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Children diagnosed with Idiopathic Toe Walking (ITW) walk on their toes and are liable for leg pain and fall injuries. It is crucial to understand how toe walking affects energy expenditure in these children compared to typical children of the same age. In this study, we utilized an inertial measurement unit (IMU) attached to the low back to evaluate the number of steps and energy expenditure in the child’s natural setting for three days. Twenty participants were instructed to wear a sensor on their low back for three days, and their activities of daily living (ADL) were objectively quantified during weekdays and weekends in their natural settings. We found total energy expenditure was significantly higher among children diagnosed with ITW compared to typical controls (p<0.05). We also found the children diagnosed with ITW took shorter and significantly more steps than age-matched controls (p<0.05). A future investigation into biomechanics and new gait interventions is needed to improve gait efficiency and energy expenditure among children diagnosed with ITW.