Dyspraxia & EDS comorbidity

Athour: 

Dr Caryn McAllister, PT, DPT (USA) President & CEO High Quality Home Therapy

Socials: @hqhtherapy Website: HQHTherapy.com

I've been a physical therapist since 1995 and have a strong passion to help others. My specialties include complex medical conditions, all things neurological, chronic pain, neurodivergence and EDS. I’m also interested in hormonal health, psychology and the brain/body connection, spasticity, breathing, pelvic floor rehab and mindfulness.

Over the past 5-6 years I’ve seen a strong relationship between dyspraxia and hypermobility, Ehlers-Danlos Syndrome, and feel it’s important to share my findings with both the dyspraxia community and the EDS community. It’s my hope to create awareness and help as many people as possible live their best lives. Knowledge is power and through sharing of information and evidence-based clinical trials, we can identify patterns and perhaps determine an association.

Ehlers-Danlos Syndrome (EDS) is a connective tissue disorder marked by 13 different subtypes, with the most common being hypermobile EDS. While all patients with EDS present differently, symptoms often include joint hypermobility and subluxations, ligamentous and skin laxity, tissue fragility, chronic pain, dysautonomia, fatiguability, craniocervical instability, headache and POTS (positional orthostatic tachycardia syndrome). EDS is more prevalent in females and there seems to be a genetic predisposition. Most of my patients with EDS report comorbid diagnoses of anxiety, depression, attention deficit hyperactivity disorder and learning disability(USA)/difficulty(UK). Interestingly, I’ve yet to meet a patient with EDS that’s not highly intelligent.

Dyspraxia, also called Developmental Coordination Disorder (DCD), is often underrecognized by healthcare professionals and educators. I first learned of dyspraxia (versus apraxia - I thought they were the same at the time) and how it affects people with attention deficit hyperactivity disorder and anxiety about 20 years ago. An occupational therapist explained to me how the brain can be hijacked by struggling to focus causing difficulty with gross and fine motor skills. I witnessed the difficulty a highly intelligent child experienced simply copying notes. This child was then diagnosed with dyspraxia but only after neuropsychological testing and therapies. Her mom struggled with the school because the school thought the child wasn’t trying but she was. The information I gained at that time helped me advocate for the patient and opened up my ongoing curiosity of neurodivergent brains with respect to functionality.

I did a literature review of EDS and dyspraxia and found that there’s not a lot of information on the two together. However the few that I found provided valuable insights. Ghibelline et al (2015) found a significant link between EDS and coordination deficits. Calletti et all (2015) found that of 41 Italian children with DCD, close to one half screened positive for generalized joint hypermobility. Henderson et al (2017) explains the neurological complications in EDS and provides a sound mechanical framework for understanding motor coordination deficits for patients with EDS. Westermen et all (2025) suggest that connective tissue laxity affects proprioception; joint instability impacts motor learning and structural brain changes as well as possible small fiber neuropathy in EDS can cause neurological factors that impact coordination. Baeza-Velasco (2021) provides a review of neurodevelopmental conditions associated with EDS and positions motor coordination challenges within broader neurodevelopmental spectrum disorders.

More research needs to be done in this field and it really takes a team of patients, providers and researchers to make a dent. If anyone is interested in exploring this more, I’m happy to work with you on a study. But based on the limited research, if you have EDS you may want to ask your medical providers if you also have dyspraxia and if you have dyspraxia, you might want to ask your medical professional about other diagnoses such as EDS.