05/23/2026
So thankful for our very own Heather Marsh, who has educated all of us at Treehouse on hypermobility and how often is actually occurs with our kiddos.
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.]
