When Rejection Feels Bigger Than It Looks: Understanding RSD in Adult Women Have you ever found yourself replaying a conversation over and over in your mind, wondering if you said the wrong thing? Have you ever received a piece of feedback at work and spent the rest of the day feeling unsettled, even though you knew it was meant kindly? Or perhaps you’ve found yourself withdrawing from the people you love after a disagreement, not because you don’t care, but because the emotions feel too big to hold. If any of this feels familiar, you are not alone. For many neurodivergent women, particularly those with ADHD, Rejection Sensitive Dysphoria (RSD) can be a significant yet often unseen part of daily life. It can shape how we experience relationships, work, parenting, friendship, and even the way we see ourselves. And yet, so many women carry these experiences quietly, believing they are simply “too sensitive” or that they need to try harder to cope. What if the reality is something different? What if your nervous system is working incredibly hard to keep you safe? What is Rejection Sensitive Dysphoria? RSD is often described as an intense emotional response to perceived or actual rejection, criticism, exclusion, or failure. The important word here is perceived. A delayed reply. A change in someone’s tone. Constructive feedback from a manager. A partner seeming distracted after a long day. While another person may barely notice these moments, someone experiencing RSD may feel them deeply and intensely. It’s not a choice. It’s not attention-seeking. And it’s certainly not a sign of weakness. For many women, it can feel as though the emotional volume has suddenly been turned all the way up, making a seemingly small interaction feel incredibly painful. The Women Who Carry It Quietly One of the reasons RSD often goes unnoticed in women is because many of us become very skilled at hiding our struggles. We learn to smile. We learn to push through. We learn to over-achieve, overthink, over-apologise and over-accommodate. From the outside, we may appear capable, organised and successful. Inside, however, we might be carrying a constant fear of disappointing others. We may spend hours analysing conversations. We may work twice as hard to avoid criticism. We may say yes when we desperately need to say no. Not because we lack confidence, but because rejection feels genuinely painful. Over time, this can become exhausting. When the Nervous System Shuts Down Something I wish more people understood about RSD is that it doesn’t always look dramatic. Sometimes it looks like silence. Sometimes it looks like disappearing. Sometimes it looks like shutting down. When emotions become overwhelming, many women don’t become outwardly angry or reactive. Instead, the nervous system moves into protection mode. The mind feels foggy. Words become difficult to find. Decision-making feels impossible. Even simple tasks can suddenly require enormous effort. You may find yourself retreating to a quiet room. Ignoring messages. Avoiding conversations. Cancelling plans. Staring at your laptop unable to begin the task you know needs doing. Not because you don’t care. Not because you’re being difficult. But because your nervous system has reached capacity. A shutdown is not a failure. It’s often a sign that your system is overwhelmed and trying to protect itself. The Impact on Family Life Family life can be beautiful, messy, joyful and demanding all at once. For women carrying RSD, family relationships can sometimes feel particularly tender. A child’s frustration may trigger feelings of inadequacy. A partner’s feedback may land much harder than intended. A disagreement can feel less like a momentary conflict and more like evidence that you’ve somehow failed the people you love. When a shutdown follows, there can be an added layer of guilt. You may want connection but feel unable to engage. You may need space but worry others will misunderstand. You may withdraw to regulate your nervous system, only to criticise yourself for doing so. Many women tell themselves they should be able to cope better. But perhaps the kinder question is this: What support does your nervous system need right now? Because needing recovery time does not make you a bad partner, parent or friend. It makes you human. The Workplace Nobody Sees Work can present a unique set of challenges for women experiencing RSD. Performance reviews. Emails that seem abrupt. Meetings where ideas aren’t acknowledged. Mistakes that everyone else forgets but you carry for days. The emotional labour involved in navigating these moments can be immense. Many women become perfectionists, striving to avoid criticism at all costs. Others avoid opportunities altogether, not because they lack ability, but because the possibility of failure feels too painful. And then there are the shutdowns. The days when one difficult interaction makes it impossible to focus. The days when your brain seems to go offline. The days when you’re physically present but emotionally exhausted. These experiences are rarely visible to colleagues, which can make them feel even lonelier. The Weight of Self-Criticism Perhaps one of the hardest parts of RSD is the story we often tell ourselves afterwards. The conversation ends, but the self-criticism begins. Why did I react like that? Why can’t I just let it go? What’s wrong with me? But what if there is nothing wrong with you? What if the goal isn’t to become less sensitive, but to understand your sensitivity differently? Many of the same traits that make rejection feel deeply painful are also connected to empathy, creativity, intuition, passion and a profound capacity for connection. The challenge is learning to offer ourselves the same compassion we so readily offer others. A Gentler Way Forward Understanding RSD doesn’t mean every difficult feeling suddenly disappears. But it can create space for something powerful. Self-understanding. When we recognise that our responses are connected to a sensitive nervous system rather than a personal failing, we can begin to replace shame with curiosity. We can notice our triggers without judging ourselves for having them. We can build recovery into our
Tag: therapy
Is It PDA or RSD? Understanding What Might Be Beneath the Behaviour
Is It PDA or RSD? Understanding What Might Be Beneath the Behaviour In recent years, there has been increasing awareness of Pathological Demand Avoidance (PDA), or more accurately, a PDA profile of autism. Social media has played a significant role in helping families discover language that resonates with their child’s experiences, often bringing a sense of relief and validation after years of confusion. For many parents, reading about PDA can feel like finally finding a missing piece of the puzzle. The intense avoidance of everyday demands. The resistance to requests. The need for autonomy. The emotional responses that can seem disproportionate to the situation. The anxiety that appears to sit beneath it all. However, as awareness of PDA has grown, another important question has emerged: Is it always PDA? Or could some children and teenagers be experiencing something that looks similar on the surface but is being driven by a different underlying mechanism? One possibility worth considering is Rejection Sensitive Dysphoria (RSD). While PDA and RSD can coexist, and neither experience should be dismissed, there are situations where what appears to be demand avoidance may actually be rooted in a profound fear of criticism, shame, failure, or disappointing others. Understanding the difference can help us provide more effective and compassionate support. What Is PDA? PDA is generally understood as a profile associated with autism in which an individual experiences an intense need to avoid demands and maintain a sense of autonomy. Demand avoidance itself is not unique to PDA. All humans avoid demands at times. What makes PDA distinct is the intensity of the response and the significant anxiety that often sits beneath it. Demands may include: Being asked to complete a task Following instructions Transitions Expectations from others Everyday routines Even activities the individual wants to do For those with a PDA profile, demands can trigger a profound sense of threat, leading to avoidance strategies that are often driven by nervous system activation rather than deliberate oppositional behaviour. What Is RSD? Rejection Sensitive Dysphoria (RSD) is commonly discussed within ADHD communities and refers to an intense emotional response to perceived rejection, criticism, failure, disapproval, or not meeting expectations. While RSD is not currently a formal diagnostic category, it is widely recognised by many ADHD clinicians and individuals with lived experience. For a child or teenager with RSD, experiences that seem minor to others may feel deeply painful. Examples may include: Receiving corrective feedback Making a mistake Losing a game Not achieving a desired result Feeling compared to peers Perceiving disappointment from adults Struggling with a task Importantly, the fear of these experiences can become so overwhelming that avoidance develops as a protective strategy. When RSD Looks Like PDA This is where things become particularly interesting. A child with significant RSD may begin avoiding demands not because the demand itself feels threatening, but because of what the demand represents. The demand may carry the possibility of: Getting it wrong Being corrected Failing Feeling embarrassed Disappointing someone Being judged Being perceived as incapable In these situations, avoidance becomes a form of self-protection. For example: A child refuses to start homework. At first glance, this may appear to be demand avoidance. However, underneath the refusal may be a fear that they will not understand the work, will make mistakes, or will be criticised for getting it wrong. Similarly: Avoiding sports may be driven by fear of poor performance. Avoiding school may be driven by fear of failure or social judgement. Refusing new activities may stem from anxiety about not being immediately successful. From the outside, the behaviour may look remarkably similar to PDA. The internal experience, however, may be very different. The Role of Neurodivergence Many neurodivergent young people experience a lifetime of subtle and not-so-subtle messages that they are getting things wrong. They may have: Been corrected more frequently than peers Struggled with executive functioning Found social situations confusing Experienced sensory overwhelm Felt misunderstood by adults Internalised feelings of inadequacy Over time, this can create a heightened sensitivity to criticism and perceived failure. For children with ADHD in particular, RSD can become a powerful driver of behaviour. The nervous system learns that avoiding the situation feels safer than risking emotional pain. Why Social Media Has Increased the Conversation The recent spotlight on PDA has undoubtedly helped many families access understanding and support. For some children, a PDA profile is absolutely the most accurate explanation for their experiences. However, social media content often focuses on observable behaviours rather than underlying drivers. A child refusing school. A child avoiding homework. A child saying “no” to requests. A child becoming distressed when expectations are placed upon them. These behaviours can occur in PDA. They can also occur in: RSD Anxiety Burnout Trauma Perfectionism Sensory overwhelm Chronic health conditions Executive functioning difficulties Behaviour alone rarely tells the whole story. Understanding the “why” beneath the behaviour is often far more important than the behaviour itself. Questions Worth Exploring Rather than asking: “How do I stop this avoidance?” It can be helpful to ask: What is making this situation feel unsafe? Is there fear of failure? Is there fear of criticism? Is there fear of disappointing others? Is perfectionism playing a role? Has this child experienced repeated experiences of feeling unsuccessful? What happens when mistakes occur? The answers can offer valuable clues about whether RSD may be contributing to the presentation. A Neuro-Affirming Perspective From a neurodiversity-affirming perspective, neither PDA nor RSD should be viewed as problematic behaviours that need to be eliminated. Instead, both can be understood as adaptive responses. The nervous system is always trying to keep the individual safe. If demands feel threatening, avoidance may emerge. If criticism feels unbearable, avoidance may emerge. If failure feels devastating, avoidance may emerge. The behaviour makes sense when we understand the context. Our role is not to force compliance. Our role is to build safety. Supporting Children with RSD When RSD is present, support often focuses on reducing shame and increasing psychological safety. This may include:
