REPLAY: Ask the Experts (Neurodivergence), with Jo Southall and Alexandra Lawrence, 15th October 2026.
Our October Ask the OT session featured Jo Southall, an independent occupational therapist, joined by guest co-host Alex Lawrence, also an independent occupational therapist. The session focused on the overlap between hypermobility, chronic illness, neurodivergence, pain, fatigue, POTS, burnout, sensory needs, interoception and mobility aids, with live questions from attendees throughout.
Jo introduced the session as an informal, recorded Q&A with live chat questions, while Alex shared expertise in supporting neurodivergent adults, including around sensory needs, workplace adjustments, executive functioning, burnout and energy management, alongside lived experience of chronic illness and mobility aid use.
Our LinkFairy has now sufficiently rested and recaffeinated, so you can watch the replay here. The session and associated chat are summarised below.
Main themes from the discussion
Neurodivergence, regulation and chronic illness
One of the strongest themes throughout the evening was the link between nervous system regulation, sensory needs and symptom management. In response to a question about supporting an 11-year-old with PDA, chronic pain, fatigue, POTS and migraine, Alex suggested starting with sensory modulation, identifying both calming and energising sensory input, and building a personalised list of strategies that can be used in different situations.
Jo added that pacing is essential, but that pacing for neurodivergent people often works better when it involves alternating different types of activity rather than simply doing something and then stopping completely. Jo explained that cognitive rest and physical rest are not always the same thing, and that switching between tasks with different demands can help reduce overload while still allowing recovery.
Both speakers emphasised that symptom management is often about small gains adding up, rather than finding one single fix.
Burnout, the “October slide” and being kinder to yourself
Several questions centred on the seasonal worsening many members experience in autumn. Jo and Alex discussed the impact of autistic burnout, overwhelm, fatigue, stress, weather changes and reduced daylight, and both highlighted the importance of stripping back non-essential demands during difficult periods.
Alex encouraged attendees to revisit the basics of meeting sensory needs, especially where those supports may have slipped. Examples included adjusting lighting, taking time in a dark quiet space, using soothing sounds, and incorporating compression or other calming input. Joy and pleasurable experiences were highlighted as essential, not optional.
Jo spoke about the value of seasonal coping strategies, noting that different times of year may require different plans for pain, sleep, temperature regulation and general function. Jo also recommended short periods of symptom and routine tracking to help identify what is actually driving a flare, such as changes in sleep, energy or environmental factors.
Workplace adjustments and disclosure
A question about when to disclose disability or adjustment needs while job hunting led to a thoughtful discussion about reasonable adjustments, workplace culture and self-protection. Alex noted that early conversations can act as a way of testing how an employer responds, while Jo was clear that a job that damages physical or mental health is rarely worth holding onto.
Jo also pointed out that the way adjustments are framed can make a difference. Explaining not just what is needed, but why it helps someone perform better at work, may support more constructive conversations.
Hypermobility and exercise
Exercise for people with hypermobility was another major topic. Jo stressed that responses to exercise vary hugely between individuals and that there is no one-size-fits-all approach. Examples were given of adapting posture and activity type, including recumbent options such as lying down with pedal exercisers, particularly for people with POTS-type symptoms.
Jo also discussed the role of compression clothing in improving body awareness and helping people notice strain, pain or instability sooner. The importance of slow, consistent progression was emphasised, along with caution around overloading too quickly.
A specific resource recommended during the session was Jeannie Di Bon’s Zebra Club, described as a movement-based programme designed with hypermobility, chronic pain and autonomic issues in mind.
Ageing, hormones and hypermobility
Another important discussion focused on ageing with hypermobility, especially in relation to hormonal changes and menopause. Jo explained that hormonal shifts can increase joint laxity, pain, injury risk and loss of muscle support, and suggested that adapted exercise, compression and conversations about HRT may be relevant for some people.
