Recognise, Understand, Support
A Step by Step Guide to PDA.
Neurodiversity Ireland · Guide · November 2026
PDF, 36 pages, 589 KB
A guide for families and educators
Understanding Neurodivergence
This page helps to guide on how different minds experience the world in different ways, centring lived experience.
What is neurodiversity?
The term neurodiversity refers to the collective of brain types - neurodivergent and neurotypical. Many types of brains fall under the neurodivergent umbrella.
As we centre disability rights and disability justice, we increasingly understand that there really is no "neurotypical" brain and that brains or rather, people whose experience of the world varies from the norm, are considered to be neurodivergent. More fundamentally, when children's needs are unmet, they are deemed to deviate from what is considered to be societally normative. Children are very often disabled by a society and environment that fails to meet their needs.
To be neurodivergent encompasses being Autistic, ADHD, PDA,speech and/or language differences, Dyscalculia, Dysgraphia, Dyslexia, Dyspraxia, Tics and/or Tourette's, using assisted communication, C/PTSD, trauma, FASD (Foetal Alcohol Syndrome), acquired brain injuries, rare disease, OCD, epilepsy, intellectual disability, schizophrenia mental health challenges and others. The neurodivergent umbrella is inclusive.
“Neurodivergent isn’t an identity that says our brains function differently.. Neurodivergent is an identity that reflects and names the structures, power dynamics and dominant societal and cultural norms that shape our experiences.”
The Lived Experience Educator - Sonny Jane Wise
The Neurodiversity Smorgasbord
“The Neurodiversity Smorgasbord is an attempt to offer an alternative to diagnostic categories as well as an opportunity to understand neurodiversity outside of the pathology paradigm. It’s about acknowledging these differences and experiences as a part of being human instead of being a mentally ill or disordered human.
Consider the Neurodiversity Smorgasbord as a way to understand our unique profile, or plate, of individual differences beyond the DSM.”
The Neurodiversity Smorgasbord was created by Sonny Jane Wise, the Lived Experience Educator, and is shared here with their work unaltered.
A neuroaffirmative perspective
Neurodiversity describes the natural variation in how human brains develop and experience the world. There is no single right way for a brain to work. Differences in attention, learning, movement, communication, sensory processing and regulation are part of human diversity.
A core component of the Neurodiversity Paradigm is that it is both natural and important to have variations in neurological development and ways of being with humans and we are not all meant to be the same. Differing neurologies include differing developmental trajectories. In most cultures, value has been placed on neuro-normativity and this has infiltrated how we conceptualise and understand neurodivergence and the experience of different neurotypes.
People who are neurodivergent differ from societal, conformist norms in how they experience the world, in their ways of thinking and how their brains work. The neurodivergent umbrella includes Autistic people, AuDHers and ADHDers, dyslexic thinkers, dyspraxic individuals, PDA’ers, people with different language development pathways and many more.
To be neuroaffirmative means you value every brain type equally and view differences not deficits to be fixed, but as valuable variations of human ways of being. By understanding how a child’s nervous system and brain works, we can provide support by changing environments, systems, cultures and practices to meet their needs.
A note on language - it is important to note that preferences in terminology frequently differ between members of the autism community, and that the preferences of the Autistic person with whom you are engaging should always be the first consideration. That said there are a number of widely preferred terms. Overwhelmingly, ‘identity first’ language is preferred by most Autistic people because they see being Autistic as integral to who they are, not as something they ‘have.’ We recommend consulting our Guide to Inclusive Language and Values, a living, evolving document that helps to ensure we are up to date and respectful of the community about whom we speak:
Being Autistic
Sensory & social communication differences
Autistic children often experience differences in how they process sensory information and social communication. Sensory input such as sound, light, movement, or touch can feel more intense, unpredictable, or harder to filter. This can increase nervous system stress across the day, particularly in busy or noisy environments and can contribute to mental and physical fatigue and overwhelm. As with all humans, capacity fluctuates and the cumulative impact of internal and external stimuli will vary depending the degree of nervous system stress experienced.
Social communication differences may include a preference for direct language, difficulty interpreting unspoken rules, or differences in how connection is expressed. Autistic communication is meaningful and valid and to be valued. Some Autistic children may be non, minimally or variably speaking using mouth words. We should always presume competence and understand that there is a vast range of means by which to communicate. Stimming (self stimulating) actions and activities (and thoughts) are the body and mind’s embodied sensory language — rhythmic movement, sound, or touch that supports regulation and expression. It enables flow and interdependent connection between Autistic people, other beings, and the sensory worlds of which we are all part.
Monotropism is increasingly considered to be the underlying principle behind autism and is becoming more widely recognised, especially within autistic and neurodivergent communities. Fergus Murray (opens in a new tab) describes montropism by saying; ‘we are all interested in many things, and our interests help direct our attention. Different interests are salient at different times. In a monotropic (opens in a new tab) mind, fewer interests tend to be aroused at any time, and they attract more of our processing resources, making it harder to deal with things outside of our current attention tunnel‘.
Autistic /ADHD / AuDHD people are more likely to be monotropic. If you are monotropic, your attention may be pulled very strongly towards a specific focus, interest or sensory experience. This may mean things outside that attention tunnel get missed whilst the majority of your attention is directed towards something specific. Monotropic interests are often very intense and can be completely consuming. It may feel like you are deep diving; being hyper-focused may use all (or the majority) of your energy and attention resources affecting your mind and body. Some interests may be fleeting but still very intense.
