Date Presented 04/04/2025
This study examined patterns of sensory integration (SI) functioning in children with idiopathic toe-walking, a common problem in children with SI dysfunction. Nearly all children demonstrated somatodyspraxia and bilateral motor coordination challenges.
Primary Author and Speaker: Teresa A. May-Benson
Additional Authors and Speakers: Aymen Balikci
BACKGROUND: Children with sensory integration challenges typically demonstrate postural-ocular challenges associated with vestibular-proprioceptive sensory processing difficulties. Toe-walking is one such behavior, however, there is debate about which sensory-motor challenges contribute to this problem.
PURPOSE: The purpose of this paper was to examine patterns of sensory integration functioning present in children with idiopathic toe-walking.
DESIGN: A quantitative descriptive study was completed.
METHOD: 27 children with idiopathic toe-walking (age M = 6.4, SD = 1.6, Range 4 – 9 years; 23 males) were identified as part of a larger study. Informed consent was obtained. Each child was administered the Sensory Integration and Praxis Tests (SIPT) by a qualified therapist. Primary test scores representative of the SIPT patterns of dysfunction were examined across all participants.
RESULTS: 24 participants met the criteria for Somatodyspraxia, (e.g. had scores below -1.0 on 1 or more tactile tests, e.g. Graphesthesia or Manual Form Perception, and Postural Praxis). The other three participants had Postural Praxis scores in the -.70 range. All but five participants scored low on Oral Praxis and Bilateral Motor Coordination tests. All but six participants scored low on Standing and Walking Balance. Less than half had low scores on Post-Rotary Nystagmus (n – 12).
CONCLUSIONS: These results suggest that children with idiopathic toe-walking have decreased tactile processing, and postural and oral praxis challenges consistent with Somatodyspraxia. Bilateral motor coordination challenges and decreased vestibular-proprioceptive processing were present in some children.
IMPACT FOR PRACTICE: This is important for therapists to know as improvement of tactile discrimination skills, body scheme, and praxis skills may help decrease toe-walking in these children.
References
Bauer, J. P., Sienko, S., & Davids, J. R. (2022). Idiopathic Toe Walking: An Update on Natural History, Diagnosis, and Treatment. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 30(22), e1419–e1430. https://doi.org/10.5435/JAAOS-D-22-00419
De Oliveira, V., Arrebola, L., De Oliveira, P., & Yi, L. (2021). Investigation of muscle strength, motor coordination and balance in children with idiopathic toe walking: A case control study. Developmental Neurorehabilitation, 24(8), 540–546. https://doi.org/10.1080/17518423.2021.1899326
Donne, J. H., Powell, J. A., Fahey, M. C., Beare, R., Kolic, J., & Williams, C. M. (2023). Some children with idiopathic toe walking display sensory processing difficulties but not all: A systematic review. Acta Paediatrica, 112(8), 1620–1632. https://doi.org/10.1111/apa.16821
