Dyspraxia & Autism – The Overlap
In many of my blog posts I have mentioned that there are a lot of similarities between dyspraxia and autism, but I haven’t always gone into a lot of detail about them. So I thought I would write a blog post which specifically looks at the overlap between dyspraxia and autism.
Dyspraxia and autism can both be considered to be part of ‘neurodiversity’. For those of you who don’t know what is meant by this, this diagram is useful in giving an overview of the make-up of neurodiversity along with details about the various overlaps:
For this blog post I also decided to create my own diagram to show you how I picture the link between dyspraxia and autism:
As you can see from the diagram, dyspraxia is classed as a ‘Specific Learning Difficulty’ and isn’t on ‘The Autism Spectrum’. However, it has a lot of similarities to autism, in particular Asperger’s and High Functioning Autism which are at the mild end of the autism spectrum. Some people with dyspraxia actually consider themselves to be ‘on the spectrum’. I must also point out that in addition to the overlap, people with dyspraxia may also have an additional diagnosis of autism. Someone may be diagnosed with both dyspraxia and autism at the same time, or they may be diagnosed with dyspraxia first and autism later on in life or vice versa.
A common phrase used when talking about autism is “If you’ve met one person with autism, you’ve met one person with autism” and it’s the same for dyspraxia too. While a lot of people with dyspraxia will experience a lot of overlaps with autism, this won’t be the case for every single person with dyspraxia. Some people with dyspraxia may have lots of overlap with autism, others may just have a bit of an overlap, while for some there will be none at all.
In my opinion, the ways in which dyspraxia is similar to autism are the least understood part of dyspraxia. For those people who have heard of dyspraxia before, when they think of dyspraxia words such as ‘clumsiness’ are likely to spring to mind when in fact there is so much more to it than that. I myself have only really fairly recently begun to understand in how many ways dyspraxia and autism are linked.
Firstly, I’ll start off by looking at social situations. Difficulties with social situations aren’t the same as just being shy, they are genuine difficulties that can be experienced by people with dyspraxia and autism. While they are probably one of the least likely things to be associated with dyspraxia, they are probably one of the most likely things to be associated with autism. Rosie has recently written an excellent blog about the social side to dyspraxia which can be found here: http://thinkoutsideofthecardboardbox.blogspot.co.uk/2015/08/the-social-side-of-dyspraxia.html.
During social situations eye contact can be difficult to maintain. I’ll often be looking at something in the distance when talking to someone. To some people this may seem rude as it may look as though I’m not listening to you. I can assure you though, I am listening.
I’ve noticed that when talking to someone who has autism, if they’re someone who doesn’t like to make eye contact, I can tell that they’re not making eye contact. However, to me this doesn’t seem strange or something that is noticeable, it just seems natural. When I say that I have difficulty with eye contact obviously that doesn’t mean that I don’t look at a person at all when I’m talking to them, it just means that I might not make as much eye contact as other people would.
There are all sorts of aspects to social situations, whether it’s knowing when to interject in a conversation, knowing how to respond, or judging other people’s tone of voice. These are all things that come naturally for most people, but they do not always come naturally to those of us with dyspraxia or autism.
Personally, I find that I have the most difficulty in social situations when I am in a large group of people. I find that because there is so much going on it is difficult for me to process all of the information that is being said, so by the time I’ve thought of something to say as well as how I’m going to say it, everyone else has moved on to the next point! This is when there is only one conversation going on in a group, two conversations going on between different people in a group are even more difficult for me to keep up with.
My little brother, Ramsey, who is 3 years old has autism and I know that he can also find it difficult to process lots of information at once. For Ramsey, wherever possible we’ll shorten what we want to say. For example, rather than saying “Ramsey your dinner’s ready now! Come and sit at the table!” we will say “Ramsey, dinner” and show him his plate. My mum was advised about this from the Speech and Language Therapist as it will also help to develop his language skills. Although Ramsey has more difficulty in processing information than I do, it still shows how both people with dyspraxia and autism can have difficulty processing information. I’ve heard that people with autism also tend to prefer being in smaller groups than larger ones, which may be due to difficulties with processing.
Another aspect to social situations is taking things literally. I’m currently reading ‘The Curious Incident of the Dog in the Night-Time’. It’s a fantastic book. For those of you who don’t know what it’s about, it’s a fictional book about a fifteen year old boy, Christopher, who is thought to have Asperger’s syndrome (although this isn’t directly stated in the book). The book gives a brilliant insight into autism, and it is written from the perspective of Christopher. So I was reading the book and came to the point where he talks about metaphors and how he doesn’t understand them. I was sat there reading this page of the book thinking “I have no idea what most of these phrases mean either”.
