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Writer's pictureJane Green MBE

Co-Occurring Physical Health Challenges in Neurodivergent Children & Young People: A Topical Review

Updated: Sep 19, 2023



Click on hyperlink below to read the actual Paper.


This is an easy read of the hyperlink article. This exciting, new paper explains the increasing research around the co-occurrence between neurodivergent (Autistic, ADHD, Dyspraxic/DCD and Tourette’s syndromes) children and young people (CYP) and physical health challenges in schools by authors, B Donaghy, Dr D Moore and Jane Green MBE.


CYP experience different types of hypermobility including Ehlers-Danlos syndromes, Joint hypermobility, or symptomatic hypermobility if no formal diagnosis. Symptoms of pain, gastrointestinal/stomach pains, reflux, bowel bladder issues and extreme tiredness.


Diagnosis issues and or symptom disbelief:

Neurodivergent CYP are at greater risk of having hypermobility issues and pain-related conditions but there are problems due to Health Care Professionals (HCP) not knowing about the increased occurrence of it. Diagnostic overshadowing is when a HCP assumes a patient’s complaint is due to their other diagnoses, ie a mental or neurodevelopmental diagnosis or disability rather than fully investigating the symptoms, and communication issues resulting in a misdiagnosis or different diagnosis or underdiagnosis, no diagnosis, so not believed which can lead to further trauma.


Quote from paper:

“Sadness and anger are examples of emotional displays for symptoms and subsequent symptomatic distress …. For example, when a CYP joints hurt, they may feel sad, frown or cry and as this pain turns to fatigue they may feel angry”.

Communication issues: including differences in interoception, an inner sense, verbal vs non-verbal communication, as well as emotional and behavioural displays such as ‘masking’ of physical health conditions. This means they often are misunderstood, do not receive help or support for these physical health problems that occur with neurodivergence more than the general neurotypical population.


Educational impacts: These physical health challenges often means neurodivergent CYP have poorer attendance and attainment in mainstream schools, poorer social life with their friends/peers and this affects their mental health and wellbeing as well.



QUOTE from reader

“This is great. Like reading my own story. How many lives could be improved by bi-directional screening for ND and EDS? Esp as ND is overlooked in girls - and worsening of EDS often precipitated at 'tween' age, with a key window for preventative intervention prior!

Recommendations are made for educational organisations and health care professionals, with the importance emphasis of including the voices of CYP in taking these recommendations forward. The recommendations are themed around improving support for CYP, attendance and attainment, the school environment, managing and understanding pain,symptomatic hypermobiity training, training of school staff, diagnostic and treatment pathways, building trust with pupils, support for parents/carers and the need for further funded research.

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I’m going to share this and have a think about how speech and language therapists can support CYP in their care in schools. Schools don’t always start to have conversations until school absence becomes critical and a child may have been disbelieved for many years. It’s too then because they won’t be able to trust any adults to believe them and even harder when they don’t know how to describe it. I was disciplined as an employee for being off for a week with what I described as “mouth ulcers” but was actually severe acute fatigue caused by severe stress. I didn’t know I was autistic then but it coincided with an OFSTED visit so then my job was threatened…

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