Idiopathic toe walking (ITW) refers to ambulation with a toe-to-toe gait in the absence of a known cause. Although it is exhibited by typically developing children, it is more common among children with autism spectrum disorder (ASD). Persistent ITW can cause several long-term medical problems, including ankle deformities and balance and posture abnormalities. In the current study, we first conducted a series of no interaction or alone conditions to verify that ITW exhibited by four children with ASD persisted in the absence of social consequences. We then evaluated a hands-on-shoulder plus praise procedure in which gentle pressure is applied to participants' shoulders to prompt their heels to contact the ground, along with praise for appropriate steps in order to reduce ITW. Results suggest that the procedure was effective with all participants, and measures of social validity indicate that caregivers approved of the procedure. We discuss the results in terms of the putative mechanisms responsible for the effects of the procedure as well as the conditions under which the procedure might be used.

中文翻译：

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进一步评估减少踮脚走路的“动手肩加表扬”程序

特发性踮脚行走 (ITW) 是指在没有已知原因的情况下以脚趾对脚趾的步态行走。虽然正常发育的儿童会出现这种情况，但在患有自闭症谱系障碍 (ASD) 的儿童中更为常见。持续性 ITW 可能会导致一些长期的健康问题，包括踝关节畸形以及平衡和姿势异常。在当前的研究中，我们首先进行了一系列无互动或单独的条件，以验证四名自闭症儿童表现出的 ITW 在没有社会后果的情况下持续存在。然后，我们评估了一种手扶肩加表扬的程序，其中对参与者的肩膀施加轻微的压力，促使他们的脚后跟接触地面，并对适当的步骤进行表扬，以减少 ITW。结果表明该程序对所有参与者都有效，社会效度测量表明护理人员认可该程序。我们根据造成该程序效果的假定机制以及该程序可能使用的条件来讨论结果。