It wasn’t until after this that I realised that I do tend to imagine phrases literally and think of them in a very visual way, even when I do know their actual meaning. And for when I don’t know their meaning, I just have an amusing image in my head which is most likely to be nothing to do with what the person is talking about!
Not only does literal thinking come into phrases, it comes into all sorts of parts of a conversation. If someone makes a sarcastic comment I often can’t tell whether they’re being serious or not. If it’s a close friend or family member I’ll just admit that I thought of it literally and laugh about it. On the other hand if I’m with someone I don’t know very well they might think it’s a bit strange how literally I take some things.
Something else that can make social situations difficult is background noise. This is something that I only realised was related to my dyspraxia until fairly recently. Most people would go into a loud environment and may struggle a bit to make out what someone is saying but they would still be able to distinguish the noise of the conversation from other background noises. For me, however, the noises seem to merge into one and I find I have to focus really hard to try and figure out what the person is saying.
I know that, similarly to this, lots of people with autism can experience sensory overload in these sorts of situations. This video gives an idea of what sensory overload can feel like:
As well as noise, people with autism can also be over or under-sensitive to light, texture and temperature. My little brother Ramsey is over-sensitive to certain noises. One of the noises he hates is the echo when walking through a tunnel. Even if we haven’t reached the tunnel yet but he knows its coming up soon he will cover his ears with his hands, which shows how loud the noise must seem to him.
People with dyspraxia can also be over-sensitive to noise, light, texture and temperature too, although not always to the same extent as someone with autism might be. For me, I’m over-sensitve to certain temperatures, particularly the cold. I get cold very easily and often will find myself shivering even where it’s not the sort of temperature you’d need a coat for! I also hate certain textures. When I was younger I used to not like certain clothing because of it’s texture. I don’t have as many problems with that now, but I do find that there are certain foods that I hate not because of their taste but because of their texture.
Lots of people will associate a need for routine with autism, but again it’s not something that people would tend to associate with dyspraxia. One time when explaining to someone that I don’t like changes in routine because of my dyspraxia they actually said “But that’s more Asperger’s isn’t it?” After my dad pointed out that Asperger’s and dyspraxia are quite closely related to each other she then pointed out that dyspraxia is classed as a Specific Learning Difficulty and Asperger’s is an Autism Spectrum Disorder. People just don’t seem to understand the similarities.
Those of us with dyspraxia and autism can become upset and frustrated when our routine changes. We like to plan things out in our head so we know exactly what we are doing. For me, an example of a change of routine in the past which I didn’t like would be when I was at school and forgot to make my lunch the night before. Most people would just do it in the morning and not worry much about it at all. However, I did things in a certain order when getting things ready for school. So when I realised I’d forgotten to make my lunch 15 minutes before we needed to leave, rather than my reaction being “15 minutes will be plenty of time, I’ll just make it now” it would be “I’ve only got 15 minutes! How am I going to get everything done in time? I still need to get other things ready! What am I going to do?”
Another example of a change in routine was when I had an athletics competition. My mum suggested that I could stay round hers in the morning and then my dad could pick me up on the way to the competition. Rather than starting to think of all the things I would need to take with me to my mum’s I started to worry about the changes. “What if mum’s alarm doesn’t go off?” “What if I forget to take something to my mum’s that I need for the competition?” were the sort of things I started to worry about. I’d just always had the same routine when getting ready for an athletics competition that I didn’t like the thought of it changing.
I also find that when I do need to do things in a slightly different order to my usual routine I end up missing something out. For example, if I have to get up really early in the morning for a day out I might decide not to have breakfast as soon as I get up. But because I would normally have breakfast straight away I end up completely forgetting to have any breakfast at all!
Ramsey also very much likes his routine. He gets upset if the furniture is moved around or if something is not in the right place. He also has a routine on the way back from town. There is a specific bollard that he will touch and he will get upset if he isn’t able to do it. Ramsey also doesn’t like being in unfamiliar places, even if he is going on a different route to town than usual he will get upset. This proves that he has a much better sense of direction than me despite the fact that I’m 15 years older! I still end up going the wrong way to town sometimes when I’m at my mum’s, despite the fact that she has lived where she is now for 3 years!
