Neuropsychiatric symptoms and problems among children with idiopathic toe-walking

J Pediatr Orthop. 2012 Dec;32(8):848-52. doi: 10.1097/BPO.0b013e31826bec08.


Background: Idiopathic toe-walking (ITW) is a condition in which otherwise healthy children walk on their toes. The diagnosis is a diagnosis of exclusion. The aim of this study was to elucidate the occurrence of neuropsychiatric symptoms among 5- to 13-year-old children with ITW.

Methods: Fifty-one consecutive children (31 boys, 20 girls) with a mean age of 9 years and 1 month were referred to a pediatric orthopaedic unit for ITW. Evaluations included assessments by a pediatric orthopaedic surgeon and a pediatric neurologist and the parents were asked to complete the Five to Fifteen questionnaire, a validated screening tool for neuropsychiatric problems. The study cohort was compared with an age-matched normative group previously described.

Results: In the study group, the percentage of children scoring above the 90th percentile, indicating difficulties, were for the different domains; motor skills 39.0%, executive functions 17.6%, perception 25.5%, memory 23.5%, language 23.5%, learning 25.9%, social skills 25.5%, and emotional/behavioural problems 21.6%.

Conclusions: Children with ITW as a group displayed more neuropsychiatric problems than a normative group of age-matched children. These findings merit future larger studies. Furthermore, when children with ITW are referred for orthopaedic or neurological assessment, a structured neuropsychiatric history is advisable and further neuropsychiatric investigations should be considered.

Level of evidence: II.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Executive Function*
  • Female
  • Humans
  • Interpersonal Relations
  • Language Disorders / epidemiology
  • Learning Disabilities / epidemiology
  • Male
  • Memory Disorders / epidemiology*
  • Motor Skills Disorders / epidemiology*
  • Perception
  • Surveys and Questionnaires
  • Toes
  • Walking* / psychology