Treatment of idiopathic toe-walking in children with autism using GaitSpot Auditory Speakers and simplified habit reversal

Ann Marcus, Brigit Sinnott, Stephen Bradley, Ian Grey

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


This study aimed to examine the effectiveness of a simplified habit reversal procedure (SHR) using differential reinforcement of incompatible behaviour (DRI) and a stimulus prompt (GaitSpot Auditory Squeakers) to reduce the frequency of idiopathic toe-walking (ITW) and increase the frequency of correct heel-to-toe-walking in three children with autism. The study involved a delayed multiple baseline changing criterion design across individuals. Firstly, a baseline phase was conducted to determine the number of intervals where ITW occurred. Secondly, the GaitSpot Auditory Squeakers were paired with reinforcers. Thirdly, children wore GaitSpot squeakers over the heels of their feet under their shoes for a small number of 10 min sessions and when weight was placed on their heel, a squeak was emitted which was subsequently reinforced. Fourthly, the length of time the children wore the GaitSpot Auditory Squeakers was extended. Finally, the GaitSpot Auditory Squeakers were faded out and tests for generalisation and maintenance of heel-to-toe walking were conducted. The intervention produced substantial reductions in ITW across all participants though degree of reduction differed. The role of SHR and additional modifications for the treatment of ITW are discussed.

Original languageEnglish
Pages (from-to)260-267
Number of pages8
JournalResearch in Autism Spectrum Disorders
Issue number2
Publication statusPublished - Apr 2010
Externally publishedYes


  • Applied behaviour analysis
  • Autism
  • Idiopathic toe-walking
  • Treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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