- in-toeing, walking with one or both feet turned inwards
- out-toeing, walking with one or both feet turned out.
I thought that toe walking was called out two decades ago when I was in university - I remember it being mentioned in a psych class. Otherwise, that kind of includes everyone who doesn't walk with feet straight, doesn't it?
I guess the real "news" is just that it made it into the DSM:
> Having an "odd gait" is now listed in the Diagnostic and Statistical Manual of Mental Disorders as a supporting diagnostic feature of autism.
I'd be particularly interested in seeing if these gait differences are limited to childhood, or if they persist into adulthood. It might simply be delaying a developmental step.
Running purely on the balls of your feet seems like its more of a sprinting thing
> Our sources say that Native Americans tended to land on the ball of the foot (a "forefoot strike"), or flat-footed ("midfoot strike"), rather than landing on the heel and rolling forward ("heel strike"). [0: 90]
> Our sources indicate that Native Americans commonly walked with toes pointed straight ahead or turned slightly inward, rather than turned outward. [0: 91]
I've pulled just one article here, but there's a huge trove of racial and ethnic gait stereotypes with all sorts of moral implications. It's important not to repeat that stereotyping when trying to address autism.
[0] Ranalli, B. 2019. "Thoreau's Indian Stride." The Concord Saunterer 27: 89-110. https://www.jstor.org/stable/45271429
I’m not of one opinion or the other, I just don’t see why it’s self evident that certain groups of people wouldn’t walk a certain way.
But we don’t often pay attention to other types of physical and behavioural culture being as geographically entrenched as they sometimes seem to be.
Accents hold some special place in being so recognisable but I think there’s no obvious reason we wouldn’t have many other layers of physical culture like this.
The signal is a bit harder to pick up but I’m sure it’s there.
I’m not trying to make any particular point for or against damaging stereotypes here.
Alright, that's enough HN for me today, I'm outie. Have a great evening y'all.
We recently moved into house with wood floors. I experience my daughter and wife's gaits in new way. Their footfalls have a distinct "thud-thud-thud" with the landing of their heels first, whereas mine are a lot lighter. My daughter definitely didn't inherit my gait, even if she did inherit some of my psychological and mental eccentricities.
Shoes are evil. Barefoot all the things.
I think I might be a bit autistic...
But we also should be careful not to over-diagnose neurodivergence based on outward behavior. Not everyone who fidgets is ADHD
> based on outward behavior
Yes, neurodivergence can only be diagnosed based on how you work on the inside. It is not possible to diagnose based on outside behavior as people can show symptoms very differently and can mask their symptoms.
And no, you obviously can not diagnose people based on how they walk. If anything it can only give you hints or be a fun thing to talk about.
> over-diagnose
Both autism are ADHD are vastly under-diagnosed especially in women and adults. The fear of over-diagnosis makes no sense.
There are very hard criteria for an diagnosis and it requires that every other explanation for the behavior is excluded before a diagnosis can be made. The reality it that it is a huge struggle for anyone with autism or ADHD to get any form of help or even diagnosis.
Medication for ADHD works extremely well. Not for everyone but for like 70% and that is insanely good. Still there is so much fearmongering against it. But anti-depressants that can have much more serious side-effects and don't even work that well? Yes, they giving them like they are candy. Insanity.
Struggle mentally in any shape or form? Oh, you must be depressed? What causes the depression? We will not dig deeper. Have your pills and be happy! But stimulants, no those are of the devil!
Not to say that some people don't have just depression but the double standard is infuriating and often undiagnosed neurodivergence causes depression.
How is this known or proven?
https://pmc.ncbi.nlm.nih.gov/articles/PMC8870038/
> As of 2018, 2.94% of 10- to 14-year-olds had a diagnosis (1 in 34), vs. 0.02% aged 70+ (1 in 6000).
https://pmc.ncbi.nlm.nih.gov/articles/PMC8870038/
> The ratio of males to females with ASD is generally quoted as 4:1,[..]The true male-to-female ratio appears to be 3:4. Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women.
Is this standard truly being upheld? Most stories I've heard from people in US & UK go something like "I filled out some forms, hopped on a call/saw a psychiatrist for 30-60 minutes and walked out with a diagnosis and a prescription". Sometimes people even joke about how their psychiatrist talked to them for 10 minutes and concluded that they definitely have ADHD, and while that might be the case, it doesn't seem like many professionals are being particularly thorough about the differential diagnosis and ruling out other causes.
Personally I had to undergo relatively rigorous testing where they went through my entire medical history and administered about a dozen different neuropsychological tests which took about 5 hours total, over 2 months, multiple appointments, and then another month for them to analyze everything and come back to me with the diagnosis.
Of course that doesn't mean that ADHD is overdiagnosed or that those diagnoses are wrong, but it doesn't seem like many places are being as rigorous as they're supposed to be? Am I missing anything?
I had three appointments and lots of questionnaires to fill out at home that were designed to exclude all kind of conditions. And with a diagnosis I was still far away from getting a prescription, that is whole other hurdle.
As for the US, well the CDC says in the section for conditions that must be met:
> The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
https://www.cdc.gov/adhd/diagnosis/index.html
So it is pretty clear on that.
As I read through your entire comment, I see you might agree. And yes, I've seen that woman on Reels before, some of her observations I can confirm, such as "body double" or whatever it's called where you are more productive when interacting with someone else, even if they aren't helping you with something.
Aside: I don't think my PCP is the #1 person to talk to regarding variations in ADHD treatment. I have adderall, which can help sometimes focus me on a task and bypass the anxiety of talking/typing through issues at work. But I loathe using it daily. I wonder if any other medication works differently. Ritalin is different but similar.
You might be susceptible to those kinds of unhealthy issues and have more of them without even realising it.
You may look anti-social to your environment.
It is especially painful when you are neurodivergend and undiagnosed and spent half your life wondering why people just hate you for being you.
Thankfully people can get over it when they make an effort and educate themselves. So it is good that you admit you feel this way. Maybe you can learn to appreciate people being different or at least tolerate them more.
Roughly speaking, in our brains have to reconcile the internal models of the world with predictions and what we receive through stimuli. Neurotypical people can do this without issues, disregarding either one. Autistic people basically are wired to pay way more attention to external stimuli no matter how small it is.
This sort of explanation makes the most sense, and can contextualize this as well. The gait trait is basically an optimization that comes from a higher sensory sensitivity and low value of "how should I be walking".
Allegedly some law enforcement uses gait analysis to identify and follow individual people on CCTV recordings. Gait has diagnostic value in some neurological conditions (like multiple sclerosis). Doesn't seem far fetched that a complex disorder like autism would also affect gait.
In a world with AI systems that can be trained in an unsupervised way against basically all the data we can collect, the amount of information that can be accurately predicted about you is probably proportional to the number of bits of observational data about you available to to the AI, and I would suspect there is a roughly logistic relationship between bits available and the % of information it can reliably guess.
I'm not sure if it's the differences in gait that might cause people with autism to need less arm swinging for balancing or if swinging less causes them to develop those differences in gait.
haha couldn't be me...
Facts aren't data, but as a counter to the narrative in this article: in my own experience strong calf muscles likely related to autism have allowed me to place at running events as someone with <2 years competitive running experience, and my mother to be the national champion at her age range for a decade.
Long distance though of course would still benefit from stronger calves. However toe walking also might make you tend toward tighter calves and posterior chain (which would leady to injury - especially when doing distance)
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