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NEW YORK (Reuters) -- Children who habitually walk on their toes may have significant delays in their speech and language development, according to a small study of preschool children. The seemingly benign action may be a sign of deficits that could pose trouble for children in school if not diagnosed and corrected with speech and language therapy, according Dr. Lisa H. Shulman, and colleagues from the Hospital for Joint Diseases in New York City. "The children in our study demonstrated delays in multiple developmental areas," the researchers write in the April (97) issue of The Journal of Pediatrics. "Significant language delays were the most prevalent, occurring in more than 75% of cases." "Delays were also found in the fine motor, visuomotor, and gross motor abilities, but to a lesser extent," they add. Motor skills have to do with movement -- either of large muscle groups, as in walking (gross motor), or control of precise movements, as in holding a pen or turning pages in brochures (fine motor). Although these problems would most likely surface as the child gets older and goes to school, catching the problem early is important Toe-walking may provide a simple, but valuable sign to parents and pediatricians that helps pinpoint the problem prior to school enrollment. "It is our recommendation that all children with idiopathic (no known cause) toe-walking... should be referred for developmental assessment," the team conclude. The children in the study had no signs of illness or retardation, but toe-walking sometimes can be indicative of cerebral palsy, various brain disorders, spinal injury, muscle weakness and autism. It may also stem from physical birth defects or problems encountered when the child first learns to walk such as improper flexing of the ankle or a deformity of the foot that prevents the child from putting his or her foot flat on the floor.

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