How the way you WALK could reveal a hidden autism diagnosis – the 3 signs to look for in your child

The Sun

12 hours ago

AUTISM is a neurodevelopmental condition that affects how people socialise, communicate and interact with the world.
Autistic people may find socialising confusing or tiring, become overwhelmed in loud or crowded places and crave order and routine.
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But the condition - which is not an illness or disease that needs to be 'cured' - can also affect how some people move or walk, researchers say.
In fact, the Diagnostic and Statistical Manual of Mental Disorders (DSM) - a guide book widely used for diagnosing mental health conditions - lists an "odd gait" as supporting feature of autism.
Nicole Rinehart, a Professor of clinical psychology and director of the neurodevelopment program at Monash University outlined three "noticeable gait differences" autistic people might have in The Conversation.
These may include:
Walking on the toes or the balls of the feet is fairly common in children who are just beginning to walk, until the age of three.
Most will outgrow it the habit.
If toe-walking doesn't correct itself over time, or begins suddenly, the NHS recommends children be assessed by a health professional for growth-growth related pain, neurodevelopmental disorders or autism.
"Children with autism spectrum disorder or sensory integration issues will frequently toe walk as it feels more comfortable for them," the East Sussex Healthcare NHS Trust explains.
In and out-toeing are also fairly common and can simply be caused by the rotation of the thigh and shin bones, aside from autism.
Simple 10-question test that can help determine if you have autism
They don't usually need treatment and will go away on their own by the time a child is eight.
The NHS advises parents to speak a GP about their children's gait if they're worried about it.
Autism can cause other, more subtle changes to the way people walk, according to Prof Rinehart.
She pointed to 30-year study of autistic people, which found that some with the condition may:
Walk more slowly
Take wider steps
Spend longer in the 'stance' phase, when the foot leaves the ground
Take more time to complete each step
"Autistic people show much more personal variability in the length and speed of their strides, as well as their walking speed," Prof Rinehart wrote.
"Gait differences also tend to occur alongside other motor differences, such as issues with balance, coordination, postural stability and handwriting."
She explained that gait differences in autistic people might be caused by "differences in brain development".
What is autism?
Autism spectrum disorder (ASD) is an incurable, lifelong developmental condition that affects how people perceive the world and interact with others.
It affects around one in 100 people in the UK and is three to four times more common in boys than in girls.
Many people with ASD find it hard to understand other people's feelings and emotions, and they may have difficulty holding conversations.
When they are young, their language development may take longer and they can struggle to use facial expressions, using gestures to communicate instead.
They may also find it hard to connect with other people and to hold eye contact with unfamiliar individuals.
Many children with ASD like to follow a routine, and changes to this can cause distress.
High functioning autism is an informal term some people use to describe those on the autism spectrum disorder.
Areas such as the basal ganglia - which is responsible for making walking effortless, smooth and automatic - and the cerebellum, which controls and coordinates movement, may develop differently in people with autism, the expert said.
"While some researchers have suggested that autistic gait occurs due to delayed development, we now know gait differences persist across the lifespan.
"Some differences actually become clearer with age."
Some people with gait differences may also have more difficulties with language and cognition.
In some cases, these signs can indicate that an autistic person is experiencing "sensory or cognitive overload" and might need some "extra support or a break" in that moment, the expert said.
Do gait differences need to be treated?
Differences in the way autistic people walk don't necessarily need to be treated, Prof Rinehart said.
"Some autistic people might have subtle gait differences that are observable during testing," she wrote.
"But if these differences don't impact a person's ability to participate in everyday life, they don't require support."
But some may be at increased risk of falls, have difficulty participating in sports or other physical activities, or may get pain in their legs or back from the way they walk.
In these cases, children may benefit from some additional support, whether that be from a clinic, at school, or in their local communities.
"Our community-based intervention studies show autistic children's movement abilities can improve after engaging in community-based interventions, such as sports or dance," Prof Rinehart said.
"Community-based support models empower autistic children to have agency in how they move, rather than seeing different ways of moving as a problem to be fixed."
The key characteristics of autism - and why they go unnoticed
