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What Causes A Toddler To Walk On Toes Along With Speech Problems?

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Posted on Mon, 2 Mar 2015
Question: Need a Pediatric neurologist to discuss some issue for Child
doctor
Answered by Dr. Sumanth Amperayani (22 hours later)
Brief Answer:
I am a pediatrician - if you don't mind - you can

Detailed Answer:
Hi....I am a pediatrician with a good work experience in a tertiary care referral hospital. If you are willing you can discuss your son's problem with me.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (5 minutes later)
I have 3 years old baby boy who walks on toe till now. Also he doesn't speak more than 5-6 words in a day and cannot complete a sentence. He don't eat much which I think is not a big issue as many babies don't eat homemade food.
doctor
Answered by Dr. Sumanth Amperayani (26 minutes later)
Brief Answer:
I have a few questions - please get back with answers

Detailed Answer:
Hi...Thank you for consulting in Health Care magic. I understand your concern.
I have a few questions - .

Questions:
1. What was the birth weight and what is the current weight and length?
2. How is the attaining of developmental milestones - I mean whether he attained social smile at 3 months/ rolling over at 5-6 months/ transfer of objects form one hand to another by 6 months/ sitting with support by 7-8 months and standing with support by 11-12 months and walking with support by 12-14 months ?
3. Did he cry immediately after birth or did he require any special assistance to take the first breath?
4. Was he hospitalized in new born period (in first 28 days of life in the NICU)?
5. Is there any history of recurrent serious infections or lung problems?
6. Was he born with his feet in tip-toeing position or he has tip toeing only after he attained walking?
7. How long does he see television or tablet or cartoons per day?
8. Did any one of the parents' had a speech delay as children?
9. How many word s does he speak as of now- I mean his vocabulary consists of how many words?
10. Let me know what are all the activities he can do now on his on?


Regarding his feeding pattern -
I agree with you completely.
1. An active is a well kid even if she/ he is not eating well.
2. Development of a kid is as important as or I would say even more important than growth alone.
3. As the kids grow their interest in food decreases and interest in play activities increases so that they eat small quantity and run away to play. As parents we need to be more patient and feed than less quantity but more aliquots per day.
4. This age rather than the quantity of the food I suggest you concentrate more on the number of times you feed her and also make whatever you feed her calorie dense by adding good amount of ghee to it.
5. I suggest you not to use appetite stimulants on long run as they may cause drowsiness.

Hope I didn't bother you with too many questions - but the information you provide me in the answers is going to be vital for me in guiding you further.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (1 hour later)
PLease find my comments on each question,

Questions:
1. What was the birth weight and what is the current weight and length?
XXXX: Birth weight is 4 KG and current weight is 15 KG and height not sure.

2. How is the attaining of developmental milestones - I mean whether he attained social smile at 3 months/ rolling over at 5-6 months/ transfer of objects form one hand to another by 6 months/ sitting with support by 7-8 months and standing with support by 11-12 months and walking with support by 12-14 months ?
XXXXX: He did all his activity 8 months late like started standing at age of 1.5 years, speaking after 2.2 years etc.

3. Did he cry immediately after birth or did he require any special assistance to take the first breath?
Mayank: I heard that he cried after birth.

4. Was he hospitalized in new born period (in first 28 days of life in the NICU)?
XXXX: No, not hospitalized.

5. Is there any history of recurrent serious infections or lung problems?
XXXX: No such infections. However, when he open his mouth it feels like he has ulcers.

6. Was he born with his feet in tip-toeing position or he has tip toeing only after he attained walking?
XXXX: After he attained walking.

7. How long does he see television or tablet or cartoons per day?
XXXX: sometimes concentrate very much for 10-15 mins.

8. Did any one of the parents' had a speech delay as children?
XXXX: No delay

9. How many word s does he speak as of now- I mean his vocabulary consists of how many words?
XXXX: He speaks only 5-6 words daily until we insist him to speak some specific words.

10. Let me know what are all the activities he can do now on his on?
XXXX: He is only baby at home and mostly stays in house means no play with colony babies other than in school, Daily dependent on cow's milk and eat less homemade food, shy when interacting others, speaks repetitive words 2-3 times continuously, climb to stairs with staircase support, etc
doctor
Answered by Dr. Sumanth Amperayani (52 minutes later)
Brief Answer:
Possibilities and suggestions

Detailed Answer:
HI...
Possibilities -
1. Spastic diplegia due to periventricular leucomalacia in brain.
2. Spinal dysraphism and tethered cord and this could be the reason for toe walking.
3. HIE or hypoxic ischemic encephalopathy with global developmental delay as more than 2 mils stone patterns are delayed.

Suggestions -
1. He will definitely get benefitted with physiotherapy and speech therapy.
2. He needs an MRI imaging of brain and spine to rule out the above 1st and 2nd conditions which I have mentioned.
3. If the neuroimaging is showing some abnormality he might need a neurosurgical consult too.
4. I suggest you are doing great by singing rhymes to him.
5. Do not use tablet or computer or TV or laptop for doing that.
6. Do not force him too much comparing him with others.

Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8339 Questions

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What Causes A Toddler To Walk On Toes Along With Speech Problems?

Brief Answer: I am a pediatrician - if you don't mind - you can Detailed Answer: Hi....I am a pediatrician with a good work experience in a tertiary care referral hospital. If you are willing you can discuss your son's problem with me. Regards - Dr. Sumanth