Breathwork for Children with Hypermobility: A Neuro-affirming Approach
Why Breathwork Isn’t Always Simple: Supporting Children and Teens with Hypermobility Through Neuro-Affirming Breathwork “Take a deep breath.” It’s one of the most common pieces of advice given to children and teenagers who are feeling anxious, overwhelmed or dysregulated. But what if taking a deep breath isn’t actually as simple as it sounds? For many children and teens living with hypermobility, dyspraxia, autism, ADHD, chronic stress, burnout, or nervous system dysregulation, the ability to access a deep diaphragmatic breath may not come naturally. In fact, for some young people, the neural pathways required to take a full, relaxed breath may need to be developed first. This is why at Little Kneaders, we take a neuro-affirming approach to breathwork, one that recognises that breathing is not simply a skill to be instructed, but a pattern that often needs to be experienced, explored and gently learned. The Diaphragm and Hypermobility Many children and teenagers with Hypermobility Spectrum Disorder or Hypermobile Ehlers-Danlos Syndrome experience altered breathing patterns. This may seem surprising at first. After all, we don’t usually think of breathing as being connected to connective tissue. However, the diaphragm is closely linked to the rib cage, spine, core muscles and connective tissue systems that support posture and movement. When joints are less stable, the body often compensates by creating protective tension. Over time, this can contribute to: Shallow chest breathing Breath holding Upper chest tension Reduced diaphragmatic movement Rib cage restriction A feeling of not being able to take a satisfying breath For many young people, what appears to be a “tight diaphragm” is often the body’s attempt to create stability and protection. The Nervous System Connection The diaphragm is also deeply connected to the nervous system. When a child is living in a state of chronic stress, anxiety, sensory overwhelm or burnout, breathing patterns often become shorter and more shallow. This is not a choice. It is an automatic nervous system response. Many neurodivergent children and teenagers spend significant periods of time navigating environments that place high demands on their sensory, social and cognitive resources. Over time, the nervous system may become accustomed to operating in a heightened state of alertness. The body learns to brace. The shoulders lift. The chest tightens. The diaphragm moves less efficiently. And eventually, shallow breathing becomes the default pattern. Why “Take a Deep Breath” Often Doesn’t Work One of the biggest misconceptions about breathwork is the assumption that everyone automatically knows how to access a deep breath. Many children simply don’t. Particularly those who are: Autistic ADHD Dyspraxic Hypermobile Recovering from burnout Experiencing chronic anxiety Living with persistent pain For some young people, the instruction “take a deep breath” feels confusing because they cannot easily identify what a deep breath should feel like in their body. This is where a neuro-affirming approach becomes so important. Rather than expecting a child to perform a skill they may not yet have developed, we can focus on teaching the skill in a way that makes sense to their nervous system. Creating the Neural Pathways First Before breathwork can become a regulation tool, the brain and body often need opportunities to build familiarity with diaphragmatic breathing. This is where repetition, play and visual learning become incredibly powerful. Every time a child experiences a successful diaphragmatic breath, the brain strengthens the neural pathways associated with that movement pattern. Over time, what once felt unfamiliar becomes more accessible. Rather than forcing breathing techniques, we can focus on creating positive experiences that allow the nervous system to discover breathing naturally. This is often far more effective than asking a child to sit still and follow complex instructions. The Importance of Visuals in Breathwork Many neurodivergent children and teenagers are visual learners. Telling a child to “breathe into your belly” may not create a meaningful image. Showing them what that looks like often does. Visuals help bridge the gap between abstract language and physical experience. Examples may include: Watching a feather move with the breath Placing a soft toy on the tummy and watching it rise and fall Using bubbles Following visual breathing cards Watching scarves move in the air Using imagery such as balloons, waves or clouds These visual cues provide immediate feedback and make breathing more tangible. For many young people, seeing breathing happen is far easier than simply being told how to do it. Feather Breathing: A Playful Way to Build Breathing Skills One of our favourite approaches at Little Kneaders is feather breathing. The concept is beautifully simple. A child holds a feather and uses their breath to gently move it. There is no pressure to perform. No expectation of perfection. Just curiosity. The feather immediately provides visual feedback. Children can see whether their breath is short, strong, gentle or sustained. As they experiment, they naturally begin exploring: Longer exhalations Breath control Diaphragmatic engagement Nervous system regulation Most importantly, it feels playful rather than therapeutic. For many children, this creates far greater engagement than traditional breathing exercises. Breathwork as Co-Regulation Another important consideration is that breathwork is often most effective when taught through connection. Many children learn breathing patterns through co-regulation before they can self-regulate. This means: Breathing together Modelling calm breathing Practising in safe environments Using predictable routines Removing performance expectations The goal is not to force relaxation. The goal is to create conditions where the nervous system feels safe enough to access regulation. A Neuro-Affirming Perspective At Little Kneaders, we believe that if a breathing strategy is not working, the answer is rarely that the child is doing it wrong. More often, the strategy needs adapting to fit the child’s nervous system, sensory profile and developmental stage. Neurodivergent children are not failing at breathwork. Many simply require different pathways into learning it. When we shift our focus from compliance to curiosity, we create opportunities for genuine connection and skill development. Final Thoughts Breathing is one of the most powerful tools we have for supporting nervous system regulation, emotional wellbeing and body awareness. But for children and
Carefully Considered Collaborations: Little Kneaders X Sport Ireland
Carefully Considered Collaborations: Little Kneaders X Sport Ireland At Little Kneaders, every collaboration begins with a question: Will this genuinely support the young people and families we work with? If the answer is yes, we explore it further. If the answer is no, we politely decline. This philosophy sits at the heart of our Carefully Considered Collaborations Series — partnerships that are intentionally designed to support the wellbeing, regulation and lived experiences of neurodivergent young people. Today, I am delighted to share the beginning of a very special collaboration between Little Kneaders and Sport Ireland. Over the next six weeks, we will be supporting a small group of neurodivergent teenage girls through gentle, accessible movement experiences designed to nurture confidence, connection and wellbeing. Our first session has already begun, and we couldn’t have imagined a more fitting start. Beginning with Gentle Yoga Our first class was a beautiful gentle yoga session facilitated by Adrienne McGrath, whose passion for restoring peace, connection and healing through movement was evident from the moment she entered the room. Adrienne created a calm, welcoming environment where the girls could engage at their own pace, free from pressure or expectations. There was no focus on performance. No competition. No requirement to “keep up.” Instead, the emphasis was on listening to the body, exploring movement gently, and experiencing the benefits of being present in a supportive space. For many of the girls attending, this was exactly what was needed. Why This Collaboration Matters This collaboration was deeply intentional. Many of the neurodivergent teenage girls I work with have complicated relationships with movement and exercise. Not because they do not want to move. Not because they are unwilling. But because traditional sports and physical education environments often fail to accommodate their needs. Many of my clients experience challenges such as: Postural Orthostatic Tachycardia Syndrome and autonomic nervous system dysregulation Hypermobility and chronic pain Dyspraxia and motor coordination differences Burnout recovery and depleted energy levels Sensory sensitivities Strong rejection sensitivity profiles Anxiety and reduced confidence in group settings For some young people, PE lessons can become associated with feelings of failure, exclusion, overwhelm or embarrassment. Repeated experiences of struggling to keep up with peers can gradually erode confidence and create understandable avoidance of movement altogether. Yet movement remains one of the most powerful tools we have for supporting mental wellbeing. The challenge is not convincing young people to move. The challenge is creating environments where movement feels safe, accessible and enjoyable. Movement as Part of Holistic Mental Health Support At Little Kneaders, we view wellbeing through a