toe walking in children with autism

[julhay]

Hi Everyone,

I thought I'd add my bit. I'm an occupational therapist working with children with autism, some of whom toe walk. For starters, SPD is not yet a recognised diagnosis so while we may describe a child as having SPD, we do not diagnose them with it. A child's sensory processing and sensory integration is assessed by using the Sensory Integration Praxis Test (SIPT) or more commonly the Clinical Observations (a non standardised ax originally developed by A Jean Ayres). This information is collated with the results of the sensory profile mentioned previously and general observations of the child's function in different settings (school, clinic, home etc.).

I have been working on the hypothesis that toe walking is a sensory seeking behaviour, with the child seeking deep pressure, proprioceptive or vestibular stimulation (or all three). All of the children I see have significant sensory processing dysfunction and this hypothesis is in line with their overall sensory profile. In terms of treatment, I use a sensory diet along with the Wilbarger Brushing Protocol and I have also been using Kinesio Tex Tape to inhibit gastroc/soleus and facilitate tib. anterior. The sensory diet and Wilbarger Protocol improve a child's sensory integration and decrease sensory seeking behaviours. The Kinesio tape increases proprioception to the muscles as well as utilising the specific muscle application. Within treatment sessions we frequently use vestibular, proprioceptive and deep pressure stimulation.

I realise that there is no significant scientific research to support this, as I said this is just a hypothesis. I have however, seen a decrease in toe walking and improvement in gait stability in the children I have been treating.

Julia

[estherderu]

Dear Julia,
thank you so much for your imput.
I have been researching the (kinesio) elastic therapeutic tape for a while now. Have come to believe that it doesn't always matter in which direction the tape is applied.
Have you tried different directions or just kept to the (kinesio) protocol?
I have been wondering if taping either only the tibialis or the triceps would make the same difference.

Have also thought about using other/nieuw tape applications. have done so and so far the results have been meager.
Could you tell me a little more about the number of patients you have used tape on and your success rate?
If you are interested in the "new" applicaties, please leave me you email address and I will send them to you.

kind regards

Esther

[Bobby Nabeyama]

Hi Everyone,

I thought I'd add my bit. I'm an occupational therapist working with children with autism, some of whom toe walk. For starters, SPD is not yet a recognised diagnosis so while we may describe a child as having SPD, we do not diagnose them with it.

Unfortunately, therapists including OTs diaganose SPD as if it is recognized.

A child's sensory processing and sensory integration is assessed by using the Sensory Integration Praxis Test (SIPT) or more commonly the Clinical Observations (a non standardised ax originally developed by A Jean Ayres). This information is collated with the results of the sensory profile mentioned previously and general observations of the child's function in different settings (school, clinic, home etc.).

Unfortunately, the SIPT is not used much nor is it validated for what is currently looked upon as SPD, there are no clinical observations to validate SPD, and the Sensory Profile merely provides subjective measures to hypothesize SPD even if the child may not have SPD.

I have been working on the hypothesis that toe walking is a sensory seeking behaviour, with the child seeking deep pressure, proprioceptive or vestibular stimulation (or all three). All of the children I see have significant sensory processing dysfunction and this hypothesis is in line with their overall sensory profile.

This hypothesis does not have the empirical backing by way of literature, scientific, and theoretical support to suggest any validity.

In terms of treatment, I use a sensory diet along with the Wilbarger Brushing Protocol and I have also been using Kinesio Tex Tape to inhibit gastroc/soleus and facilitate tib. anterior. The sensory diet and Wilbarger Protocol improve a child's sensory integration and decrease sensory seeking behaviours. The Kinesio tape increases proprioception to the muscles as well as utilising the specific muscle application. Within treatment sessions we frequently use vestibular, proprioceptive and deep pressure stimulation.

That protocol is antiquated without any validity and should not even be mentioned in therapy anymore.

I realise that there is no significant scientific research to support this, as I said this is just a hypothesis. I have however, seen a decrease in toe walking and improvement in gait stability in the children I have been treating.

Julia

You should be commended to at least know and admit that there is no significant research to back such mentioned hypotheses.

However, to suggest that practicing protocols based on admitted unfounded hypotheses are purely rationalizations. Therapists need to move away from rationalizations. We can rationalize anything to make something sound good, make sense, appear acceptable and intuitive.