Clumsy, or Neurodivergent?

Jillian Enright

Clumsy, or Neurodivergent?

An explanation of some unexpected symptoms in ADHD and Autism

Written by Jillian Enright, CYW, BA Psych.

I was nervous but on the surface…

…. I looked even more nervous.

One of the very first dinners I had with my now husband’s family was Thanksgiving dinner. I was in my early 20s, we were newly dating, and I was heckin’ nervous.

I already struggle with anxiety, now add to this meeting my partner’s large, happy family during a fairly major holiday dinner. Yikes.

How did it go, you might ask?

Welp.

During dinner, I noticed a big salad bowl near my right elbow and was trying to keep my elbows in so that I didn’t knock it over. Unfortunately, in doing so, I was cutting my turkey at an awkward angle. My hand slipped, and I somehow ended up with a little mashed potato…. In. My. Hair.

I am not sure if anyone else noticed, but my partner subtly pointed it out to me, so I excused myself to the bathroom and tried not to cry as I nearly had a panic attack over my clumsiness.

Or at least that’s what I used to call it.

It turns out that neurodivergent people are not really “clumsy” after all. In fact, there’s a perfectly reasonable scientific explanation for these types of issues: we neurodivergents often have difficulties with proprioception and interoception (Kutscheidt et al., 2019).

Proprioception

Proprioception is the sense through which we perceive the position and movement of our body, including our sense of equilibrium and balance (Wolff & Shepard, 2013). It is the unconscious perception of movement and spatial orientation arising from stimuli within the body.

The root word, proprio, is derived from the Latin word proprius. Translated into English, proprio means one’s own — as in belonging to — or personal.

Proprioception gives us awareness of where our own body is in space and in relation to other objects.

Interoception

Interoception is defined as the sense of the physiological condition of the body, such as conscious awareness, emotional processes, and behaviour related to afferent physiological information arising from the body (Schleip & Jäger, 2012).

In other words, interoception helps you understand and feel what’s going on inside your body, it is our felt experience of the internal workings of the body. Interoception can refer to experiences such as thirst and hunger, or feeling the need to go to the bathroom.

The prefix, inter, also comes from Latin, meaning interior, inside, or in between (Ceunen et al., 2016).

Individual Differences

Not all neurodivergent people have difficulties with these, but many of us do — and not everyone experiences these in the same way. Just as not all neurodivergents experience these issues, not everyone who experiences these issues has ADHD or is Autistic.

People with a sensory processing disorder and developmental coordination disorder (DCD, sometimes referred to as dyspraxia), for example, also may experience some of these difficulties. Many of these conditions are also comorbid with ADHD and Autism.

We Got Gross Skills

I’ve always been an athlete and a pretty good one too. I’m never going to make a living at it, but I’ve played competitive sports my entire life, including hockey and soccer. My son is only 8, but he’s already quite skilled at baseball and basketball.

I never would have thought that either of us had issues with proprioception or interoception, but now that I better understand these concepts, I see where they do impact our lives.

It’s funny how I can be agile and coordinated while playing sports, yet I bump into walls and the edges of counters and stub my toe on a daily basis. Part of this is because there’s a major difference between gross motor skills and proprioception.

Gross motor skills are abilities that allow us to perform tasks involving large muscle groups. While some people with ADHD experience challenges with gross motor skills (Pila-Nemutandani et al., 2018), many others may be able to use their hyperactivity, energy, and hyper-focus to become great athletes.

Many professional athletes have come out in the media as having ADHD: Simone Biles, Michael Jordan, Michael Phelps, Terry Bradshaw, Carl Lewis, André Torres, and Cammi Granato, to name just a few.

I’m no Olympian, but my son and I can both climb trees like nobody’s business, so there’s that.

Fine Motor Skills

Another challenge I have is with fine motor skills. These give us the ability to make movements using the small muscles in our hands and wrists.

Many neurodivergent people have difficulty with fine motor skills (Mokobane et al., 2019), in particular with writing. There are a high incidence of impairments impacting the physical act of writing, such as dysgraphia, amongst the neurodivergent population (Mayes et al., 2019).

Not me, though, oh no, I had to be extra special. I love writing, I don’t even mind handwriting — although, I did always hold my pen or pencil wrong, and I always print rather than write in cursive for some unknown reason.

Anyway.

No, my issue with fine motor skills is more of a bull-in-a-china-shop situation. If something requires precision and a delicate touch, we call... anyone but me.

Picture me trying to make something — anything — work, and my husband trying to help:

Husband: “um, babe, I don’t think it’s supposed fit together like that”

Me: [ignoring him, forcibly trying to make something fit together that probably shouldn’t] “… almost … got it…”

[insert the sound of breakables… well, breaking]

Sigh.

We even have a name for this in our family. Actually, it’s my name, my noun turned verb. Being rough with something that requires finesse resulting in damage is now referred to as “Jillying” something. Yep, I’m officially a verb.