How Autistic Children are Identified
Identification usually involves gathering a developmental history and understanding how the child experiences sensory input, communication, relationships, and the demands of daily life. The criteria contained in the American Journal of Psychiatry’s reference manual, the DSM-5 are largely considered to focus upon behaviours that an autistic person would exhibit when distressed, whereas a neuroaffirmative assessment focuses upon understanding the child’s profile and support needs rather than measuring deficits or compliance.
At present, there is no publicly funded standalone autism assessment for children in Ireland, albeit a new HSE Autism Assessment Protocol was introduced in March 2026 that claims children can get an autism assessment across primary care, mental health and disability services. Neurodiversity Ireland cautions that mental health services provide inconsistent support at best and often fail to support Autistic and neurodivergent children and waiting times for CDNTs and Primary Care can run into years. Therefore, it is not known what change, if any, the HSE Autism Protocol will make to the current system in Ireland, which leaves families heavily reliant upon Assessments of Need (AON) applications. The AON process does not usually involve a full autism assessment, which can confuse families who seek an identification for their child and support for their needs. Neurodiversity Ireland says the AON system is completely broken and should be overhauled, in accordance with our submission to the Minister for Disability found on our Advocacy Page.
Critical Review - Assessment of Need
There are a range of providers of private autism assessments and we recommend consulting our Guide to Choosing a Psychologist, for information on how to determine which professional is suitable for your child. The Children’s Clinic, Sandycove, are the original neuroaffirmative autism assessors in Ireland.
We recommend highly the Neurodiversity Affirmative Child Autism Assessment Handbook by Dr Kavanagh, Dr Day, Davida Hartman, Tara O’Donnell-Killen and Jessica K Doyle, for advice on what to expect from an autism identification process carried out by neuroaffirmative practitioners.
Download the Guide to Autistic Experiences - Information for Friends and Family (opens in a new tab) from adultautism.ie, where you can also find helpful links (opens in a new tab).
Listen to the Two Sides of the Spectrum Podcast (opens in a new tab), by Meg Ferrell, Learn Play Thrive.
Our Critical Review of the Assessment of Need system and our Language & Values Guide are both on the advocacy page.
Persistent Drive for Autonomy [PDA]
PDA is a neurotype that experiences loss of autonomy and inequity as a disabling impact on our nervous system, resulting in fight, flight or freeze - survival responses.
This can look like “aggressive behaviour” which we view as distress, OCD or bodily focussed, repetitive movements or actions including self harm, eloping or other risk-taking and loss of daily life skills, namely the ability to eat, communicate, to sleep and impacting toileting and personal hygiene.
Neurodiversity Ireland is the only children’s charity that provides a focus upon PDA across all of our support services and all of our staff are PDA-informed.
See more information about PDA on our Understanding PDA page.
For teachers, SNAs and school staff
Eating, ARFID and PDA
Safe food at school, without pressure
Why food needs a different approach
Many autistic and neurodivergent children have an eating difference called ARFID (Avoidant/Restrictive Food Intake Disorder), and many of these neurodivergent children might also be PDA (Persistent Drive for Autonomy). They may eat only a few safe foods, because of internal and external pressure, sensory differences, fear of choking or being sick, or unclear hunger signals. This is not fussiness.
In schools, adults usually decide when, where and what children eat. A PDA child feels that imbalance of power in their body. A child-led approach hands control back: the child is the expert on their own body.
Adult-ledSet snack timeHealthy eating rules“Just try one bite”
Child-ledFood within reachParents’ choiceNothing said
Let food be available, not scheduled
Eat when ready
Including during lessons, or once the yard noise has passed.
Lunchbox within reach
On the desk, not in a bag or on a shelf.
A quieter space
If the lunch room is too much, eat somewhere calmer.
Uneaten food goes home
With no note and no comment.
Food first thing
Food is regulating for many children. After a hard morning, breakfast may not have happened. Have their safe snack ready on arrival, within reach, with no questions asked.
Neutral responses
No praise, no surprise, no follow-up questions.
- “Can I eat now?”
- Sure. or Of course.
- “I don’t want this.”
- OK.
- “Where’s my lunchbox?”
- On your desk.
- SafetySafe foods are always allowed.
- PredictabilityFood is there. No one remarks on it.
- EquityAdults eat when hungry. So can the child.
- AutonomyWhat, when and how much is their choice.
How you can help
Simple things anyone can do in any classroom
- Healthy eating, redefinedTheir familiar, safe foods, without restriction or judgement.
- Parents’ choice comes firstRelax the healthy eating policy. What the family packs is fine.
- Try strewingLeave safe food within reach, quietly. Don’t watch or comment.
- Don’t talk about their lunchAssume the child always hears it, even adult chat in the staffroom.
- Drop the extrasNo reminders, “one more bite”, praise, stickers or rewards.
- Work with the familyAgree a neurofaffirming plan with parents and clinicians, out of the child’s hearing.
Try this tomorrow
- Put the lunchbox within the child’s reach.
- Tell all staff: whatever the family packs is fine.
- Stop all talk about their food, even praise.
Glossary
- PDA (Persistent Drive for Autonomy)
- a nervous system difference where autonomy is essential to feeling safe and regulated.
