The Aware Mama

19/05/2026

Hypermobility is something popping up a bit in neurodiversity circles for adults, but I haven't seen any conversation that centers children yet (and this study did use data from adults but we share some thoughts about kids at the bottom)

This was an observational study, sometimes called a cross-sectional comparison study where the researchers gathered data from people who already had neurodevelopmental diagnoses and compared them to people who didn't, looking for patterns.

The three main questions they were trying to answer:

1. Are neurodivergent individuals more likely to have joint hypermobility than the general population?

2. Do they experience more symptoms of orthostatic intolerance (where your body struggles to adjust to standing up, resulting in symptoms like dizziness, lightheadedness, brain fog, and a rapid heart rate - this is linked to autonomic nervous system dysfunction) and more musculoskeletal pain than people without those diagnoses?

3. If yes to both, does joint hypermobility help explain why? In other words, is the hypermobility acting as a kind of biological bridge between being neurodivergent and having these physical symptoms?

HOW THEY DID IT

They recruited 109 adults with confirmed clinical diagnoses of autism, ADHD, or Tourette syndrome (the "neurodivergent group") and 57 adults without those diagnoses (the "comparison group"). All participants had a trained clinician perform the Beighton score, which is a physical exam that checks how far certain joints bend (thumb to forearm, pinky finger backward, elbows, knees, palms to floor). The Beighton score runs from 0 to 9.

They used two different cut-offs to define generalized joint hypermobility (GJH): the older criterion of 4 or above, and the stricter 2017 criterion used for diagnosing hypermobile Ehlers-Danlos syndrome, which adjusts for age.

Participants also filled out the AQQoL questionnaire, which asks about symptoms like dizziness when standing and pain in various joints.

They then ran statistical tests to compare the groups and used a mediation analysis (a method for testing whether one variable explains the link between two others) to see if hypermobility was the mechanism connecting neurodivergence to physical symptoms.

They also pulled in existing data from a much larger UK population study (the ALSPAC birth cohort of 6,022 adolescents) to compare general-population rates.

WHAT THEY FOUND

• 51% of the neurodivergent group met the older criteria for generalized joint hypermobility, compared to 17.5% in the comparison group and about 20% in the general UK population.

• Using the stricter age-specific cut-off, 28.4% of the neurodivergent group qualified, compared to 12.3% of the comparison group.

• Females in the neurodivergent group had the highest rates by far: 69% met the older criteria, compared to 22.6% of comparison females.

• Neurodivergent participants had much higher orthostatic intolerance symptom scores (average 24.2 vs 5.1) and much higher musculoskeletal pain scores (average 6.8 vs 3.58).

• The higher someone's Beighton score, the more orthostatic intolerance and pain symptoms they reported.

• The mediation analysis showed that hypermobility statistically accounted for part of the link between being neurodivergent and having these physical symptoms.

Broken down by diagnosis, hypermobility was 4.51 times more likely in autistic participants, 4.34 times more likely in ADHD participants, and 7.02 times more likely in Tourette syndrome participants compared to the general population.

The Tourette finding was the first systematic estimate of its kind.

AUTHORS CONCLUSIONS

The authors concluded that joint hypermobility appears to be a shared biological feature that helps explain why neurodivergent people more often experience dysautonomia and chronic pain. They suggest that connective tissue variation may be a unifying thread linking neurodivergence with these co-occurring physical symptoms.

Clinically, they argue this matters because services tend to separate "physical" and "mental" health, and neurodivergent people often end up under-recognized for physical symptoms that significantly affect quality of life. They call for larger studies and for interventions that address both the psychological and physical sides together.

The authors also flagged honest limitations: the comparison group wasn't formally screened for neurodevelopmental conditions, the pain measure was self-report and didn't cover all body areas, and they assessed symptoms of autonomic dysfunction rather than running full autonomic function testing. They suggested future studies use more comprehensive pain measures (like the Brief Pain Inventory or Pain Interference Index) and direct autonomic testing.

