title: Neuropsychiatric symptoms and problems among children with idiopathic toe-walking.
abstract: 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.
  
  
  METHODS
  II.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. pahr.engstrom@ki.se
authors.forename: Pähr
authors.initials: P
authors.lastname: Engström
authors.forename: Ingrid
authors.initials: I
authors.lastname: Van't Hooft
authors.forename: Kristina
authors.initials: K
authors.lastname: Tedroff
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D056344:Executive Function; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007806:Language Disorders / Q000453:epidemiology; D007859:Learning Disabilities / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology*; D019957:Motor Skills Disorders / Q000453:epidemiology*; D010465:Perception; D011795:Surveys and Questionnaires; D014034:Toes; D016138:Walking / Q000523:psychology