Toe walking is relatively common among children with autism spectrum disorder and, if untreated, can contribute to a number of medical problems. Previous research has suggested that toe walking may vary by walking surface. Some (e.g., rough) surfaces may inhibit toe walking, whereas other surfaces may encourage it. In the current study, we first conducted a functional analysis screening to verify that toe walking exhibited by two young children with autism was maintained by automatic reinforcement. Next, we assessed toe walking on a variety of surfaces, including tile, artificial grass, and grip tape. Finally, we placed inserts of the surface associated with the lowest level of toe walking into each participant's shoes. The inserts were effective to nearly eliminate toe walking by one participant and reduce toe walking to low levels for the second participant. To decrease the second participant's toe walking further, we added a hand-on-shoulder procedure, which was also effective. We discuss the results in terms of the putative mechanisms responsible for the reduction.

中文翻译：

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评估鞋垫以减少自闭症幼儿的脚趾行走

脚趾行走在自闭症谱系障碍儿童中相对常见，如果不治疗，可能会导致许多医疗问题。先前的研究表明，脚趾行走可能因行走表面而异。一些（例如，粗糙的）表面可能会抑制脚趾行走，而其他表面可能会鼓励它。在目前的研究中，我们首先进行了功能分析筛选，以验证两名自闭症幼儿表现出的脚趾行走是通过自动强化维持的。接下来，我们评估了在各种表面上的脚趾行走，包括瓷砖、人造草和握带。最后，我们将与脚趾最低水平相关的表面插入到每个参与者的鞋子中。插入物有效地几乎消除了一名参与者的脚趾行走，并将第二名参与者的脚趾行走减少到低水平。为了进一步减少第二名参与者的脚趾行走，我们增加了一个手放在肩上的程序，这也很有效。我们根据负责减少的推定机制来讨论结果。