OUR THOUGHTS

If you're a parent, a therapist, or a teacher working with neurodivergent children, it's worth asking what role hypermobility might be playing in shaping their day-to-day experiences.

Hypermobile kids may struggle even more to sit still, stand up straight in a line, keep their posture during a task, with handwriting, or tolerate the physical demands of PE and sports.

They might do stretches "wrong" without anyone realizing. For example, bending forward to touch their toes to stretch their hamstrings. If their knees hyperextend, they're not actually stretching their hamstrings. They're just sinking deeper into their knee joints. Nobody around them notices, nobody tells them to keep a soft bend in their knees so they can actually feel the stretch where it's supposed to be, and it can lead to pain later.

They might be labeled fidgety, or uncoordinated, or just not athletic, when their joints are actually doing something very different from their peers'.

Interventions and lessons that assume a typical body, whether that's a handwriting program, a yoga class, a sports practice, or a "just sit still" expectation, may not land the same way.

The other layer to this is that many neurodivergent kids also experience differences in interoception, which is the sense of what's happening inside the body. So if something is off in a joint, a stretch isn't landing in the right place, a movement is causing strain, they may not register it clearly enough to know, they may not know its different from what others experience, and they may not have the words to describe it if they do. They can't always tell the adults around them, "this doesn't feel right" or "I'm not feeling this stretch where I'm supposed to" or "my heart races when I stand up". That puts even more responsibility on the adults to watch closely and ask the right questions.

The goal is to help kids succeed at whatever an activity is meant to accomplish, which sometimes means changing how they do it. The point of bending forward to touch your toes is to stretch the hamstrings. You're told to do it with a straight leg, but if your knees hyperextend, a straight leg doesn't stretch your hamstrings at all. To get the actual outcome, the movement has to be adjusted.

The same logic applies to handwriting when finger joints are hypermobile and a pencil grip falls apart after a few minutes. It applies to sitting cross-legged on the floor, to holding scissors, to standing in line, to riding a bike. The activity might need to be adapted, the expectation might need to shift, or the kid might need a tool or a support that lets their body do the work without paying for it later.

Hypermobile neurodivergent kids can absolutely move, learn, and thrive. The adults around them just need to notice what their bodies are actually doing and adjust accordingly so they can succeed.

**Note: This graphic is a screenshot of published research. It shows the title of the study, the authors' names, and the DOI link. The caption summarizes the research and the researchers' findings and conclusions. This is shared strictly as information to our audience and is not intended as an endorsement or a claim that the research findings are definitive.**

[Image description: A graphic featuring the title page details of a research article. The article is an Original Research piece published in Frontiers in Psychiatry, Section: Psychological Therapy and Psychosomatics, on 01 February 2022, Volume 12 - 2021. The title reads "Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain." DOI: 10.3389/fpsyt.2021.786916. The Think Sensory logo appears at the bottom of the image.]

17/05/2026

Some people spend their entire lives believing they only have ADHD… until one day they realize ADHD was actually masking autism underneath the whole time.

And for many late-diagnosed adults, that realization changes everything they thought they understood about themselves.

Why ADHD And Autism Are So Commonly Confused

ADHD and autism are both neurodevelopmental conditions, and they often overlap more than people realize.

In fact, many people experience traits of both, sometimes called AuDHD.

The difficult part is that ADHD traits can sometimes hide autistic traits so effectively that a person grows up feeling “different” without ever understanding why.

Especially because ADHD often appears louder externally:

impulsivity,
hyperactivity,
talking fast,
emotional intensity,
novelty-seeking,
or distractibility.

Meanwhile, autistic traits may remain hidden underneath years of masking, adaptation, and survival strategies.

That is why many adults only recognize the autism side later in life.

1. ADHD Social Energy Can Hide Autistic Social Exhaustion

A lot of people assume autistic individuals never enjoy social interaction.

But many AuDHD adults genuinely love people, conversations, humor, deep connections, and spontaneous interaction.