holistic lens. Mental health does not exist separately from the body. The nervous system, sensory system, movement, sleep, hormones, nutrition, social connection and emotional wellbeing are all interconnected. Every young person participating in this programme is either experiencing mental health challenges or actively recovering from them. Many are rebuilding after periods of significant stress, anxiety, burnout, school avoidance or nervous system dysregulation. For these young people, movement is not about fitness goals. It is not about performance. It is not about pushing through discomfort. Instead, movement becomes an opportunity to: Support nervous system regulation Improve mood and emotional wellbeing Build body awareness and proprioception Increase confidence Encourage gentle strength and resilience Reduce stress and overwhelm Reconnect with the body in a compassionate way Small, consistent experiences of success can often be far more transformative than intensive interventions. Creating Space for Friendship and Belonging One of the most important aspects of this programme is something that cannot be measured on a fitness tracker. Connection. The classes are intentionally small, with a maximum of six participants. This allows us to create an environment that feels safe, predictable and supportive. Many neurodivergent teenagers tell us that making and maintaining friendships can feel challenging, particularly after periods of school avoidance, burnout or social isolation. Within a smaller group, there is more opportunity for authentic connection to develop naturally. There is no pressure to socialise. No expectation to perform socially. Just the opportunity to spend time alongside other young people who often share similar experiences and understand one another in ways that can be difficult to find elsewhere. Sometimes healing happens through movement. Sometimes healing happens through being understood. Often, it is both. A Neuro-Affirming Approach to Movement This programme has been designed through a neurodiversity-affirming lens. We recognise that neurodivergent bodies and minds are not broken versions of neurotypical ones. They simply have different needs. That means: Choice is prioritised. Participation is flexible. Rest is respected. Sensory needs are accommodated. Individual pacing is encouraged. Success is defined differently for every participant. For some girls, success may look like participating in the full class. For others, it may mean simply arriving, observing, or trying one new movement. Every step matters. Every experience counts. Looking Ahead This first yoga session marks the beginning of what we hope will be a meaningful journey for the young people participating. We are incredibly grateful to Sport Ireland for supporting this initiative and to Adrienne McGrath for bringing such warmth, expertise and compassion to our opening session. As the programme progresses, we look forward to witnessing the confidence, connection and self-belief that can emerge when young people are given the opportunity to engage with movement in a way that truly honours their individual needs. Because when movement feels safe, supported and accessible, it becomes so much more than exercise. It becomes a pathway back to connection, with the body, with others, and with ourselves. Back To Blog
The Advantages of Gel Nails for those with Hypermobility Syndrome
The Advantages of Gel Nails for People with Hypermobility Syndrome: Proprioception, Function and Everyday Support For many people living with Hypermobility Spectrum Disorder or Hypermobile Ehlers-Danlos Syndrome, everyday tasks can sometimes require more effort than they appear to on the surface. Hypermobility affects connective tissue throughout the body, which can influence joint stability, muscle fatigue, sensory processing, and even how we perceive our own movement. In recent years, there has been growing awareness of the overlap between hypermobility and neurodivergence, including Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Within this context, even small adaptations — including something as simple as gel nails — can offer meaningful functional and sensory benefits. This is not about aesthetics as a standard of beauty. It is about supporting the body, improving function, and creating sensory and proprioceptive feedback that helps the nervous system feel more anchored in space. Understanding Proprioception and Hypermobility Proprioception is our body’s ability to sense where it is in space. It tells us: Where our joints are positioned How much force we are using How we are moving through the environment In hypermobility, proprioception is often less reliable. Because connective tissue is more elastic, joints may move beyond typical ranges, and the sensory feedback from muscles and joints can be less clear or delayed. This can lead to: Clumsiness or frequent dropping of objects Difficulty judging grip strength Joint overextension without noticing Fatigue from “over-correcting” movement A general feeling of disconnection from the body For neurodivergent individuals, especially those with autism or ADHD, proprioceptive differences may already be part of their sensory profile. When combined with hypermobility, this can create an even greater need for external sensory anchors. How Gel Nails Can Support Proprioceptive Awareness Gel nails may seem like a purely cosmetic choice, but for some people with hypermobility they can function as a subtle proprioceptive tool. Because gel nails are slightly thicker and more structured than natural nails, they can provide: 1. Increased sensory feedback The added structure of gel nails can give clearer tactile feedback when touching objects. This can help improve awareness of grip and contact, particularly for tasks like: Holding pens or pencils Using phones or tablets Picking up small objects Typing or using keyboards 2. Improved grip awareness Some individuals report feeling more “aware” of their fingertips when wearing gel nails. This can help reduce accidental over-gripping or under-gripping, both of which are common in hypermobility due to altered proprioception. 3. Reduced fingertip discomfort For those whose joints are sensitive or easily overloaded, gel nails can act as a light protective layer over the fingertips, reducing discomfort during repetitive tasks. 4. Functional anchoring for the nervous system From a neuro-affirming perspective, sensory tools that help the nervous system feel more organised in space can reduce cognitive load. Small, consistent sensory input — such as the feeling of structured nails — may help the brain maintain a clearer sense of body position during daily activities. Hypermobility, Fine Motor Skills and Fatigue Many people with hypermobility experience fatigue in the hands and fingers, especially when writing, typing, or doing repetitive fine motor tasks. This is often due to: Joint instability in the small joints of the hands Overuse of compensatory muscle tension Reduced proprioceptive efficiency Increased effort required to stabilise movement Gel nails can sometimes support fine motor function by offering: Slight mechanical resistance that helps guide movement Improved tactile awareness of surfaces Reduced micro-adjustments needed during tasks While not a replacement for occupational therapy or clinical support, they can be a low-effort, accessible self-support strategy. A Neuro-Affirming Lens: Supporting, Not Correcting From a neurodiversity-affirming perspective, including the approach used by Little Kneaders, the goal is not to “fix” sensory differences or hypermobility traits. Instead, it is about recognising that: Different nervous systems experience the world differently Sensory needs are valid forms of communication Support can come in small, everyday adaptations Function and comfort matter more than conformity For many autistic and ADHD individuals with hypermobility, sensory regulation is not optional — it is foundational. Tools like gel nails can sit alongside other supports such as weighted items, fidget tools, compression garments, or environmental adjustments. Practical Considerations While gel nails can be supportive for some people, they are not suitable for everyone. A few considerations include: Nail sensitivity or allergies to products Difficulty maintaining appointments if energy is limited Risk of nail damage if removal is not done carefully Individual sensory preferences (some may find them overwhelming) As with all supports, the key is individual experience rather than a one-size-fits-all approach. Final Thoughts For some people living with hypermobility, small sensory supports can make a meaningful difference in daily life. Gel nails may offer more than aesthetic value — they can provide proprioceptive feedback, improve functional awareness, and support the nervous system in feeling more grounded during everyday tasks. In a neuro-affirming framework, this is not about changing the body to fit the world, but about finding ways the world can better fit the body. Sometimes support looks like therapy or clinical intervention. And sometimes it looks like something as simple as how your fingertips meet the world. Back To Blog
The Impact of Hypermobility in Teenage Girls and Women
The Impact of Hypermobility in Teenage Girls and Women: Nervous System, Hormones, Digestion and School Avoidance Hypermobility is often described as “being double-jointed” or “extra flexible,” but for many teenage girls and women it is far more than a physical trait. For those living with Hypermobility Spectrum Disorder or Hypermobile Ehlers-Danlos Syndrome, hypermobility can affect almost every system in the body — from digestion and hormones to energy levels, mood, and the nervous system. Increasingly, clinicians are also recognising a strong overlap between hypermobility and neurodivergence, particularly Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. This connection helps explain why many young people experience symptoms that feel “whole body,” fluctuating, and difficult to fit into one medical category. For teenage girls especially, these symptoms often emerge or intensify around puberty, a time of significant hormonal and neurological change. Hypermobility and the Nervous System The nervous system plays a central role in how hypermobility is experienced. Many individuals with hypermobility show signs of autonomic nervous system dysregulation, including conditions such as Postural Orthostatic Tachycardia Syndrome. This can affect heart rate, blood pressure, temperature regulation, digestion, and energy levels. When the nervous system is in a heightened state (fight, flight, freeze or shutdown), the body may experience: Chronic fatigue or sudden energy crashes Dizziness or “brain fog” Heightened sensory sensitivity Difficulty concentrating Anxiety or overwhelm Feeling “wired but tired” For neurodivergent girls, especially those who are autistic or ADHD, sensory processing differences can amplify these responses. School environments – with noise, social demands, bright lighting, and pressure to perform – can become overwhelming for a dysregulated nervous system. Digestive System and Hypermobility The digestive system is rich in connective tissue and is highly influenced by