Introduction Autism Spectrum Disorder (ASD) is an umbrella term, which includes conditions with problems of socialization, communication, and stereotypic problems. 1 Even though psychological and behavioural problems are commonly observed in children with ASD, motor impairments are not uncommon, the motor problems in these children include difficulties in gait, 2 balance, coordination, fine and gross motor skills 3 and sensory motor integration. 4 Moreover, all these motor impairments are not stable, and they are different between age groups. 5,6 The reasons for these motor problems are hypothesized directly to involve minimal brain damage, deficiency in motor control, and motor learning, and indirectly to muscle weakness, hypotonicity, hypermobility, and ligament laxity. Joint hypermobility refers to the excess of range of joint extensibility beyond the normal limits. 7 Some studies indicated hypermobility in children with ASDs, but the clear amount of clarification is not there concerning the quantification of ligament laxity. 8,9 Klein et al. compared hypermobility between typically developing children and children with ASD. This study used a general range of motion (ROM) measured using a universal goniometer. The study did not use any criteria or a valid measurement tool that is specific to quantify the overall extent of hypermobility. 9 Clark et al. reported that adults with joint hypermobility had chronic widespread pain, autonomic symptoms, gastrointestinal symptoms, and chronic fatigue syndrome. 10 Children with ASD who have hypermobility might also have similar issues, which the child would not be able to express due to issues with communication and social interaction. Hypermobility in the joints might lead to arthritis, low back pain, 11 altered neuromuscular control during activity 12 and it might even affect the muscle activation pattern. 13 A recent review was published by Velasco et al. in 2018 in Frontiers of Psychiatry titled "Autism, Joint Hypermobility-Related Disorders and Pain" concluded that "Considering the high probability that pain remains disregarded and untreated in people with ASD due to communication and methodological difficulties, increasing awareness about the interconnection between ASD and hypermobility-related disorders is relevant, since it might help identify those ASD patients susceptible to chronic pain". 14 We, as Paediatric Physical Therapists, see this problem in children with autism on a day to day basis. The children with ASD were suffering from hypermobility and related problems like pain and proprioceptive deficits. Due to their communication difficulties children cannot express this problem. Their sensory behavioural pattern changes J Pak Med Assoc 1076 RESEARCH ARTICLE Hypermobility among children with autism spectrum disorders and its correlation with anthropometric characteristics Jaya Shanker Tedla, Faisal Asiri, Mastour Saeed Alshahrani, Kumar Gular Abstract Objective: To determine the extent of hypermobility in children with Autism Spectrum Disorder and to determine the correlation between age, gender, height, weight, BMI and hypermobility. Methods: This cross-sectional study included 117 children with Autism Spectrum Disorder aged 2 to 17 years, of whom 91 were boys and 26 were girls. After obtaining the written informed consent from the parents of these children with Autism Spectrum Disorder, we assessed their level of hypermobility using the Beighton score. Results: Out of 117 children, 47 (40.17%) were normal and 70 (59.83%) showed an abnormal increase in mobility. The average Beighton score was 5.33 ± 2.42. There is a moderate negative correlation between height, weight, and age with hypermobility. Conclusion: The extent of hypermobility among children with Autism Spectrum Disorder was 60%, that is, 70 out of 117 children had hypermobility. Our results also suggested that the age, height, weight, and BMI of the child had a moderate negative correlation with hypermobility. Keywords: Autism Spectrum Disorder, Hypermobility, Beighton score, Children and Ligament laxity. (JPMA 71: 1076; 2021) DOI: https://doi.org/10.47391/JPMA.436 Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia. Correspondence: Jaya Shanker Tedla. Email: jtedla@kku.edu.sa