At least I’m not alone (or so I’m told). According to Dr. Iveta Boržíková (2020), we use the fine motor skills in both our eyes and hands — namely, hand-eye coordination — to determine the shape and mass of an object. We then use this information to determine the force with which we grasp and manipulate that object.

People with ADHD have difficulty distinguishing fine hand movements from larger body movements — check. People with fine motor issues also may frequently drop objects (Boržíková, 2020). Well, that explains a lot.

I also have very little patience, so while part of my brain is like, “hold up, we should maybe read the instructions first — ” my ADHD has already proceeded to step five, which may or may not have resulted in the destruction of property.

This impatience is also known as impulsivity, which is a very common ADHD symptom (Barkley, 2015).

Are you really clumsy, or Neurodivergent?

So, back to my original question — are you actually clumsy? Or perhaps, like me, you stumble and bump your way through life thanks to poor proprioception. Seriously. I’m supposed to have an IQ in the high 140s, yet I once closed my own head in my car door — how did I not realize my own damn head was in the door?!

Oh, that’s right, I have a neurobiological disorder that influences how my body perceives itself and the world around me, among many other things (Curatolo et al., 2010).

The current DSM-V criteria for ADHD is painfully oversimplified and misses many of the most significant symptoms and co-morbidities affecting people with ADHD.

When the “bible” for diagnosing psychological and neurodevelopmental conditions so badly misses the mark, it’s no wonder the general public really has little idea about what ADHD actually is and how it impacts people’s lives.

This, in turn, perpetuates the stereotypes and stigma surrounding ADHD, and contributes to prevalent attitudes that people with ADHD just need to try harder, get a damn planner, and maybe try some yoga or meditation.

Yep, that’ll do it. I am certainly buying a day planner will totally rewire my brain to fit the neurotypical expectations — except, wait. I’ve finally begun to accept my divergent brain, and have even come to like some of the unique qualities that come with being neurodiverse.

So maybe yoga is out, and I won’t buy that day planner after all, but thanks for the suggestions, neurotypicals.

© Jillian Enright, ADHD 2e MB

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References

Barkley, Russell A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis & Treatment. The Guilford Press.

Boržíková, Iveta. (2020). Specifics of Motor Skills and Motor Learning in Children with ADHD. Journal of the Institute of Pre-School and Early School Education, 8, 105–116. University of Prešov.

Ceunen, E., Vlaeyen, J. W. S., Van Diest, I. (2016). On the Origin of Interoception. Frontiers in Psychology, 7, 743. https://doi.org/10.3389/fpsyg.2016.00743

Curatolo, P., D’Agati, E., & Moavero, R. (2010). The neurobiological basis of ADHD. Italian Journal of Pediatrics 36, 79. https://doi.org/10.1186/1824-7288-36-79

Iglesias, T., Liutsko, L., & Tous, J. M. (2014). Proprioceptive diagnostics in attention deficit hyperactivity disorder. Psicothema, 26(4), 477–482. https://doi.org/10.7334/psicothema2013.311

Kutscheidt, K., Dresler, T., Hudak, J. et al. (2019). Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD). ADHD Attention Deficit and Hyperactivity Disorders 11, 395–401. https://doi.org/10.1007/s12402-019-00299-3

Mayes, S. D., Breaux, R. P., Calhoun, S. L., & Frye, S. S. (2019). High Prevalence of Dysgraphia in Elementary Through High School Students With ADHD and Autism. Journal of Attention Disorders, 23(8), 787–796. https://doi.org/10.1177/1087054717720721

Mokobane, M., Pillay, B. J., & Meyer, A. (2019). Fine motor deficits and attention deficit hyperactivity disorder in primary school children. The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 25, 1232. https://doi.org/10.4102/sajpsychiatry.v25i0.1232

Pila-Nemutandani, G. R., Pillay, B. J., & Meyer, A. (2018). Gross motor skills in children with Attention Deficit Hyperactivity Disorder. South African Journal of Occupational Therapy, 48(3), 19–23. https://dx.doi.org/10.17159/2310-3833/20l7/vol48n3a4

Schleip, Robert & Jäger, Heike. (2012). Interoception. A new correlate for intricate connections between fascial receptors, emotion and self recognition. Fascia: The Tensional Network of the Human Body. 88–94. Elsevier. https://doi.org/10.1016/B978-0-7020-3425-1.00047-7

Wolff, P., & Shepard, J. (2013). Causation, Touch, and the Perception of Force. In Brian H. Ross (Ed.). Psychology of Learning and Motivation. (pp 167–202). Academic Press. https://doi.org/10.1016/B978-0-12-407237-4.00005-0

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Neurodivergent. 20+ years social work and psychology experience. I write about mental health, neurodiversity, advocacy, education, and parenting. Founder of ADHD 2e MB. CYW, BA Psychology.

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