What Are the Early Symptoms of CMT1A in Children?

When a parent is diagnosed with Charcot-Marie-Tooth disease type 1A (CMT1A), it is natural to watch their children closely for early signs of the condition. CMT1A is a slowly progressive condition that affects the peripheral nerves, which control muscle movement and carry sensory information ^[1]. While symptoms can begin in infancy or early childhood, they may not become noticeable until adolescence or even later ^[2].

In children, the earliest symptoms usually appear as subtle changes in how they walk, move, or the shape of their feet ^[3]. Because these symptoms can be mild initially, they are often mistaken for normal developmental variations or “growing pains.” Unlike typical growing pains, CMT-related discomfort is often localized to the feet or calves and is frequently accompanied by tripping or muscle weakness.

Early Signs in Mobility and Gait

The first signs of CMT1A in children frequently involve the legs and feet. Because the disease affects nerve signals to the muscles, you may notice:

• Delayed walking: While many children with CMT1A walk at a normal age, some may experience delays in reaching major motor milestones like crawling or walking independently ^[4].
• Frequent tripping and clumsiness: A common early sign is tripping over flat surfaces. This happens because the muscles that lift the front of the foot weaken, making the foot drag slightly—a condition known as foot drop ^[5][1].
• Walking on toes: Some children may display persistent toe-walking to compensate for weakness or tightness in their lower leg muscles ^[6].
• Difficulty keeping up: You might notice your child gets tired easily, struggles with running, or has a hard time keeping up with peers during sports or play ^[7][8].

Changes in Foot Shape

As the muscles in the feet weaken unevenly, children with CMT1A often develop visible changes in the structure of their feet over the course of years. These foot deformities are classic signs of the condition ^[3]:

• Pes cavus (high arches): The arches of the feet may slowly become unusually high ^[6][9].
• Hammertoes: The toes may begin to curl downward at the middle joint, resembling a hammer.

Other Symptoms to Watch For

While motor symptoms (movement) are usually the most obvious, CMT1A also affects sensory nerves:

• Sensory changes: Children might report numbness, tingling (“pins and needles”), or neuropathic pain (which often feels like a burning or shooting pain) in their feet ^[10][11].
• Hand weakness: Although CMT1A typically affects the feet and legs first, children may eventually show difficulty with fine motor tasks, like buttoning a shirt or using zippers, due to hand weakness ^[7].

When to See a Doctor and Genetic Testing

If you notice these signs, or if you want to be proactive due to your own CMT1A diagnosis, it is important to consult a pediatric neurologist, a multidisciplinary neuromuscular clinic, or a pediatric orthopedist.

Because you have a known genetic mutation, doctors can often perform a targeted, non-invasive genetic test (using a blood or saliva sample) to see if your child has inherited CMT1A. This can definitively confirm the diagnosis and spare your child from potentially uncomfortable electrical nerve tests (nerve conduction studies). Notably, standard nerve tests can even appear normal in very young infants who have the condition, making early genetic confirmation highly valuable ^[2].

Early intervention, including physical therapy and bracing (such as custom orthotics), can help improve your child’s walking speed, stability, and overall mobility ^[12][13].