The ADHD side may make someone appear:

outgoing,
expressive,
funny,
energetic,
or socially adventurous.

But underneath that energy, the autistic nervous system may still become deeply overwhelmed afterward.

This is why some people can socialize intensely for hours… then suddenly disappear, shut down emotionally, or need days alone to recover.

To outsiders it looks inconsistent.

But internally, the nervous system became overloaded.

2. ADHD Impulsivity Can Mask Autistic Routines

Autism is often associated with structure and predictability.

ADHD is associated with novelty and chaos.

So when someone has both, the experience can become confusing.

For example:
the ADHD brain craves stimulation and spontaneity,
while the autistic nervous system craves predictability and safety.

This creates a strange internal conflict where someone may:

constantly seek new things,
but also
become emotionally distressed by change.

They may appear “flexible” externally while internally feeling completely dysregulated.

Many AuDHD adults describe feeling like they are simultaneously craving chaos and stability at the exact same time.

3. ADHD Talking Styles Can Hide Autistic Communication Differences

Many autistic adults are stereotyped as quiet or reserved, which causes countless people to get overlooked completely.

Especially women and masked autistic adults.

Some people with ADHD talk rapidly, overshare, interrupt unintentionally, or jump between topics quickly. Because of this, people assume they are naturally socially fluent.

But underneath, autistic communication differences may still exist:

scripting conversations beforehand,
analyzing social interactions afterward,
struggling with tone interpretation,
masking facial expressions,
or constantly monitoring how they are perceived.

The person may appear socially confident while secretly feeling like every interaction is performance-based.

That level of masking becomes exhausting over time.

4. ADHD Emotional Intensity Can Hide Autistic Sensory Overload

When someone becomes emotionally overwhelmed easily, people often label it as:
“just anxiety,”
“just ADHD,”
or “being too sensitive.”

But sensory overload is frequently missed.

Many AuDHD adults experience:

strong reactions to noise,
clothing textures,
bright lights,
crowded spaces,
overlapping conversations,
or emotional overstimulation.

The ADHD side may keep the person constantly moving through stimulation anyway, while the autistic nervous system absorbs every bit of it until burnout eventually happens.

That is why many adults suddenly crash after years of functioning “fine.”

The nervous system was overloaded for far longer than anyone realized.

Why So Many Adults Discover This Late

For years, many people learned to mask instead of understanding themselves.

They became:

people pleasers,
perfectionists,
overachievers,
the funny friend,
the hyper-social one,
or the “gifted but struggling” person.

And because they could function in some environments, nobody noticed how much invisible effort everything required.

But eventually the constant masking catches up.

And many adults finally realize:
they were never “too dramatic,” “too lazy,” “too emotional,” or “bad at life.”

Their brain was simply trying to navigate two different neurotypes at the same time.

That realization can feel overwhelming at first.

But for many people, it is also the first time their entire life finally starts making sense.

09/05/2026

In many countries, teenagers are happier than previous generations. But in Australia and much of Western Europe, the opposite is true.

09/05/2026

Generational Patterns & Zooming Out

When you zoom out, this isn’t just about one child.

PDA challenges:
Control-based parenting.
Productivity culture.
The idea that children must comply to be “good.”

It exposes how uncomfortable we are with autonomy in young people.

It also exposes our own wiring.

Many parents of PDAers realise:
“I was never allowed autonomy either.”

So we end up trying to parent differently while carrying our own unresolved nervous system patterns.

That’s heavy.

But it’s also powerful.

Because awareness interrupts repetition.

And sometimes the biggest shift in a PDA home isn’t behavioural.

It’s the adult softening their own relationship with control.

🌻

07/05/2026

07/05/2026

When the Dysregulation Is Focused on You
This one hurts.

Sometimes the escalation is aimed directly at you.

The parent.
The safest person.
The attachment figure.

You get:
The yelling.
The rejection.
The “I hate you.”
The pushing away.