Alex added that hormonal changes can also worsen difficulties with executive functioning, task initiation and transitions, and shared practical strategies such as using a “bridge” between tasks, for example playing a short video while moving from one activity into another.
Jo also mentioned emerging interest in creatine research in women, especially in relation to cognition and fatigue, though this was raised informally rather than as a formal clinical recommendation.
Interoception and recognising what your body is telling you
Interoception came up repeatedly, especially for people who struggle to recognise hunger, thirst, temperature, anxiety or illness until symptoms become severe. Alex described building interoception through small sensory experiments, choosing a neutral body area and practising noticing and naming sensations in different ways. This could then lead to creating a personalised “interoception cheat sheet” or symptom table.
Jo suggested using micro-breaks built into daily routines to check in with the body regularly. Rather than relying on timers, Jo recommended linking check-ins to things already happening in the environment, such as sending an email, waiting for the kettle to boil or hearing a repeated background sound.
For members who experience a vague “I feel bad but I don’t know why” feeling, both speakers suggested trying the basics first: rest, fluids, food, medication where appropriate, sensory support and reducing demands, then reassessing after a little time. Jo also mentioned that using a digital thermometer can be a useful way to identify fever when body awareness is poor.
Splinting, upper limb pain and hand use
A question from a performing arts medicine professional prompted discussion about hand and upper limb splinting for musicians with HSD and neurodivergence. Jo noted that the right brace depends heavily on the task involved, and that overly restrictive bracing may be poorly tolerated, especially by people who need to fidget or who rely on very specific hand movements for instrument use.
Jo suggested that compression gloves can be helpful for some people, although sensory tolerance varies, and noted that wearing gloves inside out may help if seams are irritating. A referral to NHS orthotics or a specialist hand therapist was strongly encouraged where possible, if you're someone who doesn't notice infections until they're severe it can be an idea to monitor your temperature regularly and know your baseline.
Mobility aids, grief and freedom
Mobility aids were one of the most resonant topics of the evening. Jo’s view was clear: if someone is repeatedly finding themselves wishing they had a mobility aid, that is often a sign that one may be needed. Jo spoke about the importance of matching the aid to the situation, and about the fact that many people need more than one mobility option for different settings or levels of fatigue and pain.
Alex acknowledged the emotional side too, describing mobility aid use as something that can bring up grief, fear and internalised stigma, especially in the current climate. At the same time, Alex highlighted how aids often allow people to do more, go further and recover better, rather than limiting life. Gradually introducing aids in safe environments was suggested as one way to make that adjustment easier.
Jo also addressed a question about upper body pain and dislocations from canes or crutches, suggesting that where aids are causing enough pain to stop someone leaving the house, it may be time to look at wheelchair options, alongside possible input from physiotherapy, orthotics and shoulder support.
Key takeaways
A number of practical messages ran through the whole session:
Small gains matter, and multiple small adjustments can create meaningful change.
Pacing is essential, but may need adapting for neurodivergent people so that rest does not simply become another form of distress.
Sensory support is a legitimate health strategy, not just an optional extra.
Joy matters, especially during burnout, seasonal decline and periods of stress.
Interoception can be built gradually through structured practice and regular check-ins.
Mobility aids are tools for access and freedom, not failure.
Resources and recommendations mentioned in the session
The following resources or practical routes were mentioned during the discussion:
Jeannie Di Bon – Zebra Club for hypermobility-friendly movement support.
Royal College of Occupational Therapists – Find an OT as a route to locate an independent occupational therapist, including paediatric specialists.
NHS orthotics or a hand therapist for splinting and upper limb support.
Paediatric OT referral via a GP for young children with hypermobility and fine motor concerns.
Compression clothing or gloves for proprioception, pain management and sensory regulation, where tolerated.
Digital thermometers, reminders, micro-break prompts and apps for symptom awareness and routine support.
It was a lively, slightly chaotic (in the best possible way) evening full of practical tips, shared lived experience, and a whole lot of “oh wow, me too!” Key info from the chat...