- ARFID (Avoidant/Restrictive Food Intake Disorder)
- relying on a small range of safe foods, often for sensory reasons. It is not fussiness.
Where to find support
For individual support, talk to CAMHS, your local CDNT (Children’s Disability Network Team), Primary Care or the child’s GP. Neurodiversity Ireland offers information, community and advocacy.
Eating, ARFID and PDA
Safe food at school, without pressure. For teachers, SNAs and school staff.
Neurodiversity Ireland
PDF, 2 pages, 2.1 MB
This handout is not clinical advice. It aims to reduce pressure around food in school, and every accommodation here benefits all children.
Autistic burnout
Autistic Burnout is a state of exhaustion, when the demands of life exceed the mental or physical energy you have to deal with them.
- As you try to cope with this, your energy depletes, and your body struggles to manage things that you may usually find easy.
- The demands may be too much and you may not have support to cope with the demands, resulting in higher levels of stress.
- Because you do not have the energy to manage the situation, you need time/ space/ tools to recover your energy. But if you are unable to get the opportunity to properly recover, your energy reaches 0, and you are in burnout.
Autistic burnout is an incredibly difficult experience where your brain is in overdrive and you always feel stressed.
Autistic educator Judy Endow (opens in a new tab) describes Autistic Burnout as a “state of physical and mental fatigue, heightened stress, and diminished capacity to manage life skills, sensory input, and social interactions, which comes from years of being severely overtaxed by the strain of trying to live up to demands that are out of sync with our needs. Autistic young people (opens in a new tab) use words such as “exhaustion, feeling stuck, frozen and being entirely overwhelmed” to describe how burnout felt for them.
Autistic Burnout is a debilitating syndrome preceded by an overload of life stressors and the daily challenge of existing in a neurotypical world. Autistic people experience a combination of exhaustion, withdrawal and problems with their concentration and thinking. Burnout seems to be linked (opens in a new tab) to the stress experienced by autistic people in their daily lives.
Signs of burnout:
Key features of Autistic Burnout include changes in:
- Cognition, executive function, memory, speech/communication, ability to cope, ability to do things once could do
- Increased sensitivity to sensory stimulus, to sensory overload, to change to social stimulus
- Increased autistic behaviour (e.g., stimming)
- More frequent meltdowns/shutdowns
- Chronic exhaustion You may find it harder or more overwhelming to do everyday things that you used to find easy (e.g., washing, dressing, sorting and tidying, preparing snacks).
- You may be more forgetful and have difficulty remembering things people have told you, this can be really frustrating!
- It may be harder to make choices, such as choosing what to eat, watch on TV or play with.
- You may find sensory things such as different sounds / sights / smells / tastes / textures around you and the need for different movements either increased or decreased
- You may experience more headaches, tummy aches or other physical symptoms.
- You may feel constantly exhausted, or you may feel a bit like you have too much energy and feel restless and agitated.
- Your sleep and diet may be affected, you may find that you are eating / sleeping more or less than usual.
- You may be more emotional, more anxious, more tearful or angry but not really able to understand why.
- You may struggle to see your friends as much. You may want to stay at home much more and feel unable to go out, including struggling to leave your room.
- You may find that you need to work harder to focus on one thing at a time, you may feel like you want to spend all your time with your deep interests to help you manage, or you may lose interest in everything you once enjoyed as you feel too depressed and tired.
It is important to note that burnout may look similar to depression, but is different (and can occur at the same time).
The following are also signs of Autistic Burnout for children:
- Changes to diet and eating
- Changes to sleep patterns
- Changes to sensory perception
- Emotional changes: may be more tearful /connection-seeking/ angry /frustrated
- Need for more autonomy and control
- Executive functioning difficulties escalated
Recovery from burnout will look different for each individual, however, it is worthwhile to focus on what is regulating for your child’s nervous system and to centre their autonomy and equality.
Watch Viv Dawes and Helen Edgar’s webinar on Autistic Burnout and school trauma here (opens in a new tab).
The burnout webinar mentioned above is in our webinar library.
Lived experience of Autistic people
Going through the process of my daughter’s identification made me realise that the way in which I thought about things or experienced things, was due to my own neurodivergence. My nervous system has lived in a state of constant stress for as long as I can recall, showing up in tummy problems, headaches, teeth grinding, sore muscles and skin picking. Autistic girls are much more likely to be missed, due to comparisons with stereotypes that do not fit and models of assessment based on male-only research. My preference for sameness (perfectionism), repetition (in my head), justice (appearing as rigidity), rejection sensitivity and sensory preferences (attention seeking!) were overlooked. As we strove to understand and support our daughters’ needs, it became obvious that I had never understood my Autistic self. I am PDA and ADHD (as are my daughters) and believe passionately that early identification and support will prevent very many neurodivergent girls from entering the almost inevitable cycles of restricted eating, negative self image and low self esteem, masking to the point of collapse, self injurious and risk-taking behaviours and suicidal ideation.
Further information on supporting Autistic girls:
Ellie Middleton’s book about being Autistic and ADHD, “Unmasked” (opens in a new tab)
The Autistic Girl’s Network website (opens in a new tab)
Slightly older books that may still assist; Helen Clarke, Supporting Spectacular Girls and Carpenter, Happé & Egerton, “Girls and Autism.”