And it can feel personal.

But often what’s happening is this:

You represent proximity.
You represent expectation.
You represent safety.

And when a child feels most overwhelmed, the safest place to discharge is toward the safest person.

That doesn’t mean you absorb abuse.

It means you hold steady without collapsing or retaliating.

You can say:
“I’m here.”
“I won’t hurt you.”
“I’m going to give you space.”
“We’ll talk later.”

Attachment is built in rupture and repair, not in perfection.

🌻

07/05/2026

Explaining PDA to Siblings

Siblings don’t need clinical lectures.

They need simple truth.

You might say:

“Your sibling’s brain feels pressure very strongly.”
“When they feel trapped, their body reacts fast.”
“It’s not about loving you less.”

Remove moral language.
Remove “good” and “bad.”
Focus on nervous systems.

You can also gently explain:

“We don’t give them more because they deserve more.”
“We give them different because their body needs different.”

Children can be helped to understand fairness when it’s framed as need, not favour.

🌻

23/04/2026

Some children do not “act out” - they react to how safe they feel.

A child who clings, avoids, shuts down or seems overly independent is not trying to be difficult. They are showing you what relationships have felt like for them. When a child has not consistently felt safe, understood or reassured, their behaviour adapts to cope.

Some will stay close and worry about being left.
Some will push adults away and hide their feelings.
Some will swing between both, unsure who to trust.

What looks like behaviour is often attachment.

When adults respond with calm, consistency and understanding instead of control or punishment, children slowly learn that relationships can be safe. That is when behaviour begins to change - not before.

If we only focus on the behaviour, we miss the message. If we understand the attachment need underneath, we can actually help.

Free ATTACHMENT STYLES WHEEL POSTER GUIDE

LIKE the photo and comment "ATTACHMENT" and we will send you a message with a link to a free PDF of this resource.

18/04/2026

18/02/2026

13/02/2026

I've been sitting with something from supervision this week that I keep thinking about.

After years of working with children who have experienced complex developmental trauma, I'm noticing something in my PDA work that's shaking up how I understand what these children are going through.

The level of burnout and the depth of nervous system exhaustion that I'm seeing in PDA children of all ages is extraordinary. More extreme, in many cases, than children who've experienced what we'd traditionally define as severe trauma.

And it's made me wonder: what if we're not fully understanding the extent of the trauma these children are experiencing?

I want to be clear that I'm not claiming these are new or original ideas. Many others - clinicians, researchers, autistic advocates, PDA adults - have spoken about the intersection of PDA and trauma, about autonomy violations, about nervous system impacts.

What I'm sharing here is my attempt to bring together these existing threads of thinking and reflect on them through the lens of both my work as a clinical psychologist and my lived experience as a parent of neurodivergent children. These are my reflections, not groundbreaking theory - but I think they're important conversations we need to keep having.

We know PDA children often experience trauma from the systems around them. We see it clearly in schools that punish them for nervous system responses they can't control, in repeated experiences of being misunderstood and labeled "naughty" or "defiant," in exclusions, restraints, and isolation. We see it in social rejection from peers and adults, and in the accumulated impact of all of this on their sense of self and safety in the world.

This is real trauma. Significant trauma. And we're getting better at recognising it.

But what if there's more? What if these children are born with nervous systems that are more sensitive to sensory experiences and more attuned to other people's emotions? What if this heightened sensitivity means their threat system is activated repeatedly from the very beginning - not by discrete traumatic events, but by the everyday sensory and emotional overwhelm that most nervous systems filter out or tolerate?

And what if this repeated activation of their stress response - this constant state of nervous system overwhelm - is what drives the intense need for autonomy and control that we recognise as PDA? Perhaps the demand avoidance isn't the starting point. Perhaps it's a protective response that develops after months and years of a nervous system that's been chronically activated by sensory input and emotional attunement that feels overwhelming and uncontrollable.