By Alice Fuller, Health Features Editor
MODEL Christine McGuinness was a 'recluse' for eight years and only left the house at 3am.
Springwatch presenter Chris Packham says it makes him a 'task-centric workaholic who sees problems in everything he does'.
And recently, Bella Ramsey revealed they were diagnosed after struggling to wear thermals on the set of The Last of Us.
But what exactly is autism and why does it seem so different in everyone?
Leanne Cooper-Brown, neurodevelopmental lead at Clinical Partners, tells Sun Health: 'Autism is considered a spectrum, so not all people share the same traits.
'Whereas we used to think of autism as a linear line, we have come to realise that terms such as 'high' and 'low' functioning or definitions of 'mild', 'moderate' or 'severe' aren't helpful and can be misleading.
'Nowadays, we think of autism in terms of the strengths and needs of the individual, which can change over time depending on their environment and support network.'
About 700,000 people in the UK are thought to have autism - that's one in 100.
But research by University College London suggests that number could be twice as high, as many people remain undiagnosed.
Cases are on the rise though. Figures released last year showed a 175 per cent increase from 2011 to 2022.
Dr Selina Warlow, clinical psychologist and owner of The Nook Neurodevelopmental Clinic, says: 'Conversation around neurodiversity is becoming normalised, and that's so positive to see. But more awareness is needed.
'Receiving a diagnosis can open access to expert resources that support autistic people to thrive in society.'
Autism has long been associated with social difficulties, like problems maintaining conversations and forming relationships.
But research published in the journal Cell Press suggested that repetitive behaviours - like rocking or finger-flicking - and special interests - whether it's TV shows or specific animals - are more indicative of an autism diagnosis.
Generally though, experts say the core characteristics include…
Sensitivity - autistic people can be much more or less sensitive to sights, sounds, textures, tastes and smells. For example, they find bright lights or crowded spaces overwhelming, Leanne says. They may also stand too close to others or need to move their whole body to look at something.
Stimming - to manage this sensory overload, some people use repetitive movements or sounds. 'This is called stimming, and includes rocking, tapping and hand-flapping,' Dr Warlow says. 'Though it's something everyone does to some extent, those with autism are likely to engage with it as a form of self-regulation.'
Masking - this is a strategy used by some autistic people, consciously or not, to match neurotypical people, Dr Warlow says. 'It's a way of hiding your true characteristics, and could involve copying facial expressions, planning conversations in advance, or holding in 'stimming' - swapping hand clapping with playing with a pen, for example,' she adds.
Burnout - this is a state of physical, mental and emotional exhaustion and is a common feature in autism. 'Being extremely tired, both mentally and physically, can be associated with the act of masking for a long period of time, or sensory or social overload,' Dr Warlow says. 'Symptoms of autistic burnout include social withdrawal, reduced performance and increased sensitivity.'
Social struggles - socialising can be confusing or tiring for autistic people. They often find it hard to understand what others are thinking or feeling, making it challenging to make friends. Leanne says: 'In adults, autism may present as difficulties with interpreting social cues such as understanding body language or sarcasm, struggling to express emotions or preferring to be alone. This can impact relationships and work.'
Routine - many of us have a fairly regular daily schedule. But for autistic people, this becomes a 'very strong preference for routine', Leanne says. This could be needing a daily timetable to know what is going to happen and when, or having rigid preferences about foods or clothing.
Literal thinking - some autistic people have a literal view of language - like believing it's actually 'raining cats and dogs' or that someone really wants you to 'break a leg'. Dr Warlow says: 'This can result in confusion with figures of speech, irony or indirect requests. 'For instance, being told to 'pull your socks up' might be understood literally, not as a motivational phrase.'
Hyperfocus - often associated with ADHD, hyperfocusing is also common in autistic people. 'It's where you're able to focus intensely on an activity and become absorbed to the point of forgetting about time,' Dr Warlow says. 'This is useful in work or hobbies but can result in neglect of other aspects of life, such as food or rest.'
Special interests - we all have hobbies and interests, but for autistic people, these are so compelling they often want to spend all their time learning about, thinking about or doing them. 'Special interests could include anything from dinosaurs to superheroes, and gardening to music,' Dr Warlow says. 'These usually begin in childhood, but can also form as an adult. 'Chris Packham is an example of an autistic person who turned his childhood special interest in animals into a successful career, becoming one of the UK's best-loved natural world TV presenters.