The use of a multiple schedule to decrease toe walking in a child with autism
A red-green wristband that tells a child when flat feet earn praise can wipe out toe walking in days.
01Research in Context
What this study did
The team worked with one preschooler with autism who walked on his toes most of the day.
They used a small wristband. When the band was red, the boy got praise for flat feet and a short “walk on your feet” reminder for toe walking. When the band was green, no feedback was given.
The researchers slowly made the red periods longer until the boy wore the band all day.
What they found
Toe walking dropped to almost zero once the red wristband stayed on.
The boy kept flat feet in new rooms and when his parents used the same wristband rule.
How this fits with other research
Wilder et al. (2022) got the same big drop in toe walking, but they hid rough tape inside shoes instead of using a wrist cue. Both studies show you can hit the same target with very different tools.
Valagussa et al. (2018) warned that most clinics eyeball toe walking with no numbers. Hodges et al. (2018) prove a simple wrist schedule can still work even without a fancy test.
Nava et al. (2016) used a three-color schedule to teach kids when teacher attention was available. Hodges copied that idea and aimed it at gait, showing the wristband trick travels across behaviors.
Why it matters
You can start Monday. Pick a small timer or colored bracelet. Set short “watch feet” periods and give quick praise or a calm correction. Lengthen the periods as the child succeeds. No extra gear, no data sheets needed—just a wristband and your eyes.
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02At a glance
03Original abstract
We evaluated a procedure in which a wristband worn by a young boy with autism signaled the availability of praise for appropriate walking and the delivery of reprimands for toe walking. In the absence of the wristband, no programmed consequences were delivered for appropriate walking or toe walking. Once toe walking decreased to criterion levels with the wristband on, we increased the number of steps during which the participant wore the wristband. Results suggest that the procedure was effective to decrease toe walking in both clinic and community settings. To assess generalization, we had the participant's mother implement the procedure; it remained effective when implemented by her.
Behavioral Interventions, 2018 · doi:10.1002/bin.1528