Think about a baby with this kind of nervous system. Everything is done TO them, and they're experiencing it all with heightened intensity. Being picked up when they didn't initiate it, nappy changes, being dressed and undressed, having their face wiped, being put down for sleep when they're not ready, being fed. But it's not just the lack of control - it's the sensory intensity of all of it. The physical sensations of clothing, labels, seams. Unexpected sounds, lights, temperatures. Being touched in ways they can't control or predict. And possibly feeling and absorbing the emotions of the adults around them - sensing stress, frustration, tiredness, anxiety - without any way to regulate or make sense of it.

They have no autonomy at all. No way to communicate their need for control. No way to escape the sensory and emotional overwhelm. And their nervous system is registering threat. Repeatedly. Multiple times per day.

Then think about toddlerhood and early childhood. Being strapped into car seats, pushchairs, highchairs. Teeth brushing, hair washing, nail cutting. Mealtimes with expectations about what, when, and how to eat. Potty training. Being told when to get dressed, what to wear. Transitions between activities. Social expectations from adults and peers. Starting nursery or preschool. Being told to share, take turns, sit still, be quiet. The constant sensory assault of daily life - tags scratching, socks feeling wrong, food textures, background noise. And all the while, picking up on the emotions of everyone around them - teachers' frustration, other children's distress, parents' worry.

Every day. For years.

That's not occasional stress. That's chronic, ongoing nervous system dysregulation - a constant state of threat response with insufficient recovery time. The cumulative load is huge.

Many of you are doing incredible work with low-demand approaches. You're modifying environments, reducing pressure, honouring your child's need for autonomy. You're doing everything "right."

And yet sometimes it doesn't feel like enough. Your child is still deeply struggling. Still burned out. Still in crisis.

What if that's because we're preventing NEW trauma accumulation (which is essential and you should absolutely keep doing), but we're not always addressing what's already accumulated? The nervous system impact that's already there. The established threat patterns. The internalised beliefs about the world being unsafe. The backlog of dysregulation.

Just like with any complex trauma, environmental change alone - while necessary - isn't always sufficient for healing. The child might also need active support for nervous system recovery. Processing. Safety-building. Expanding their window of tolerance. Both/and. Not either/or.

Here's what gives me hope: compassionate, attuned parenting means we're SEEING these children's needs. We're not forcing them underground. We're recognising their distress signals. We're identifying PDA earlier. We're responding with understanding rather than punishment.

This means we have the opportunity to support these children WHILE they're still children. To help them process and heal from the trauma accumulation before it becomes decades of buried pain. To help them develop a sense of self that isn't built on shame and masking. To give them tools and understanding and nervous system regulation support at a time when it can make a profound difference.

The adults I work with who have unrecognised, unsupported PDA often carry wounds that run incredibly deep - years of being misunderstood, punished, told they were broken or difficult or lazy. Years of forcing themselves into compliance at enormous psychological cost.

Your children might be struggling now, but they have something those adults didn't have: parents who see them. Who understand. Who are willing to fight for what they need. Who are learning alongside them.

That recognition and support - even when it feels like it's not enough - is laying a foundation that can prevent so much of the long-term damage.

Does any of this resonate with your experience? Have you noticed that low-demand approaches, while essential, haven't been the complete answer? Do you see this level of accumulated nervous system impact in your child? When you think back through your child's early years, can you see how their threat system might have been activated over and over, even in the most loving, attuned home?

What would it mean to think about your child's distress not just as PDA, but as PDA plus significant trauma - trauma that's accumulated from years of sensory and emotional overwhelm, from a nervous system that experiences the world with such intensity?

I'm still processing this thinking. I don't have all the answers. But I wanted to put these reflections out there because I think we need to keep having these conversations.

These children aren't just struggling with demand. They're often carrying a trauma load that we haven't fully recognised or named. And they deserve support that addresses the full extent of what they're experiencing.

I'd love to hear your thoughts. What are you noticing with your own children? Does this way of thinking about PDA and trauma shift anything for you?