Achilles Tendon Shortening and Communication Impairment in Children with Autism Spectrum Disorder

Aim: The study aims to compare the thickness and length of the Achilles tendon in children with autism spectrum disorder (ASD) to healthy controls, and to examine the relationship among autism severity, Achilles tendon length and thickness, and toe-walking. Material and Methods: Both Achilles tendons were examined in the longitudinal and transverse planes from the musculotendinous junctions to the insertion point of the calcaneus. The thickness was measured as the maximum anterior-posterior diameter at the level of the medial malleolus to ensure standardization, as in previous studies. ASD severity and symptoms were evaluated using the Childhood Autism Rating Scale (CARS) and the Social Communication Scale (SCS). Results: The lengths of the right and left Achilles tendons were significantly shorter in the ASD group compared to the control group. Bivariate analyses revealed a moderate negative correlation between the CARS total score and the length of the right Achilles. Conclusion: Our study is the first to examine the relationship between Achilles tendon length and thickness, toe walking, and ASD severity in individuals with ASD.