Sometimes children, once they begin to walk, will have a tendency, some of the time, to walk on their tippy toes. While this is perfectly normal when the child begins to walk, in other words, many children in the first early stages of walking, tend to walk on their tippies. Usually, as they get more coordinated, they will walk more flatfooted. However, some children will continue to walk on their tippy toes. Once again, this can be a normal part of development and we can reassure, once upon an exam, is normal. Secondly, it can be a sign of tight heel cords or mild spasticity, which may require some slight physical therapy intervention. Usually a doctor can tell that on the physical examination. Third, it can be a sign of Autism. Once again, the parents read in the magazine that tippy toe walking can be a sign of Autism. They are very worried and concerned about this. We can do a great deal of good by reassuring them, once we've taken a careful developmental history, that this isn't the case.