Gina Rippon’s book (please note, language is medicalised), “The Lost Girls of Autism (opens in a new tab)” challenges the male-bias in autism research, listen to her interview over episodes 96 & 97 (opens in a new tab) of the Hidden 20 Podcast.
autism.org: gender differences in diagnoses (opens in a new tab)
Nessa Hill, CEO, Neurodiversity Ireland
ADHD
Sensory & executive functioning differences
Kavanagh et al, in their Neurodiversity Affirming Assessment Handbook, argue that we should view ADHD as a cognitive difference, rather than the cognitive deficit as currently framed by the DSM-5. We view ADHD as divergent thinking ability and divergent attention, or variable attention. Attention in ADHD is interest based rather than effort based. When something is meaningful or engaging, focus can be deep and sustained. When tasks are externally imposed or lack relevance, initiation and follow through can feel genuinely impossible. Hyperactivity can show up both mentally and physically.
Children who are ADHD will experience much greater instances of negativity from adults, which can result in poor self esteem. Children with ADHD often experience differences in both sensory processing and executive functioning, meaning regulation can fluctuate across the day. Executive functioning differences may affect attention, nervous system regulation, working memory, task initiation and time awareness.
It is important for educators to understand that task focus differences may explain a child’s engagement in a topic, rather than framing them as being bored or not paying attention.
Living with ADHD
Living with ADHD can feel like having a fast, curious brain in a world that expects consistency and linear productivity. There can be shame attached to forgetting, procrastinating, or struggling with organisation, even though these are neurological differences rather than personal failures.
Support that focuses upon regulation, reducing cognitive load, increasing autonomy and working with interest rather than against it makes a significant difference to wellbeing. It is important to recognise and support interest-based motivation and hyper-focus/monotropism and reflect on neuro-normative assumptions about how tasks should be done, when etc and how the environment can interact with neurology to create challenges.
Listen to the ADHD Chatter Podcast (opens in a new tab) for different accounts of ADHD from a lived-experience perspective.
How ADHD is identified
Identification typically involves gathering information from home and school alongside clinical interviews. The questionnaires used for ADHD diagnosis may be considered to be slightly outmoded and male-centric and may risk missing female presentation. Diagnosis can support self understanding and access to accommodations. A neuroaffirmative approach recognises ADHD as a difference in regulation and executive functioning, not a behaviour or motivation problem.
There are currently limited options for ADHD identification in Ireland. CAMHS supports moderate to severe mental health challenges (as opposed to “just ADHD”) and will often refer autistic children onwards to a waiting list for a CDNT. There is no current, standalone public pathway for ADHD identification and very limited availability of private Child Psychiatrists.
How ADHD is supported
Children may be assisted by various forms or combinations of ADHD medication, which may only be prescribed by a Child and Adolescent Psychiatrist. If you consider that medication may be required, it is important that your child’s identification is carried out by a Child Psychiatrist, in order to avoid the requirement to obtain a second assessment. Psychologists cannot prescribe medicine.
Information about ADHD medication for children (and their families) can be found in short videos by YouthMed (opens in a new tab) which may be useful for explaining to children why it is needed and what it does.
For supporting ADHD in girls, see adhdgirls.co.uk (opens in a new tab) and Dr Sam Hiew’s instagram, ADHD Girls Collective (opens in a new tab).
You may find this short video (opens in a new tab) explaining ADHD helpful for children.
Lived Experience of ADHD
Accessing ADHD medication for our 3 year old daughter was almost impossible, but life-changing. It gave her the opportunity to slow down, to access her senses and to participate more fully in life. Medicating a child for ADHD is incredibly stressful and involves many trials, errors, changes and stressful situations. The benefits vastly outweigh the preconceived negatives. Melatonin can be invaluable for children who are ADHD, every night or at times when it becomes a necessary support. The issue of ADHD medication is still shrouded in stigma and shame, whereas in our case, we believe it has saved our daughter’s life.
ADHD presents differently in girls and assessments, forms and questionnaires are still based upon male-only research. Girls tend to be given a range of diagnoses before being recognised as ADHD or AuDHD, including General Anxiety Disorder.
Read more about the rise of late identification of ADHD in females here (opens in a new tab).
Nessa Hill, CEO Neurodiversity Ireland
Dyslexia
The Delphi definition of dyslexia (2025) describes it as a set of processing difficulties that primarily affect reading and spelling, with challenges varying in severity across individuals. Dyslexia is a difference to be supported and accommodated, not a deficit to be fixed.
It is linked to differences in how the brain processes written language, particularly phonological (sound–symbol) information, and is not related to intelligence, motivation, or vision.
Globally, around 1 in 10 people are estimated to have dyslexia as a learning difference. With the right support, dyslexic children can thrive academically and often excel in areas such as design, science, entrepreneurship, art, and leadership.
Common Signs of Dyslexia in Children
Signs of dyslexia can vary, but parents may notice:
- Difficulty learning letters, sounds, and spelling patterns
- Slow or effortful reading
- Trouble remembering sequences (e.g., numbers, days of the week)
- Avoiding reading or writing tasks
- Confusion with similar letters or words
- Strong verbal skills or creative thinking
Note: Not all children show every sign—early observation and support are key.