Jo Southall, Independent Occupational Therapist
Website: https://jboccupationaltherapy.co.uk
Socials: @jboccytherapy
Alexandra Lawrence, Neurodiversity Specialist OT Website: https://www.navigateneurodiversityot.com
Socials: @navigateneurodiversityot
Hosted by The Hypermobility Syndromes Association
Website: https://www.hypermobility.org
Email: info@hypermobility.org
Socials: @HMSACharity
🌿 Hormones, Ageing & Hypermobility
Hormones were a hot topic, especially menopause, perimenopause, and how things shift as we age. We shared two of our most‑read resources:
And yes… we are planning a dedicated session on women, hormones, and hypermobility in January. Keep an eye out, it’s going to be a good one.
🧠 Neurodivergence, Interoception & Burnout
Interoception (aka “body‑sense”) came up again and again. Lots of people shared how easy it is to miss hunger, thirst, temperature changes, or even fevers.
Cue the community’s favourite tool: The Baby Checklist™ Hot? Cold? Need the loo? Eaten? Meds? DRINK SOMETHING.
Other helpful ideas included:
Using playlists as timers
Daylight lamps
Symptom tracking apps
The VISIBLE band/app for pacing, sleep, and activity monitoring
It was lovely seeing people swap strategies that actually work in real life, not just in textbooks.
🦓 Mobility Aids: Rollators, Wheels & Permission to Make Life Easier
Mobility aids were a huge part of the conversation, and the vibe was very much “why didn’t I do this sooner?”
Key links shared:
Jo’s mobility aids guide: https://jboccupationaltherapy.co.uk/mobility-aids
HMSA’s coverage post: https://www.hypermobility.org/post/let-s-talk
People talked about:
Hiring rollators from local charities (£1/day!)
LION rollators for less juddering
Power wheelchairs being liberating
Using funky shopping trolleys to avoid carrying bags
Borrowing supermarket wheelchairs to test what helps
The overall message? Mobility aids don’t take independence away, they give it back.
🏃♀️ Movement That Works for Hypermobile Bodies
We had some brilliant recommendations for movement and exercise:
The Zebra Club (Jeannie Di Bon): https://thezebra.club (Integral Movement Method)
Adaptive yoga teachers
Jeannie Di Bon’s YouTube videos for children
Pedal exerciser example: https://amzn.eu/d/0ivj5RXY
Lots of people shared how finding the right teacher or programme made all the difference.
🧒 Kids & Support
Parents asked about:
Exercise options for little ones
How to support neurodivergent hypermobile children
We also announced something exciting: Our self‑management toolkit for primary school children is coming soon!
❤️🩹 Pain, Fainting & Autonomic Woes
From postural hypotension to fainting while sitting, stretching, or lying down, many attendees shared experiences that were instantly recognisable to others.
There was also discussion around recovering from injuries (like whiplash) when you’re hypermobile, and how standard physio approaches often need adapting.
🌈 Community, Whimsy & “Oh My Goodness, Same!”
As always, the chat was full of warmth, humour, and shared humanity. Highlights included:
Year‑round LED trees
Seasonal decorations
“MORE WHIMSY :D”
Interoception experiments
Garden adaptations
The joy of finding professionals who get it
It was one of those evenings where people felt seen, and that’s exactly why we run these sessions.
💌 Membership, Feedback & Support
If you’d like to access more sessions like this, plus access to our full library of resources, consider becoming an HMSA member: https://www.hypermobility.org/become-a-member
If you’d like to support our work, you can donate here: https://tinyurl.com/yc2s6fns
And if you watched, we’d love your feedback, it genuinely drives our content and helps us plan how we develop our provision: https://forms.office.com/e/2bxehy8ZZZu
If you're leaving feedback after watching the replay, Thanks you! Please use 'Ask Experts Oct 2026' to identify the session. :)
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