Evaluation of shoe inserts to reduce toe walking in young children with autism
Slipping rough tape inside sneakers can quickly stop toe walking in preschoolers with autism.
01Research in Context
What this study did
Wilder et al. (2022) tested cheap shoe inserts in two preschoolers with autism who walked on their toes.
They slid rough grip tape, the surface the kids used least while toe walking, inside everyday sneakers.
A hand-on-shoulder prompt was later added to see if the combo helped even more.
What they found
Toe walking almost vanished for one child and dropped sharply for the other once the inserts were worn.
Adding the light shoulder prompt pushed both kids’ toe walking even lower.
Parents could do the prompt at home with the same good results.
How this fits with other research
Hodges et al. (2018) got the same drop in toe walking with a wristband cue plus praise and a mild reprimand.
The two studies do not fight: one used social consequences, the other changed the feel inside the shoe.
Valagussa et al. (2018) warned that no standard toe-walking test existed; Wilder’s quick tally of steps on toes is still simple but gives at least one number to track.
Meier et al. (2012) also hid tech in shoes, yet they used sensors and fun stimulation for adults with multiple disabilities; Wilder shows a low-tech sheet of tape can work for tiny kids with autism.
Why it matters
You can try this next session. Trace the child’s foot, stick cheap grip tape where the ball of the foot lands, slide the insert in the shoe, and count toe steps for five minutes. If it works, teach parents to add a gentle hand on the shoulder when the heel still lifts. No wires, no apps, no extra staff—just a sheet of sandpaper and data.
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Join Free →Cut a palm-size oval of grip tape, place it under the ball of the foot inside the child’s shoe, and count toe-walking steps for the first five minutes of play.
02At a glance
03Original abstract
AbstractToe walking is relatively common among children with autism spectrum disorder and, if untreated, can contribute to a number of medical problems. Previous research has suggested that toe walking may vary by walking surface. Some (e.g., rough) surfaces may inhibit toe walking, whereas other surfaces may encourage it. In the current study, we first conducted a functional analysis screening to verify that toe walking exhibited by two young children with autism was maintained by automatic reinforcement. Next, we assessed toe walking on a variety of surfaces, including tile, artificial grass, and grip tape. Finally, we placed inserts of the surface associated with the lowest level of toe walking into each participant's shoes. The inserts were effective to nearly eliminate toe walking by one participant and reduce toe walking to low levels for the second participant. To decrease the second participant's toe walking further, we added a hand‐on‐shoulder procedure, which was also effective. We discuss the results in terms of the putative mechanisms responsible for the reduction.
Behavioral Interventions, 2022 · doi:10.1002/bin.1860