autonomic nervous system function. Common digestive experiences in hypermobility include: Bloating and abdominal pain Constipation or diarrhoea Nausea or reflux Early fullness or reduced appetite Food sensitivities Fluctuating tolerance to different foods This is partly due to altered gut motility and also the close relationship between the gut and nervous system. When the body is in a stress response, digestion naturally slows or becomes erratic. Over time, this can create cycles of discomfort that further increase nervous system load – a loop that can feel difficult to break. For some individuals, these symptoms may overlap with patterns seen in Mast Cell Activation Syndrome (MCAS), adding another layer of sensitivity and reactivity. Hormones, Puberty and Menstrual Cycles Hormonal changes can significantly influence hypermobility symptoms. Many teenage girls notice that symptoms intensify around puberty, and later fluctuate across the menstrual cycle. Oestrogen influences connective tissue, pain sensitivity, and autonomic nervous system regulation, which may explain why symptoms often worsen: Before menstruation Around ovulation During hormonal fluctuations in puberty During perimenstrual phases later in life In addition, many girls and women with hypermobility experience heavier and more painful periods. This can be partly explained by differences in connective tissue integrity, particularly collagen. Collagen plays a key role in supporting blood vessel structure and uterine tissue stability. When connective tissue is more lax or fragile, the uterine lining may shed more heavily, and blood vessels may be less structurally supported, potentially contributing to increased bleeding and cramping. Dysautonomia, heightened pain sensitivity, and inflammatory responses may also amplify menstrual pain, making periods feel more intense both physically and neurologically. For those with hypermobility, this may present as: Increased joint pain or instability Fatigue and energy crashes Headaches or migraines Digestive flares Emotional sensitivity or overwhelm Increased anxiety or shutdown responses Heavier, more painful menstrual bleeding These cyclical changes can make symptoms feel unpredictable, especially for young people still learning to understand their bodies. Chronic Fatigue and Energy Fluctuations Chronic fatigue is one of the most disabling aspects of hypermobility for many women and teenagers. This is often not simply “tiredness,” but a complex interaction between: Autonomic nervous system load Musculoskeletal effort required for joint stability Digestive energy demands Hormonal fluctuations Sleep disruption Sensory and cognitive overload Many describe a pattern of “boom and bust” energy – periods of relative functioning followed by significant crashes. For neurodivergent individuals, especially those with ADHD, this can be intensified by masking, executive function demands, and difficulty pacing activity. School Avoidance and Hypermobility School avoidance is a growing concern among hypermobile and neurodivergent young people. This is often misunderstood as anxiety or disengagement, but in many cases it reflects genuine physical and neurological overwhelm. Contributing factors may include: Chronic pain or fatigue Sensory overload in classrooms Difficulty with prolonged sitting or standing Brain fog affecting concentration Anxiety from unpredictable symptoms Gastrointestinal discomfort Social exhaustion and masking During heavier and more painful menstrual cycles, some teenage girls may feel unable to attend school due to the intensity of symptoms, particularly when appropriate accommodations (such as rest spaces, flexible attendance, or menstrual support) are not available For autistic and ADHD students, the combination of sensory demands, social complexity, and executive functioning requirements can become overwhelming when layered on top of a physically dysregulated body. Avoidance is not refusal; it is a nervous system protection response. The Overlap Between Hypermobility, Autism and ADHD There is increasing recognition of overlap between hypermobility and neurodivergence, particularly autism and ADHD. This may be linked to differences in: Connective tissue development Interoception (internal body awareness) Sensory processing Nervous system regulation Dopamine and arousal systems For many girls, this combination can lead to late diagnosis, misdiagnosis, or being described as “anxious,” “sensitive,” or “dramatic,” when in reality their body is processing information and stress differently. Understanding this overlap can be deeply validating and can shift the narrative from “something is wrong” to “my system needs different support.” Holistic Support for Hypermobility There is no single approach that works for everyone, but many people benefit from a combination of nervous system support, gentle movement, and sensory-aware strategies. The goal is not to “push through,” but to support regulation, stability, and energy conservation. Nervous System Regulation Supporting the autonomic nervous system can be foundational: Breathwork (gentle, non-forced) Yoga nidra or guided rest Time in low-stimulation environments Predictable routines
MCAS in Women: Understanding Hormones, Food Sensitivites and Holistic Support
MCAS in Women: Understanding Hormones, Food Sensitivities and Holistic Support For many women, living with Mast Cell Activation Syndrome (MCAS) can feel like trying to predict the unpredictable. One day, your body seems relatively settled. The next, you may be navigating digestive discomfort, skin flare-ups, headaches, fatigue, anxiety, dizziness, or reactions to foods that felt completely safe only days before. Many women describe feeling as though their symptoms fluctuate alongside their hormones, yet struggle to find clear answers as to why. As awareness of MCAS grows, researchers and clinicians are beginning to better understand the complex relationship between mast cells, female hormones, digestion, and the nervous system. While every person’s experience is unique, recognising these connections can be an empowering first step towards understanding your body with greater compassion. What Is MCAS? Mast cells are an important part of the immune system. They help protect us by releasing chemical messengers, including histamine, in response to potential threats. In people with MCAS, mast cells can become overly reactive, releasing these chemicals more frequently or inappropriately. Because mast cells are found throughout the body, symptoms can affect multiple systems at once. Common symptoms may include: Digestive discomfort Food sensitivities Flushing and skin reactions Hives or itching Fatigue Headaches and migraines Dizziness Brain fog Anxiety Sinus congestion Sleep disturbances Many women spend years seeking explanations for these seemingly disconnected symptoms before discovering MCAS may be part of the picture. MCAS and Female Hormones One of the most commonly reported experiences among women with MCAS is symptom fluctuation throughout the menstrual cycle. Mast cells and hormones appear to communicate closely with one another. Oestrogen can influence mast cell activity, while mast cells themselves can affect hormone signalling. For some women, this creates a cycle where hormonal changes may contribute to increased mast cell activation and symptom flare-ups. Many women notice worsening symptoms: Before menstruation Around ovulation During periods of significant hormonal change During perimenopause Following pregnancy These fluctuations may show up as increased headaches, skin reactions, digestive symptoms, fatigue, anxiety, or heightened sensitivities. When viewed through a hormonal lens, patterns that once seemed random can sometimes begin to make more sense. MCAS and Menstrual Health For some women, mast cell activation may also contribute to menstrual challenges. Women frequently report: Heavier periods Increased menstrual pain More significant bloating Heightened fatigue during menstruation Premenstrual migraines Increased digestive symptoms around their cycle The inflammatory chemicals released by mast cells can influence many of the systems involved in menstrual health, potentially contributing to these experiences. Keeping a symptom diary that tracks both MCAS symptoms and menstrual cycles can often reveal patterns that might otherwise go unnoticed. Why Are Food Intolerances So Common? One of the most frustrating aspects of MCAS can be food sensitivities that seem to change from week to week. Many individuals find that foods they once tolerated suddenly trigger symptoms such as: Bloating Reflux Nausea Stomach pain Headaches Skin reactions Fatigue Brain fog This does not necessarily mean a true food allergy is present. Instead, mast cells located throughout the digestive tract may react to certain foods, food chemicals, additives, or naturally occurring histamine levels. Common triggers may include: Aged cheeses Fermented foods Alcohol Processed meats Vinegar Tomatoes Citrus fruits Certain food additives Importantly, every person with MCAS is different. A food that causes symptoms for one individual may be perfectly tolerated by another. Rather than focusing on restriction alone, many practitioners now encourage a gentle, individualised approach that prioritises nourishment, nervous system support and identifying personal patterns. The Gut, The Nervous System and Mast Cells The digestive system is home to a significant proportion of the body’s immune activity. Mast cells sit throughout the gut lining, constantly communicating with both the immune system and the nervous system. For many women with MCAS, periods of stress can trigger digestive symptoms, while digestive symptoms can in turn increase feelings of stress and overwhelm. This is not “all in your head.” It is a reflection of the powerful communication that exists between the gut, immune system and nervous system. Supporting one area often helps support the others. Holistic Ways to Support the Body While medical support is an important part of managing MCAS, many women find that holistic wellbeing practices help them feel more regulated and supported alongside their healthcare plan. There is no one-size-fits-all approach to MCAS. The aim is not to “fix” the body but to create conditions that support rest, recovery, resilience and regulation. Understanding the Neuro-Immune Connection Many women living with MCAS also identify as autistic, ADHD, or neurodivergent in other ways. Emerging research suggests there may be important connections between sensory processing, nervous system regulation, immune function and mast cell activity. For some neurodivergent women, heightened sensory sensitivity can mean that changes in temperature, smells, textures, noise levels, stress, hormonal fluctuations, or environmental exposures feel more intense. These same factors may also influence mast cell activation and nervous system responses. Hormonal changes throughout the menstrual cycle, pregnancy, postpartum periods and perimenopause can further affect both sensory experiences and MCAS symptoms. As a result, symptom fluctuations may feel particularly pronounced and sometimes difficult to predict. Understanding these interactions can help women move away from self-judgement and towards greater self-compassion. Rather than seeing symptoms as random or excessive, they can be understood as part of a complex conversation between the nervous system, immune system, hormones and environment. Lymphatic Support The lymphatic system plays an important role in moving fluid, cellular waste and immune cells throughout the body. Unlike the circulatory system, it relies on movement, breathing and muscle contraction to function efficiently. When we are stressed, exhausted, sedentary or recovering from illness, many people report feeling sluggish, puffy or congested. Gentle lymphatic support may include: Dry body brushing Lymphatic drainage massage Rebounding (gentle bouncing on a mini trampoline) Walking in nature Stretching and mobility exercises Adequate hydration Deep diaphragmatic breathing Many women find these practices particularly supportive during times of hormonal change, when feelings of bloating or fluid retention may be more