Strengths Often Seen in Dyslexic Children
Many dyslexic children have unique strengths, including:
- Creativity and imagination
- Big-picture or systems thinking
- Problem-solving and innovation
- Visual-spatial reasoning
- Oral storytelling and communication
- Resilience and persistence
Recognising these strengths helps children build confidence while receiving the support they need.
Impact in school and learning environments
Dyslexia primarily impacts how written language is processed. Reading, spelling, and written expression may require more effort and time, particularly in environments that prioritise speed and accuracy. These difficulties can mask underlying strengths in comprehension, reasoning, creativity, and verbal expression.
School settings that rely heavily on written output can increase stress and negatively impact confidence if supports are not in place.
Lived experience
Many dyslexic children describe feeling intelligent but misunderstood. They often know what they want to say but struggle to get it onto the page. Repeated experiences of failure or comparison can lead to anxiety around learning, even when curiosity and intelligence are high.
How dyslexia is identified
Identification is usually carried out by an educational psychologist or specialist teacher through formal assessment of literacy and cognitive processing. Diagnosis can support access to accommodations such as assistive technology, reduced written demands, and alternative ways to show learning.
Children can be assessed for dyslexia once they are at least 6 years old and have had around 18 months of formal schooling (late in Senior Infants). Contrary to a common myth, children do not need to be 8 or older to be assessed.
Steps for Parents
- Talk with the school Share your concerns with your child’s teacher or learning support team. They can observe learning patterns and may already have informal screening data.
- Ask about a public assessment (NEPS) The National Educational Psychological Service (NEPS) can provide assessments through schools. These are free but limited and usually require significant evidence of need.
- Arrange a formal dyslexia assessment A psycho-educational assessment by a qualified educational psychologist or specialist provides a definitive evaluation. Important: Ensure assessors meet recognised qualifications and follow guidance from Dyslexia Ireland (opens in a new tab) and Neurodiversity Ireland (opens in a new tab).
- Get and use the report The report should include recommendations for the school (teaching strategies, supports, and accommodations). Parents usually:
○ Arrange a meeting with the school principal or learning support team
○ Discuss implementing the recommended strategies
- Note: School supports can be provided on a needs basis, so a formal report is not always required for interventions.
- Support outside school Workshops, tutoring, and reading support services can help children build literacy confidence. All literacy strategies should be Structured Literacy programmes based on the Science of Reading. Learn more: The Literacy School – Structured Literacy Guide (opens in a new tab)
Available Accommodations for Dyslexia
Irish Exemption
In Ireland, Irish (Gaeilge) is compulsory. Children with significant literacy difficulties, including dyslexia, may qualify for an exemption from studying Irish.
● The child has received appropriate learning support
● Literacy difficulties are severe and ongoing
● Standardised test scores remain very low despite support
Important: A formal diagnosis is helpful but not always required. Parents apply through the school principal using the Department of Education form. If granted, the exemption certificate remains valid through primary and secondary school. Parents can appeal if an application is refused.
Learn more: Department of Education – Irish Exemption (opens in a new tab)
Assistive Technology
Children with dyslexia may also benefit from:
- Text-to-speech software
- Audiobooks and digital reading tools
- Word processors and spellcheck software
- Mind-mapping or visual planning tools
Dublin City Libraries: Borrow C-Pen Reading Pens in our branches, opens in a new tab
Useful Resources
Dyslexia
A Support Guide for Parents
Neurodiversity Ireland · Family Resource · August 2026
PDF, 3 pages, 353 KB
Enquire at info@neurodiversityireland.com about joining our Dyslexia Support Whatsapp Group.
Lived Experience of Dyslexia
For me, having severe dyslexia means that reading and writing often take much more effort than people expect. When I look at a page of text or even a menu, depending on the font or spacing, it can start to look like alphabet soup—letters appear muddled or blurred together. Filling in forms, reading emails, or spelling words can take much longer because I feel the need to double-check everything. Even then, spell checkers can miss mistakes, especially when a word is spelled correctly but isn’t the word I meant to use.
Dyslexia also affects everyday situations that people don’t always think about. For example, I often mix up left and right, get times confused, and find it difficult to read signs quickly. Following written instructions or writing something on the spot can take extra time. If I’m asked to read something out loud, it can be stressful because the words don’t always come out the way they appear on the page—it can feel like there’s a disconnect, like weak Wi-Fi between my brain and my mouth! That doesn’t mean I don’t understand the information; it just means my brain processes written language differently.
Because of this, I often rely on assistive technology, such as text-to-speech, focus mode, on-screen rulers, voice typing, or having information explained verbally.
Dyslexia also comes with strengths. I have strong visual-spatial reasoning and can see the bigger picture in many situations. This helps me with problem-solving and understanding how different pieces fit together.
Dr Keith Murphy shared his personal experience of dyslexia on RTE’s Lost for Words documentary. Lack of support for his dyslexia resulted in negative impact upon his self-esteem, mental health and relationships. Dsylexia affects every single part of life - showing up in sleep patterns, movement, moods, hyper-focus; but without identification or support, children are labelled as bold, stupid and disruptive. Keith left school believing that he was stupid and functioned by avoiding the world, never putting himself out there. A serious accident resulted in a change of career for Keith, who went back to education and ultimately became a lecturer in Social Policy for TU Dublin, Tallaght. Keith used typing and voice recording to aid his learning and is a passionate advocate for better recognition and support for dyslexic learners.
