is when someone walks on their toes for no known medical reason. Sensory toe walking is a type of toe walking that happens when a child’s sensory processing is different. They walk on their toes to get certain sensory input (like proprioception) or to avoid uncomfortable sensations (like certain textures). There are different ways to treat sensory toe walking. For example, it needs both physical and sensory integration strategies.
When should I start to worry about my child’s toe walking?
Children who are just learning to walk often walk on their toes, but this should get better over time. If your child is still toe walking after the age of 2 or 3, walks on their toes more than half the time, or shows more toe walking as they get older instead of less, you should talk to a doctor about it.