Hypermobility, POTs, MCAS & Neurodiversity: Understanding the Connection
MCAS, POTs, Hypermobility and Neurodiversity – Understanding the connections As awareness of neurodivergence continues to grow, many families are discovering that autism and ADHD often come with additional physical health challenges that may have previously been overlooked or misunderstood. For some children and adults, challenges such as chronic fatigue, dizziness, digestive difficulties, pain, allergies, sensory sensitivities and fluctuating energy levels may not be separate concerns at all. Increasingly, researchers and clinicians are recognising connections between neurodivergence and conditions including Mast Cell Activation Syndrome (MCAS), Postural Orthostatic Tachycardia Syndrome (POTS), and Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS). While every individual is unique, understanding these connections can help families make sense of symptoms, seek appropriate support, and develop greater self-compassion. What is Mast Cell Activation Syndrome (MCAS)? Mast cells are a normal part of our immune system. They help protect us by releasing chemicals such as histamine when they detect potential threats. In people with MCAS, mast cells can become overly sensitive and release these chemicals inappropriately or excessively. This can create symptoms throughout the body, often affecting multiple systems at once. Common symptoms of MCAS may include: Frequent allergic-type reactions Itching, hives or unexplained rashes Flushing or sudden warmth Digestive difficulties such as nausea, reflux or abdominal pain Headaches and migraines Fatigue Brain fog Sensitivity to foods, medications or environmental triggers Respiratory symptoms such as wheezing or congestion Because symptoms can vary significantly from person to person, MCAS is often difficult to recognise and may take time to diagnose. What is POTS? Postural Orthostatic Tachycardia Syndrome (POTS) is a condition affecting the autonomic nervous system—the system responsible for regulating many automatic body functions including heart rate, blood pressure, digestion and temperature regulation. When someone with POTS moves from lying down or sitting to standing, their heart rate increases significantly, often leading to a range of symptoms. Common symptoms of POTS may include: Dizziness or light-headedness when standing Rapid heartbeat Fainting or near-fainting episodes Extreme fatigue Exercise intolerance Brain fog and concentration difficulties Headaches Digestive symptoms Temperature regulation difficulties Nausea Many children and adults with POTS describe feeling as though their energy levels fluctuate dramatically throughout the day. What is Hypermobility Syndrome? Many people think of hypermobility simply as being “double-jointed” or unusually flexible. However, for some individuals, hypermobility affects far more than their joints. Hypermobility Spectrum Disorders (HSD) and Hypermobile Ehlers-Danlos Syndrome (hEDS) involve differences in connective tissue, which provides support throughout the body. Common symptoms of hypermobility may include: Joint pain Frequent sprains or injuries Joint instability Fatigue Muscle aches Poor proprioception (body awareness) Digestive difficulties Headaches Coordination challenges Easy bruising Heavy and painful menstrural cycles For some people, symptoms are mild. For others, hypermobility can significantly affect daily life, physical comfort and energy levels. How Are These Conditions Connected? Researchers have observed a notable overlap between MCAS, POTS and hypermobility conditions. Although the exact mechanisms are still being investigated, these conditions frequently appear together. One theory suggests that differences in connective tissue associated with hypermobility may affect blood vessels and autonomic nervous system function, contributing to POTS symptoms. Mast cell activity may also influence inflammation, vascular regulation and nervous system responses, creating further overlap between MCAS and POTS. Many of us working as clinicians now refer to this as a “triad” because these three conditions are so commonly seen together. Not everyone with one condition will develop the others. However, when symptoms seem to span multiple body systems, it can be helpful to explore whether there may be an underlying connection. What Does This Have to Do with Autism and ADHD? Many neurodivergent individuals report experiences that align with one or more of these conditions. Emerging research suggests higher rates of hypermobility, autonomic nervous system differences and immune system dysregulation among autistic and ADHD populations compared with the general population. While we do not yet fully understand why these connections exist, several theories are being explored, including: Shared genetic factors Differences in connective tissue development Nervous system regulation differences Immune system variations Sensory processing differences that increase awareness of physical symptoms It is important to remember that autism and ADHD are not caused by MCAS, POTS or hypermobility, nor do these conditions occur in every neurodivergent person. Rather, they may represent interconnected ways in which the nervous system, immune system and connective tissues develop and function. Looking Beyond Behaviour For neurodivergent children especially, physical symptoms can sometimes be mistaken for behavioural challenges. A child who appears anxious may actually be experiencing dizziness from POTS. A child who struggles with concentration may be dealing with fatigue, pain or brain fog. A child who seems irritable may be coping with digestive discomfort, headaches or mast cell activation symptoms. When we view behaviour as communication, we open the door to understanding what the body may be trying to tell us. A Whole-Person Approach Recognising the potential links between neurodivergence, MCAS, POTS and hypermobility encourages a more holistic understanding of health. Rather than viewing physical, emotional and sensory experiences as separate, we can begin to appreciate how closely connected they often are. For families navigating these complexities, knowledge can be empowering. Understanding the bigger picture may help explain experiences that previously felt confusing or disconnected and support more tailored care and accommodations. Every person’s experience will be different, and no single explanation fits everyone. However, listening carefully to both the body and the nervous system can often provide valuable clues. Learn More About Hypermobility and MCAS One particularly interesting area of ongoing research is the relationship between hypermobility and Mast Cell Activation Syndrome. Many individuals with hypermobility report symptoms commonly associated with mast cell activation, and researchers continue to explore the biological links between connective tissue differences and immune system function. In future blog posts, we’ll take a closer look at hypermobility and MCAS, exploring why these conditions frequently occur together and what families may wish to know when seeking support. Back To Blog
Why We Don’t Offer Intensives (tPBM)
Why We Don’t Offer Intensive tPBM Programmes at Little Kneaders At Little Kneaders, one of our core values is simple: the nervous system must feel safe, calm and regulated in order for meaningful development to happen. This guides every single service we offer, including our tPBM programmes. Over recent years, intensive neurological programmes have become increasingly visible online. Parents are often shown clips on Instagram or social media of children completing daily tPBM sessions alongside intensive reflex integration work, with dramatic promises attached to them. We completely understand why families become hopeful when they see these videos. When you are searching for support for your child, it is natural to want the biggest and fastest changes possible. But at Little Kneaders, we take a very different approach. We do not offer intensive tPBM programmes for children, and we intentionally limit our programmes to one highly individualised one-hour session per week. Why? Because the nervous system matters more than intensity. The Nervous System Cannot Be Forced tPBM is neurological work. Reflex integration is neurological work. Any therapy that influences the brain and nervous system needs to be approached carefully, thoughtfully and respectfully. When children are exposed to intensive daily neurological input, especially when multiple approaches are layered together, the nervous system can become overstimulated rather than supported. For some children, this can lead to periods of severe dysregulation. This may look like: heightened anxiety sleep disruption emotional overwhelm aggression or meltdowns withdrawal increased sensory difficulties difficulty coping with everyday tasks significant behavioural changes exhaustion or burnout As with all neurological work, we do acknowledge that there are temporary periods of increased regression or small increases in dysregulation as the nervous system processes change. This can happen with many therapeutic approaches. But there is a significant difference between: a mild, temporary adjustment periodand a nervous system becoming overwhelmed and destabilised. At Little Kneaders, our priority is always regulation first. We never want a child’s nervous system pushed beyond what it can safely process. Why We Choose Weekly Sessions Children’s nervous systems need time. Time to process.Time to integrate.Time to settle.Time to feel safe again. This is why our programmes are carefully paced and highly individualised. No two children are the same. What supports one child beautifully may overwhelm another. We work slowly and responsively, always observing how a child is coping emotionally, physically and neurologically. Our one-hour weekly model allows us to: support regulation rather than overstimulation observe changes carefully adapt to the child’s needs protect emotional wellbeing ensure therapy remains sustainable for the child and family For us, therapy should never feel like survival mode. Looking Beyond “Speech” Another important conversation we often have with families is around expectations, particularly when it comes to communication. Many parents explore tPBM hoping it will “create speech.” While speech may develop, it is important to understand that communication is much broader than spoken language alone. Often, the earliest and most meaningful changes happen long before words emerge. tPBM may support a child to: use more initiative seek connection hold your hand calmly tolerate closeness make sounds or gestures express needs differently improve planning and organisation understand tasks more clearly engage more purposefully with the world around them These changes matter deeply. Communication is not only speech. Communication is connection, regulation, understanding, intention and interaction. Speech often comes secondary to these foundational skills. Bigger Promises Are Not Always Better We know it can be difficult when social media presents intensive programmes as quick solutions with dramatic outcomes. But short video clips rarely show the full picture: the child’s nervous system afterwards the level of overwhelm experienced the sustainability of changes the emotional impact on the child and family whether the child truly feels safe and regulated At Little Kneaders, we will always choose gentle, responsive and nervous-system-led support over intensity. Progress does not need to come at the expense of regulation. Children deserve support that honours their nervous systems, respects their pace and protects their wellbeing. And that is exactly why we take things slowly. Back To Blog