Dyspraxia
Motor coordination and learning new tasks
Dyspraxia impacts motor coordination and motor planning. Children may take longer to learn new physical tasks and may need more repetition and explicit teaching. Everyday activities such as handwriting, dressing, using tools, or participating in sports can feel effortful and tiring.
Handwriting difficulties are common and may include poor letter formation, slow writing speed, or discomfort when writing for extended periods. These challenges are neurological and not a reflection of effort or motivation.
Dyspraxia is contained in the DSM-5-TR (2022) as “developmental coordination disorder” and in 2011, the UK group Movement Matters formed and produced a consensus statement describing DCD as affecting fine and/or gross motor coordination in children and adults, distinct from other motor disorders such as cerebral palsy, across a range of intellectual ability.
Differences associated with dyspraxia may vary and change over time, depending upon environmental demands and life experiences. Differences can arise with regulation, time management, planning and organisation, which may impact education and employment. Strengths of dyspraxia include being tenacious, creative, empathetic, kind, sensitive and often good at drama, singing and creative activities.
How dyspraxia is identified
Identification is typically carried out by an occupational therapist through a full functional assessment. This includes observing motor planning, coordination, daily living skills, and handwriting. Handwriting assessment forms an important part of understanding how dyspraxia impacts school participation.
Occupational therapy focuses on supporting participation, confidence, and adaptive strategies rather than forcing skills to look typical.
Lachambre et al (2021) explain that ADHD frequently co-occurs with dyspraxia (in about 50% of children), as does autism (about 30-50%) and over 79% of Autistic children have movement difficulties consistent with dyspraxia. The Neurodiversity Affirming Child Autism Assessment Handbook (page 153) recommends that although motor challenges are common in Autistic young people, clinicians need to be mindful not to simply attribute them to autism, in the absence of proper clinical assessment by appropriate professionals.
Neurodiversity Ireland considers that the individual’s fluctuating capacity and the impact of hypermobility will very regularly overlap with the features of dyspraxia, therefore a focus upon regulation, through child-led sensory supports such as climbing and swinging will also benefit core strength, hand strength and overall nervous system safety.
Lived Experience of Dyspraxia
Dyspraxia is a difference in motor planning, how my brain plans and coordinates movement. The messages between my brain and body take longer so everyday physical tasks require more effort. This can make fine motor skills such as zips or shoelaces difficult. Tasks like handwriting can be slower, messy and exhausting. Skills like riding a bike can take longer and be much more difficult to acquire. Noisy environments and tasks with lengthy instructions can also be difficult, so school can be tricky. It is important to remember that even if it looks like I didn’t do much, children like me are working very hard to keep our bodies organised and this is why we are often exhausted after school. Children like me, with Dyspraxia, are often very aware of our difficulties which can lead to breakdowns in social situations or in accessing school.
Supporting children like me appropriately is essential. Breaking down tasks into simple steps and using meaningful visuals to support lengthy instructions is essential. Supports like Velcro straps instead of laces and assistive technology instead of handwriting tasks can make my day a lot easier. With all tasks or verbal instructions, it is essential to allow me time to process. You might have to say it twice or 3 times, but remember I am listening!
Tics and Tourette's
Tics and Tourette’s
Tics are sudden, rapid and repeated body movements or sounds that serve no purpose. They are involuntary meaning your child is not doing them by choice.
The movements (called motor tics) can affect any part of the body although most often affect the head and neck. Common examples of motor tics include rapid blinking, twitches in the neck and nose wrinkling.
The sounds (called vocal tics) commonly involve sniffing, tutting or throat clearing noises.
Tics can be simple. This means they involve just one muscle or making a noise.
Tics can also be complex. Complex tics involve lots of muscles moving together or spoken words, for example jumping on the spot or repeating words.
Some tics can be hard to spot whereas others can be very noticeable to other people.
Although tics vary from person to person, they often share certain traits.g is identified
Tourette’s syndrome is just one of several names doctors use to describe a child's pattern of tics. Although doctors use different labels, they think that tic disorders represent points on a spectrum. They all share the same underlying cause.
Find out more about tics from Dr Seonaid Anderson and NHS (opens in a new tab).
Lived Experience of Tics and Tourettes
Keelan Tiernan’s Mum, Lorna first realised that her son was showing symptoms when he was just two and a half years old. It started with “head-jerking” after a coughing fit on holidays and progressed after that. Lorna explained how hard it can be to deal with because there isn’t much awareness of the condition in Ireland, and there are no support groups in Ireland either.
She said: “There is not enough awareness about it in Ireland. When he has tics it can be not only emotionally draining but physically exhausting. He used to punch himself in the head when he got overwhelmed.”
Speaking proudly about her son, Keelan’s mum, Lorna, reflected on the challenges that her son has faced and the progress he has made over the past year. “A year ago he was leaving school early, because it was too overwhelming for him.”
Keelan (10) said how he copes when he gets overwhelmed by “slowing down” his breathing, using fidget toys and “singing a song in [his] head”. He says that it also helps when people around him are calm, too.
Contact Tourette’s Support NI (opens in a new tab) & ROI or email tourettesni@gmail.com
Watch the incredibly moving film about the story of Scottish Tourette's campaigner John Davidson over 36 years, from the time his symptoms first appeared as a child, “I Swear” (opens in a new tab) (available on Netflix (opens in a new tab)). The biopic beautifully highlights the impact of unconditional positive regard, safety, and regulation and is a powerful example of how a person may be understood through a behaviourist lens - or a nervous system safety lens.