Something that links into routines is that for those of us with dyspraxia or autism things have to be ‘just right’. For example if Ramsey is lining up his toys he won’t just line them up any old way, they have to be lined up perfectly and if someone has moved them even slightly he will notice. One particular example of this I can remember from when I was younger was a toy that I had. In fact I’ve managed to find a photo of the same toy online:
There’s a home video of me saying to my dad “I don’t want these bits!” I can remember at the time I was referring to the accessories that came with the toy. It’s difficult to explain but to me a toy had to be all in one, so the fact that there was nowhere for the accessories to go inside the buggy meant that it ‘wasn’t right’. If I played with the buggy I had to play with the accessories too because they were part of the same toy but if there was nowhere to put there accessories then I couldn’t play with them too. To me, it does seem a bit silly thinking back to it but at the same time I can understand what I was thinking too. Although I’m not sure whether it makes sense to anyone else though!
When I was playing with this toy it’s most likely that I was sitting there quietly moving the buggy around. This is because something that can be difficult for people with dyspraxia and autism is imaginative play. I did used to make up some sort of story in my head but I didn’t tend to say it out loud. At the time it just seemed weird to me to say it out loud. I would dress up dolls and move them around a bit etc. but certainly didn’t play as imaginatively with toys as other children would. On the other hand, I enjoyed creative writing and would be imaginative in my story ideas. Again, Ramsey is similar to me with imaginative play. He doesn’t often play imaginatively with his toys, instead he tends to line them up or move them backwards and forwards. I’ve noticed that when Ramsey is playing with his cars he tend to press down on them really hard. Difficulty judging the amount of pressure to apply is something that is linked to both dyspraxia and autism. Going back to imaginative play, Ramsey has a couple of times held up his toy phone to his ear, it’s just not very often that he does this. My mum said to me that Ramsey even once said “Hello” into the phone which was surprising but lovely to hear (as Ramsey is non-verbal).
Speech is another way in which dyspraxia and autism can overlap. People with autism may be non-verbal or they may have delayed language development. People with dyspraxia can also have difficulty with speech, our speech can be immature or we can get words muddled up. If someone has significant difficulties with speech they are diagnosed with verbal dyspraxia. With dyspraxia we often have a tendency to repeat ourselves and talk continuously about one thing, I know I do this a lot. People with Asperger’s may also talk continuously about one particular subject.
While it’s not something that I do, some people with dyspraxia or autism may flap their hands. Ramsey flaps his hands when he is excited. I love this explanation of hand-flapping I saw a few weeks ago (from this article: http://www.babble.com/mom/autism-acceptance-month-10-things-i-wish-your-kids-knew-about-autism). It’s so true, it’s just another way of expressing excitement:
5. Lots of people talk with their hands.
Hand-flapping is pretty common in kids with autism. (But not every kid who flaps his or her hands is autistic, and not every kid with autism flaps.) Most of the time, hand-flapping just expresses excitement. How else do people use their hands to talk? We give the “thumbs up” and make peace signs. You raise your hand to let your teacher know you want to be called on. Deaf people might use American Sign Language. How else do you use your hands to express yourself?
Another movement that both people with dyspraxia and autism might do is to fidget a lot. It’s quite funny because when I’m at my mum’s Ramsey will often start fiddling with my necklace, for example. I’ll make some sort of comment to my mum like “Ramsey seems to really like playing with my necklace” only to find myself a few hours later doing exactly the same thing myself without even realising it!
Something else that I’ve only realised recently is that autism can affect people physically too. It’s the opposite way round this time. Physical difficulties are the most likely to be associated with dyspraxia but are probably the least likely to be associated with autism. Just like people with dyspraxia, people with autism can have difficulties with spatial awareness, fine motor skills and gross motor skills. My mum has pointed out that there are quite a few things that Ramsey does now that I used to do when I was younger. For example Ramsey will often walk with his hands in the air to help him balance, which is something that I used to do when I was younger. Ramsey also sometimes walks on his toes which I sometimes do too. Ramsey finds using cutlery difficult, which is something that I used to have a lot of difficulty with (and still have some difficulty with now) too. Also, I can certainly understand how Ramsey feels when he bumps into things that are right in front of him too, spatial awareness isn’t a strength for either of us!
Dyspraxia and autism are both hidden. You can’t tell someone has it just by looking at them! If you know enough about either of the conditions you may be able to tell that someone is dyspraxic or autistic by the way they behave over a certain period of time. You can’t, however, say that someone ‘looks autistic’ or ‘looks dyspraxic’!
Through writing this blog post I’ve actually learnt more myself about how dyspraxia and autism are similar, as there are some things that I hadn’t thought of before!
Here’s a summary of the similarities between dyspraxia and autism:
- Social situations – eye contact, processing information, literal thinking, background noise
- Sensory sensitivity
- Imaginative play
- Physical – fine & gross motor skills, spatial awareness
Another thing that dyspraxia and autism both have in common is the ability to see things from a different perspective.
It would be boring if everyone thought the same way, wouldn’t it?