Supporting Regulation, Connection, and Everyday Ease: Our Experience with tPBM at Little Kneaders
Supporting Regulation, Connection, and Everyday Ease: Our Experience with tPBM at Little Kneaders At Little Kneaders, we are always guided by one simple intention: to support each child and family in a way that feels respectful, compassionate, and attuned to their unique way of being in the world. Every nervous system is different. Every child has their own rhythm, their own sensitivities, their own strengths. And often, what families are looking for is not “fixing,” but support, support that helps things feel a little calmer, a little clearer, and a little more manageable day to day. One of the ways we have been able to offer this kind of support is through tPBM (transcranial photobiomodulation). While our role at Little Kneaders is focused specifically on providing tPBM (and we do not offer additional services such as Speech and Language Therapy, Physio or Occupational Therapy), we have been quietly observing something really meaningful in the families we work with. Over time, many parents have shared gentle but powerful shifts. They describe a sense of calmer overall behaviour, not in a way that suppresses who their child is, but in a way that allows them to feel more settled and safe in their own body. Many parents mention their child having more restorative and peaceful nights sleep, which enables and encourages further development and growth to take place. We’ve seen reduced sensory sensitivities, where environments that once felt overwhelming become more tolerable, sometimes even enjoyable. For some families, there have been moments that feel especially significant, like being able to walk through a shop hand-in-hand with their child when that previously felt out of reach. These are the kinds of everyday experiences that can carry so much meaning. Parents have also shared a reduction in dysregulation around change and new environments, alongside a reduced flight risk, allowing for a greater sense of safety and predictability when out and about. In many cases, there has been a noticeable increase in communication and more organised thinking. Children and young people seem more able to express themselves, initiate interaction, and engage with the world around them in ways that feel more accessible. We’ve also observed: An increase in initiative Improved executive functioning Increased cognitive flexibility Increased abstract reasoning Reduced impulsivity A growing ability to cope within the school environment For some individuals, families have reported a reduction in tics and Tourette’s symptoms, as well as improvements in mood and emotional regulation. One of the most significant areas of improvement with clients has been in the digestive system, with feedback of bowels moving daily, and constipation easing. This is often an area that many children and teenagers are impacted by, which causes great dysregulation due to the pain and sensory discomfort it brings with it. There have also been encouraging signs of successful integration of primitive reflexes, alongside a reduction in anxiety and depression, and a noticeable easing of brain fog, with greater clarity and focus. The teenagers and adults we have worked with have given feedback on the constant chatter in their minds, quietening, their communication becoming more articulate and organised, their sensory sensitivities becoming manageable, and their migraines reducing. At the same time, we feel it’s important to hold this work with honesty and care. Occasionally, social media can suggest that photobiomodulation therapy is a “miracle cure.” That hasn’t been our experience. Rather than changing who a child is, tPBM appears to support the nervous system in ways that can help with regulation, cognitive development, organisation, and many of the areas described above. As with anything, there also come risks, but the risks with tPBM are minimal with parents and individuals only reporting short periods of dysregulation, seeing vivid colours, tiredness following the first session and some short term abdominal bloating. And just as importantly, it’s essential to remember that a child’s neurodivergence is not something to be removed. Each child remains exactly who they are, this work simply aims to support them in feeling more comfortable, more regulated, and more able to engage with the world around them. When we step back and look at the whole picture, what stands out most is not any single change, but the way these shifts come together to support daily life. Things can feel smoother. More connected. More possible. And perhaps most importantly, families often describe a renewed sense of ease, both for their child and for themselves. It’s important to say that every experience is unique, and there is no one-size-fits-all outcome. What we offer is a supportive, non-invasive approach that works alongside each individual’s nervous system, at their own pace. We feel incredibly privileged to walk alongside the families who choose to work with us, and to witness these changes, big and small, as they unfold over time. At the heart of it all, this is about supporting regulation, connection, and the ability to move through the world with a little more comfort and confidence. And that, we believe, can make a meaningful difference. Back To Blog
Homoeopathy & School Anxiety
Homoeopathy & School Anxiety For many reasons, it’s very common for children and teenagers to experience worry or anxiety about going to school. For some, it’s the uncertainty of a new environment or unfamiliar people. For others, it’s the challenge of separating from home, or a quiet fear about what the day might hold, either in school, or away from the environment or people they feel safest with. It’s important to remember that school anxiety is not “bad behaviour” or something to be pushed through. It’s communication. Every child’s experience is different, and their feelings are always valid, even when we don’t yet fully understand them. Before we look at how to support anxiety, we gently need to become curious about what might be underneath it. For some children, school can feel overwhelming from a sensory or social perspective. For others, there may be something happening within the school environment itself, friendship challenges, feeling misunderstood, or a pace or style of learning that doesn’t align with how they process the world. When anxiety becomes more intense, or shifts into not being able to attend, it’s especially important that a child feels deeply listened to and supported. There is no one-size-fits-all approach. Support needs to be shaped around the individual child and from a whole child approach. Some families choose to include homoeopathy as part of their support toolkit. When used thoughtfully, it can gently support a child’s nervous system and emotional well-being. Within homoeopathy, remedies are not chosen based on the anxiety alone, but on the child’s overall way of being; their temperament, sensitivities, and how they respond to stress. Below are three remedy profiles often considered in the context of school anxiety. These are not labels, but gentle patterns that may help guide understanding. Baryta carbonica Some children may appear younger than their peers in how they navigate the world. They might feel unsure of themselves in group settings, find decision-making difficult, or become particularly anxious during times of transition, such as starting a new school or moving to a different class. There can be a strong desire to fit in, but also a sense of not quite knowing how. Busy classrooms and social expectations may feel overwhelming, and anxiety can build quietly over time. These children often do best with predictability and preparation. Walking through what to expect, visiting the school in advance, and gently scaffolding new experiences can help them feel safer and more secure. You might also notice a preference for routine and familiarity, doing things the same way, choosing the same foods, or feeling unsettled by change. When supported well, these children often begin to grow in confidence, gradually finding their voice, preferences, and sense of self. Silica Some children experience the world as intensely overwhelming, particularly from a sensory and energetic perspective. Noise, light, busy environments, and social demands can quickly lead to overload. These children may appear quiet, cautious, or hesitant. They often think deeply and may become stuck in “what if” worries, imagining all the things that could go wrong. They can seek safety in closeness to a trusted adult, wanting to stay near a parent, teacher, or familiar person who helps them feel regulated. There can also be a sense of low energy or stamina, where the demands of a full school day feel like too much. When supported, these children tend to thrive in calmer environments, with reduced pressure and a strong sense of safety. They may not seek large social groups, but instead form deep, meaningful connections and shine in areas they feel passionate about. Pulsatilla Some children have a deep emotional need for connection, reassurance, and closeness. For them, going to school can feel like a separation that is genuinely distressing. This may show up most strongly at drop-off, with tears, clinging, or a need for comfort. These children are not being difficult, they are seeking safety through connection. Warmth, reassurance, and co-regulation are key supports here. They often do best with nurturing relationships, both at home and in school. A kind, understanding teacher can make a significant difference. These children may be very attuned to others and eager to please, sometimes putting their own needs aside in order to feel accepted. At times, they may seem changeable, needing closeness but also becoming overwhelmed if there is too much stimulation or attention. When supported in a balanced and attuned way, they begin to feel more secure, and their confidence naturally grows. Across all children, anxiety may also show up in the body; through tummy aches, headaches, fatigue, or frequent illness. These are real, physical responses to stress, not something imagined or exaggerated. As caregivers, our role is not to remove all anxiety, but to help children feel safe enough to move through it. That might look like: slowing mornings down offering more predictability and preparation advocating for a child’s needs within the school environment or simply sitting alongside them and saying, “I see you, and I’m here.” When children feel understood, supported, and regulated, they are far more able to access learning, build relationships, and grow in confidence. And that’s the heart of it. Not changing the child to fit the environment, but shaping the environment, the supports, and the relationships around the individual child. Because every child deserves to feel safe, seen, and that they truly belong. Back To Blog