AuDHD (Autistic and ADHD)
AuDHD (Autistic and ADHD)
AuDHD is a community-created term used by people who are both Autistic and ADHD to describe how these experiences intersect. Despite the high rate of co-occurrence, it wasn’t until relatively recently that an Autistic person could also be identified as ADHD. Prior to the release of the DSM-5 in 2013, the diagnostic criteria did not allow for co-diagnosis of autism and ADHD. They were considered mutually exclusive conditions. AuDHD is a term that helps us to understand the tension between structure, novelty, regulation, impulsivity, hyperfocus and overwhelm that we experience and that can help us have a bit more self-compassion and gentleness with ourselves.
AuDHD is a complex neurotype that cannot be reduced to its individual components of autism and ADHD. It is a unique way of perceiving, thinking, and engaging with the world that comes with both struggles and strengths.
Understanding AuDHD requires a holistic view of a person and how they interact. It means moving beyond the pathology paradigm to appreciate neurodiversity.
Lynsey Mackereth describes AuDHD as a different reality rather than a double diagnosis, with 7 phenomena unique to this neurotype:-
- Fluctuating Attention Patterns: Hyperfocus + Distractibility
- Tension between order and impulse
- Social interaction that oscillates between withdrawal and impulsivity
- Complex sensory and emotional overload
- Varying responses to motivators and stimuli
- Amplified executive dysfunction - when planning meets chaos
- Sleep disruption.
Read more about AuDHD by Embrace Autism here (opens in a new tab) and follow NeurodivergentAlly, Adelle Sushames, on instagram here (opens in a new tab).
Taking off the Mask (opens in a new tab) - Dr Hannah Belcher
Strong Female Character (opens in a new tab) - Fern Brady
Christine Doyle - What is AuDHD (opens in a new tab)
The Amazing Discovery E-book (opens in a new tab) for children by Adelle Sushames, Neurodivergent Ally.
Connective Tissue Differences in Neurodivergence
hEDS and HSD are not neurodivergent conditions themselves, but the research evidence for a strong link between joint hypermobility and neurodivergence (Being autistic and ADHD in particular) is now well established. Many of the families we work with are navigating both.
What Are hEDS and HSD?
The Ehlers-Danlos syndromes are a group of heritable conditions affecting connective tissue, the material that gives strength and elasticity to skin, joints, blood vessels and organs throughout the body. There are thirteen recognised types of EDS, twelve of which have an identified genetic cause. Hypermobile EDS (hEDS) is the most common type by far, and is currently the only one without a known single genetic marker, which is part of why it is diagnosed by clinical examination rather than a blood test.
Hypermobility Spectrum Disorder (HSD) describes symptomatic joint hypermobility, pain and instability that does not meet the full diagnostic criteria for hEDS. HSD is not a “lesser” or “in-between” diagnosis. It is managed in the same way as hEDS, and for most people day to day life with HSD looks very similar to life with hEDS.
Joint hypermobility itself is common. Symptomatic hypermobility disorders like hEDS/HSD are thought to affect somewhere in the region of 1 in 500 people, though because awareness among clinicians is still limited, many people go undiagnosed or are diagnosed very late. Research reported by the Hypermobility Syndromes Association found that more than half of patients wait over ten years from first symptoms to diagnosis.
hEDS runs in families. If a parent has hEDS, there is roughly a 50% chance of passing a predisposition to it on to each child, although the pattern and severity of symptoms can vary considerably between relatives. Connective tissue differences affect the whole body, not just the joints, which is why hEDS and HSD are described as systemic conditions and why the list of possible symptoms and co-occurring conditions is so long.
Neurodivergence and Hypermobility: The Overlap
One of the more surprising things many people learn on this journey is how strongly joint hypermobility overlaps with neurodivergence, particularly being Autistic and ADHD. This is not a fringe theory. A study from Brighton and Sussex Medical School, funded by the Medical Research Council, MQ Mental Health Research and Versus Arthritis, assessed 109 autistic, ADHD and Tourette syndrome adults using the Beighton scale and compared them with a general-population control group.
Over 50% of the neurodivergent participants showed elevated joint hypermobility, compared with around 20% of the general population, a roughly fourfold increase. Hypermobility was also linked directly to greater dysautonomia (such as dizziness on standing) and greater musculoskeletal pain within the neurodivergent group, with the effect stronger among women.
The exact mechanism is still being researched, but hypermobility is thought to be one plausible physical explanation for why so many Autistic and ADHD people also experience dysautonomia, chronic pain, fatigue and interoception differences (difficulty accurately sensing internal body signals like hunger, temperature, pain or a full bladder). None of this means hypermobility causes neurodivergence, or the reverse. It means the two are found together often enough that each is worth screening for when the other is present.
What this means in practice
- If you or your child is neurodivergent also experiences joint pain, dislocations, fatigue or dizziness on standing, it is reasonable to raise hEDS/HSD screening with your GP.
- If you or your child has hEDS/HSD and also experiences differences in communication, attention/activity or nervous system regulation or sensations, it may be worth exploring a neurodiversity affirming assessment particularly if daily life expectations and tasks feel disproportionately exhausting.
