Toe walking & Developmental delays

It could be something called Sensory Integration Dysfunction. If so, this is something an Occupational Therapist would diagnose and treat. See if you can find a copy of _The Out-of-Sync Child_ by Carol Kranowitz.

Your son sounds like mine—with auditory and visual processing deficits as well as the toe walking. The toe walking is often linked to sensory integration problems, as the other poster said. My son has sensory integration problems focused on the vestibular (balance) system. In his case, at least, it has been the vestibular system which has been the key to remediating his problems. We have come a long ways, although we aren’t there yet. An OT can diagnose sensory integration problems. We had an OT evaluation done with that diagnosis. Just make sure the OT has training in sensory integration—not all do.

We ended up doing a vestibular focused interdisciplinary therapy called Neuronet instead of OT. It has been the best thing we have done. We have seen really fundamental changes in our son. You might look at www.neuroacoustics.com for information.

I have the book the book the other poster recommended. My son really doesn’t sound like the description except for the part on how the vestibular system interacts with auditory and visual processing. My son was an expert at compenstating. He rode a bike at 4 but always fast. As it turned out, he was simply incapable of riding slowly until we had done several months of Neuronet therapy.

It is a tough road with both auditory and visual processing issues. I know. Just to give you some encouragement though— my son, also 8 1/2, who we have been working with extensively for a little over a year now is reading well enough to be in the lowest reading group in his third grade class. This is quite an accomplishment for a child who entered second grade as a nonreader.

Another source of toe-walking has been shown to be gut related. Apparently by toe walking they change their stance and alleviate pressure felt in the bowel from fecal impaction. This is not to say that is the only reason, and it may not be the case in your child. But you may want to rule out the possibility. A clear indicator of this would be chronic loose stool (fecal impaction does not necessarily cause extreme constipation until such time as the bowel is completely blocked).

This is a common occurance in children on the Autism Spectrum. Many children who are very high functioning are not seen as being on the Specrum, but processing deficiets also go hand in hand with ASD. Might be something to look into.

Hi Beth, Thanks to you and the others for taking the time to write and giving me a direction to explore. I am curious about your son’s improvement, Beth. Do you attribute his reading and writing improvement to the Neuronet program or are you also doing another type of remedial work that could be contributing to the changes. I visited the site you recommended and have requested more info, although I doubt they have providers here in Canada. Are OT’s not capable of working on the vestibular system or did you just feel the Neuronet program was the better of the two choices? It was interesting to hear that he was having difficulty riding a bike, something else these two boys have in common.
Thank you again for the info, it is often only by talking with other parents who have traveled down the same road that we get the information we need. I have had no support from the pediatrician, finally I sent my husband (wearing a suit) to argue for a referral to a neurologist which he eventually got after a lengthy fight. My son’s Principal doesn’t know what I am talking about when I request access to an OT, says he has never had one in “his” school, even though he sent home a spiral bound book indicating all the services the board has to offer, including speech therapy and OT. Sad, that in this century we have to fight such ignorance from professional and men still can’t take women seriously.
Ann

OTs can work on vestibular development too. We decided on Neuronet because it was a home based program. We see the therapist every one or two weeks and do exercises every day. I think that is critical for change and the OT really wasn’t interested in designing us a home based program. Also, NN is interdisciplinary and I knew by that point my son’s problems crossed over disciplinary lines. Finally, the developer of the program lived in Ft. Lauderdale—within 45 minutes of my house.

NN does not teach academic skills no more than OT does. What it has done for my son is made him able to learn. The therapist told me that when my son first starting coming “he couldn’t do, couldn’t learn” now “he can’t do, can learn”. This is a fundamental change. Just last week I sat down and explained even and odd to him. He had got them all wrong at school, because he had never been taught the concept. He had been in resource room for Math for two years and I guess they had not covered it (I directly attribute him moving out to NN—he has good concecptual skills but was handicapped by visual-spatial, directionality, and memory problems). I asked him today whether 2 was even or odd. Then 33. He understood it! My son a year ago would have never ever retained this for a week, even if he had understood it the first time.

We have been using Phonographix (Reading Reflex) with him. We also took him to an intensive. I honestly would have gone with LIPS, like you are, if I could have found a provider. We also have done PACE which has helped but I think NN provided the foundation. The best thing in PACE for us is the Auditory processing work. I think you will get a lot of the same sort of thing with LIPS—I was speaking to the new resource teacher at my son’s school who knows LIPS (where was she when I needed her!!!) and she told me that thse exercise I was describing was similar to LIPS.

I don’t know where in Canada you are but I actually learned about NN from this board and a woman who was using it in Toronto.

Also, sound therapies can work on the vestibular system as does Balametrics. Balametrics is incorporated into NN and might be a good option along with OT, if NN is not available. Balametrics uses a balance board and a ball, which we have also used with NN. Try searching the internet. I can find it but might not get back to this message!

Betj

Hi Beth,
We can look into NN in Toronto during the summer, it is 5 hours away and I have family there. I will also look into what is available here.
You mentioned PACE, did it address your son’s visual processing difficulties? This is one area that Lindamood doesn’t work on so I am looking for a program that would address it. We are doing Vision Therapy with an optometrist, I have read a lot of negative press on Vision Therapy and am not totally convinced this is the answer, although it has helped him to track and focus at close range. I am also planning to do some “peg board exercises” that I found in a book , sorry I can’t remember the title, I lent it to a friend.
Ann

Thanks for the suggestion, but I had already ruled that out. I know the symptoms as my older child had problems due to a reluctance to drink.

We did vision therapy and it helped but didn’t completely fix everything. PACE helped too but still hasn’t fixed everything. The NN therapist says his visual problems are tied into his vestibular system so we now are doing visual tasks with NN.

PACE has worked for us to the extent that the underlying sensory motor difficulties have been remedied. In some areas, we have seen really good gains. In other rather modest. If you are thinking of doing both NN and PaCE. do NN first. I plan on trying PACE again after we finish NN.

The NN program sounds very interesting. Do you know of any books or web sites (other than www.neuroacoustics) that would give me further imformation about sensory integration problems? One of the earlier posters mentioned “The Out of Sink Child” but you seemed to think it didn’t relate to this problem. Thanks again for taking the time to write, it is much appreciated.
Ann

I would look at the book the Out of sync child . (by Carol Kranowitz) I found the discussion of the interelationship of vestibular system and auditory and visual very interesting. But the book is oriented towards preschoolers really and my child turned out to be such a good compenstater that I didn’t see him in the pages, even after I had a diagnosis. It will help you understand sensory integration though.