The Connection Between Anorexia and Autism
The Connection Between Autism and Anorexia: A Gentle Exploration of Why So Many Autistic Girls Go Undiagnosed Navigating the world as an autistic girl can be an experience full of beauty, sensitivity, and depth. But it can also be filled with challenges, often ones that are invisible to those around us. Many autistic girls grow up feeling different but unable to name why. And sadly, many are not diagnosed until much later in life, sometimes only when they find themselves in the middle of a mental health crisis like anorexia. It’s important to remember that autism doesn’t always look like what we’ve been taught to expect. For some, autism is more about the way we process the world and our sensory experiences, rather than overt social differences or behaviors. It’s easy to overlook these subtle traits, especially in girls, who tend to mask their challenges more than boys. Because of this, many autistic girls, particularly those who have not been diagnosed, often face a mental health crisis before they receive the support and clarity they truly need. In this post, I want to talk about why anorexia often surfaces in autistic girls who are undiagnosed, and how restrictive eating is sometimes misunderstood. We’ll look at how anorexia differs from other types of restrictive eating, such as ARFID (Avoidant Restrictive Food Intake Disorder), sensory-related eating preferences, and food cycles that many autistic individuals experience. Most importantly, I want this post to offer a sense of understanding, recognising that we are all doing our best to navigate a world that wasn’t made with our needs in mind. Autistic girls often go undiagnosed for a long time because they tend to mask their true selves to fit in. They might try extra hard to appear neurotypical, picking up on social cues and mimicking behaviours they don’t quite understand, but it leaves them feeling exhausted, anxious, and isolated. It’s not that they don’t want to fit in, it’s just that sometimes the world asks for things that feel impossible. When it comes to food, this is where things get even trickier. Many autistic girls experience heightened sensory sensitivities, and the idea of eating can feel like navigating a minefield. The textures, smells, and even the temperature of food can be so overwhelming that eating becomes an exhausting, anxiety-inducing task. What starts as a simple preference to avoid certain foods can evolve into more restrictive eating behaviours that are misunderstood. Without an autism diagnosis, these eating habits may be seen simply as an “eating problem,” but for many autistic girls, these behaviours are a response to the sensory overload they experience every day. Sadly, this lack of understanding can sometimes lead to further isolation, feelings of shame, and a downward spiral that may culminate in an eating disorder like anorexia. For autistic individuals, food can be a sensory minefield. Some of us are hypersensitive to certain textures or tastes, making eating a distressing experience. For others, it might be the opposite; we might crave intense flavours or repetitive eating habits to compensate for sensory input. Food becomes a way to either avoid discomfort or seek out sensory stimulation. Many autistic people experience what’s called food cycles, where they may only eat the same few foods for long stretches of time. This isn’t a choice to “be picky” or difficult—it’s often a response to sensory preferences. The texture of one food might feel safe, predictable, and comforting, while others feel overwhelming and unmanageable. These cycles can be misinterpreted as unhealthy or restrictive, but for autistic individuals, they are often a way of making the world feel more manageable. Unfortunately, when these preferences are not understood, it can lead to misunderstandings. Parents and caregivers might see a limited diet and worry, “Why won’t they eat anything else?” But for an autistic person, the answer is often tied to sensory overload and the need for predictability. The need for the food to taste the same with each bite. And when we don’t have the language to explain why certain foods feel safe, it can leave us feeling isolated, misunderstood, or even ashamed. For autistic girls who aren’t diagnosed or who feel like their differences are not understood, the pressure to conform can be immense. Society often has a very narrow idea of what it means to be a “girl” or a “woman,” and these ideals include unrealistic expectations around appearance and body size. This pressure to conform can be overwhelming, especially when navigating a world that feels unpredictable or overstimulating. For some autistic girls, eating becomes a way to gain control in a world that feels chaotic. What starts as a way to avoid certain foods because they’re unpleasant or overwhelming may evolve into more restrictive eating behaviors, driven by the desire to control food intake. And as they begin to feel the weight of societal expectations, their restrictive eating may become more tightly linked to body image concerns. But here’s the thing: it’s not about being “difficult” or “rebellious.” It’s about seeking control over something that feels too overwhelming to manage. When we don’t have the tools or the understanding to process our sensory needs, anxiety, or social struggles, we might turn to something like eating to make sense of it all. The key to helping autistic girls who are struggling with restrictive eating or anorexia is understanding. Not just understanding eating habits, but understanding the full scope of the experience. Autism isn’t a disorder that needs to be “fixed.” It’s a way of being that needs to be understood, respected, and supported. Rather than focusing solely on the restrictive eating behaviors, it’s important to look at the whole person, the sensory preferences, the need for structure, the social challenges, and the emotional complexities. When we approach eating disorders with a neuroaffirming lens, we can help autistic individuals find balance and healing, rather than perpetuating shame or misunderstanding. If you or someone you know is struggling with anorexia or restrictive eating, it’s okay to ask for help.
Glue Ear or Autism?
When It’s More Than “Just Glue Ear”: Holding Space for the Whole Child There’s a familiar moment many parents and practitioners will recognise. A child isn’t responding consistently to their name. Their speech feels delayed or unclear. They seem to drift in and out of connection, sometimes deeply engaged, other times distant. Perhaps they move through the world in their own rhythm, seeking, avoiding. Then comes a possible explanation from a PHN or GP, glue ear. And with that, a quiet sense of relief.A reason.A plan.A hope that everything will resolve once hearing improves. Glue ear, fluid in the middle ear, is incredibly common in childhood. It can absolutely affect how a child hears, processes language, and participates in everyday interactions. It deserves care, attention, and support. But sometimes, gently, we need to widen the lens. Because while glue ear can explain some things, it doesn’t explain everything. When a child experiences fluctuating hearing, the world can feel unpredictable. Sounds come and go. Words lose clarity. It makes sense that communication may look different, speech might be delayed, attention may wander, frustration may build. And yet, there are other ways children communicate who they are. A child who seeks deep pressure, who gets pure joy from watching the washing machine spin, who lines up toys with precision, who craves running and crashing into you, who loves bouncing on the sofa, who gags on food textures, who finds comfort in repetition, who thrives off routine and struggles with change, who moves on their tiptoes, who experiences the world in vivid sensory detail – these are not simply “side effects” of reduced hearing. These are expressions of a nervous system, a way of being. Glue ear can shape how a child hears the world. But it does not shape who they are. It’s not uncommon for conversations to become either/or. “It’s just glue ear.”“Let’s wait and see once their hearing improves.” And sometimes, waiting is appropriate. Children grow and change in their own time. But we can also hold a both/and perspective: A child can have glue ear and be autistic.A child can experience hearing differences and have a unique sensory profile.A child’s communication differences can be influenced by hearing and by neurodivergence. Noticing this isn’t about rushing to labels. It’s about staying curious, open, and responsive. Because when we attribute everything to glue ear, we may unintentionally overlook the child’s broader needs and the ways we could already be supporting them. With our growing understanding of autism, we must also understand that dated PHN / GP checklists may miss the signs of autistic traits. It’s easy to link everything back to hearing when glue ear is present. But some traits often sit outside its scope. For example, tiptoe walking. Tiptoe walking, even if short, sporadic and not constant, is frequently connected to sensory processing, how a child experiences movement, balance, and body awareness. For some children, it offers stability, feedback, or simply feels good in their bodies. Glue ear, while it can affect balance in some cases, doesn’t typically account for ongoing patterns like this. In the same way: Deep sensory seeking or avoidanceRepetitive movementsA strong preference for routineDifferences in social communication beyond what hearing alone explains …these invite us to look a little deeper, a little wider. Not to pathologise. Not to rush.But to understand. When we see the whole child, we open more doors. We might: Use more visual communication alongside speechCreate sensory-friendly environmentsSupport regulation through movement and touchFollow the child’s interests as a bridge to connection These supports don’t depend on a diagnosis.They don’t need to wait. And importantly, they don’t harm a child whose differences are only related to glue ear. They simply make the world more accessible. If a child in your care has glue ear and you’re noticing other differences, you’re not imagining things. You’re observing. You’re attuning. You’re responding. And that matters. There’s space to explore hearing needs and neurodivergence.There’s space to support communication and sensory experiences.There’s space to honour uncertainty while still offering meaningful support. Because children are never “just” one thing. They are whole, complex, beautifully individual humans deserving of being seen in their entirety. And when we allow ourselves to stay open to that fullness, we meet them where they truly are. Medical Papers:https://pmc.ncbi.nlm.nih.gov/articles/PMC10186415/https://bmjgroup.com/common-ent-issues-in-pre-schoolers-may-be-linked-to-autism/ Back To Blog