- Care should be affirming, not pathologising. Being both hypermobile and neurodivergent is not a personal failing or a sign of being “too sensitive.” Pacing, low pressure approaches and sensory-aware environments that work well for many neurodivergent people also tend to support people managing chronic pain and fatigue.
Neurodiversity Ireland’s own services are built around neuroaffirmative, child-led, PDA-informed (Persistent Drive for Autonomy) approaches to therapy and family support. If your family is navigating both neurodivergence and a hypermobility condition, you do not need to treat them as two unrelated problems being managed by two unrelated teams; ask each professional you see whether they are aware of, or willing to learn about, the other.
Recognising hEDS Symptoms in Neurodivergent Children
hEDS can be harder to spot in neurodivergent children — pain may be masked, mislabelled as ‘clumsiness’, or attributed to sensory processing differences.
Physical signs to watch for
- Hypermobility: joints bending beyond the normal range — fingers bending back, elbows/knees hyperextending but noting also that hypermobility can relate to any tissue or joints and may not be visible to the eye
- Chronic pain: joint aches, growing pains that persist, or muscle soreness after mild activity, stiffness from muscles that are over-compensating
- Balance & coordination: frequent ankle rolling, ‘W’ sitting, preferring to lie down rather than sit
- Skin differences: soft/stretchy skin, easy bruising, or slow-healing wounds
- Gut issues: nausea, bloating, constipation, or reflux and issues relating to periods and the pelvic area for girls and women
- Dizziness: lightheadedness or fainting on standing — possible POTS (dysautonomia)
Neurodivergent-specific overlaps
- Proprioception (body awareness) differences amplify coordination difficulties
- Masking or PDA or sensory differences can hide how much pain a child is in
- Fatigue may look like refusal or shutdown rather than physical exhaustion
- Sensory sensitivities around touch, clothing, or footwear can worsen joint pain
Managing Pain & Fatigue
Daily strategies
- Nervous System Regulation: find what causes and what reduces stress
- Pacing: Short bursts of activity with rest breaks — avoid pushing through pain
- Joint support: Supportive footwear and bracing stabilise joints and reduce injury risk
- Heat & cold: Warm baths or hot water bottles for muscle pain; cold packs for swollen joints
- Sensory support: Positioning aids, weighted blankets, and movement breaks reduce flare risk
- Sleep: Poor sleep worsens pain — a consistent, low-stimulation bedtime routine helps
During a flare
- Rest is treatment — reduce physical demands, not just medication
- Keep a simple flare log (date, trigger, severity, duration) to share with doctors
- Physiotherapy — not rest alone — is a primary treatment for hEDs
School & Accommodations
You do not need a formal hEDS diagnosis to request reasonable accommodations in Irish schools. A letter from your GP or physiotherapist describing your child’s functional needs is usually sufficient.
What to request
- Rest breaks: Permission to sit, move, or use a mat when in pain
- Seating & writing: Ergonomic seating; laptop or tablet as alternative to handwriting
- PE adaptations: Modified participation (e.g. timing rather than running) — not exclusion
- Additional support: SNA support or resource hours, for eg pain/fatigue
- Environment: Lift access, early departure to avoid crowds, lighter bag arrangements
- Attendance: Medically justified absences not counted against attendance targets
If school is resistant
- Put all requests in writing — email is sufficient
- Reference the EPSEN Act and your child’s right to an individual SSP (support plan)
- Contact your SENO (Special Education Needs Organiser) — find yours at ncse.ie
- Contact Neurodiversity Ireland
Healthcare Navigation in Ireland
Getting a diagnosis
- First step: Start with your GP — ask for a referral to paediatric rheumatology or genetics and ask for someone who specifically understands and caters for neurodivergent children
- Beighton Score: Ask your GP to perform a Beighton Score assessment in clinic but understand that this is not conclusive – the criteria are due to change in December 2026 for identification of connective tissue differences
- Where to go: Children’s Health Ireland (CHI) at Crumlin or Temple Street for paediatric referrals
- Keep a symptom diary; push for urgent referral if pain is affecting daily functioning
Key professionals to request
- Physiotherapist: Essential for building strength and stability — do not rest alone – ensure the physio understands connective tissue issues
- Gastroenterologist: For nausea, bloating, constipation, or reflux – ensure they are able to help neurodivergent patients
- Cardiologist: If dizziness or fainting present — ask for a tilt table test or NASA lean test re POTS
- Psychologist / OT: For pain management, fatigue, and co-occurring mental health needs – again ensure they understand both neurodivergence and connective tissue issues
At appointments
- Bring a written list of symptoms, frequency, and impact on daily life
- Ask for copies of all referral letters
- Use functional language: ‘My child cannot attend school 2 days a week due to pain’
- If dismissed: ask ‘What would you recommend if this continues?’ — and document the answer
This guide is for information only and does not constitute medical advice. Always consult a qualified healthcare professional for your child’s specific needs.
Navigating hEDS & HSD in Ireland
A practical guide to hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder for patients, families and carers.
Neurodiversity Ireland, August 2026
PDF, 11 pages, 360 KB
hEDS & Hypermobility
A Quick-Reference Guide for Parents of Neurodivergent Children.
Neurodiversity Ireland
PDF, 3 pages, 172 KB
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