Why Traditional CBT Often Misses the Mark for Autistic People
Why Traditional CBT Often Misses the Mark for Autistic People (And What Actually Helps Instead) Cognitive Behavioural Therapy (CBT) is often positioned as the answer to everything: anxiety, depression, intrusive thoughts, emotional regulation. For many people, it can be genuinely helpful. But for autistic adults, particularly those diagnosed later in life, traditional CBT can feel confusing, invalidating, or like it’s trying to solve a problem that doesn’t quite exist. This isn’t because autistic people aren’t trying hard enough or don’t want to change. It’s because CBT was built around neurotypical brains, nervous systems, and assumptions about how distress works, and autistic neurology operates differently. When therapy doesn’t account for that difference, it often misses the mark. Autistic overwhelm begins in the nervous system, not the thinking mind For many autistic adults, emotional distress does not begin with a thought. It begins in the body. Sensory overload, cognitive fatigue, auditory or visual processing strain, transitions, unpredictability, social ambiguity, prolonged masking, and burnout all place sustained pressure on the nervous system. When the body is already in fight, flight, freeze, or shutdown, trying to challenge or reframe a thought is unlikely to help. If the lights are too bright, the noise is too loud, or the nervous system is already overloaded, no amount of cognitive work will resolve the distress. In these moments, CBT is often working at the wrong level of the experience. Regulation comes before insight for autistic brains Traditional CBT relies on noticing a thought in real time, analysing it, and reframing it before emotions escalate. Autistic processing, however, is often slower in the moment and deeper over time. It tends to be more detailed, more sequential, and better suited to reflection rather than rapid analysis. This means that by the time an autistic adult can identify what is happening internally, a shutdown, meltdown, or panic response may already be underway. This is not a lack of skill or awareness. It is a difference in processing style. Effective therapy needs to slow down, prioritise regulation, and allow insight to come later. Autistic thinking is often accurate, not distorted CBT is built on the assumption that distress comes from distorted or irrational thinking. For many autistic adults, distress is a logical response to very real experiences. Sensory stress, chronic misunderstanding, rejection, executive functioning challenges, masking trauma, burnout, past invalidation, and practical barriers are not imagined threats. They are lived realities. When a therapist asks, “Is that thought really true?” the answer is often yes. Repeatedly questioning accurate perceptions can leave autistic clients feeling misunderstood, gaslit, or emotionally unsafe, leading them to disengage from therapy altogether. Therapy is not effective when it attempts to correct something that is not incorrect. Therapy that doesn’t include autistic lived experience can’t truly help Many standard CBT frameworks do not address the realities of autistic life. Masking and its long-term impact, autistic burnout, sensory trauma, social trauma, chronic invalidation, and growing up in environments that were not designed for autistic nervous systems are rarely acknowledged. Executive functioning differences are often treated as motivation problems rather than neurological ones. When these experiences are not named or understood, autistic adults are left feeling as though they are the problem, rather than recognising the mismatch between their neurology and the world around them. Therapy that overlooks lived experience struggles to build trust or create meaningful change. Therapy environments need to support safety, not enforce social norms Traditional CBT is typically delivered in a very specific way: two chairs, facing each other, sitting still, maintaining eye contact, and talking continuously. For many autistic people, this setup is not neutral. It can be actively dysregulating. Autistic brains and bodies need to feel safe before they can open up, reflect, or process. If a client is already using significant energy to manage posture, eye contact, social expectations, and sensory input, there is far less capacity left for therapeutic work. To truly meet the needs of autistic clients, therapy environments must be flexible and supportive rather than performative. This may include different seating options, space to move or change position, no expectation to face the therapist or maintain eye contact, access to fidget tools or weighted items, a notepad and pen for doodling or visual thinking, and full permission to regulate in whatever way feels safe. Facing the wall and talking is not a failure of engagement. For many autistic clients, it is what makes engagement possible. Safety and structure support change more than flexibility CBT often assumes that clients can experiment with new behaviours quickly, shift perspectives easily, and tolerate uncertainty. Autism, however, includes differences in cognitive flexibility. Autistic adults often need more predictability, more preparation, clearer explanations of why something matters, and step-by-step scaffolding before attempting change. Pushing for behavioural shifts before a client feels regulated and safe can increase shutdown rather than progress. Change happens most effectively when the nervous system feels supported, not rushed. What supports autistic adults more effectively The goal is not to discard CBT entirely but to adapt mental health support so it works with autistic neurology rather than against it. Supporting the nervous system first Before working with thoughts, the body needs support. Sensory recovery, stimming, deep pressure or weighted input, temperature-based grounding, gentle movement, predictable routines, co-regulation, reducing sensory load, and breathing patterns that suit autistic bodies all help calm the nervous system. When regulation improves, cognitive work becomes accessible. CBT that works with autistic brains CBT can be helpful when it is neuroaffirming and adapted. This means assuming thoughts are valid, focusing on distress tolerance rather than correction, slowing the pace, using visual structure, breaking skills into concrete steps, and integrating sensory and regulation supports. Autistic pattern recognition and logical reasoning can be strengths when therapy is structured in a way that respects them. Emotional processing models designed for autistic neurology Autistic adults benefit from frameworks specifically designed for their brains, including monotropism-based approaches, interoception training, alexithymia-friendly emotion identification, burnout recovery models, and communication styles that reduce pressure and ambiguity. These
Junior Cert 2025!
Junior Cert 2025! This year I had twelve female therapy clients in Junior Cert Year who wanted to sit their exams. In 2024, 10 of these teenagers had missed in excess of 120 days of school, most of them had attended for less than two weeks of their second school year. When they came into therapy, all of them were in neurodiverse burnout and were experiencing severe mental health challenges such as self-harm, suicidal ideation, eating disorders and had received late diagnosis’s of autism and/or ADHD as well as co-occurrences. Nine out of the twelve also have a PDA profile. All of them desperately wanted to be able to attend school. All of them wanted to sit their Junior Cert (I have many clients who don’t want to take their Junior Cert, and I fully support them in their informed decision also). Their focus was not on their studying beforehand, their focus is not on their results, their focus was being supported enough to be able to sit their exams, confident that they could achieve a pass, something many of them had been told by teachers/school staff that they would never achieve. Individualised support plans that accurately support each students needs can achieve what these clients have achieved today. Many of these twelve clients may never attend a full day of school or move away from a reduced timetable, they have proved it doesn’t matter. Eleven of these clients don’t do homework, again they have proved it doesn’t matter. Twelve of these clients didn’t start their studying for these exams until they had finished school four weeks ago, again they have proved it doesn’t matter. All twelve have different areas of support needs yet the schools had given them a generalised return to school program that wasn’t neuroaffirming or meeting their individual needs, setting them up for failure. All twelve voiced their needs, the areas they felt they needed support in and we worked to individualise their return to school plan and time and time again we altered it when needed until it was spot on and they were thriving. All twelve experienced some levels of burnout around Christmas time, before the February mocks and in their final weeks of school before the exams – however this time it was different, they understood themselves more, they put in place supports to get them through and limit the burnout, they understood taking a short break from school wasn’t failing – it was supporting themselves to enable them to go back a few days later. They knew their eating habits were reducing and changing because they were experiencing high stress, but they also knew their reliable comfort foods to get them through. They knew when to reduce social demands and when to increase their downtime. None of them reverted to self-harm, none of them experienced the crippling intrusive thoughts or suicidal experience they had in the previous school year. All twelve clients were determined to sit their junior cert exams….and today they all achieved it!!! There have been tears of relief and joy, powerful exhales, high fives, dances, celebratory air punches and the biggest proudest smiles in my therapy room this week and it has been incredible to be standing with these girls on their journey. Proud doesn’t even cut it, in awe is more accurate. Don’t ever write off a child’s ability to achieve or tell them that they won’t achieve what they want to. None of these children should ever have heard those words from their educators. They will prove you wrong when they get there anyway, in their own time and in their own way. Back To Blog