“…The life-limiting nature of DMD strongly affects both patients and parents, who are required to navigate numerous challenges, which may include: fatigue , which can be acute (e.g., following exertion) or chronic (El-Aloul & Campbell, 2017); pain , which is often linked to muscle cramps and joint pain (Jacques et al, 2019); discomfort and sleep disturbance from wearing night splints to manage limb contractures (Apkon et al, 2018); constipation , as a result of limited physical activity (Kraus et al, 2016); loss of ambulation , which occurs by 12 years (Gissy et al, 2017); and late symptoms, which may include difficulties with speech and swallowing (dysphagia) (Toussaint et al, 2016). Approximately 26% of individuals with DMD have an intellectual disability while prevalence rates of ADHD are around 32% (Colvin et al, 2018), and co-occurrence of Autism spectrum disorder (ASD) was found in 21% of cases by Ricotti et al (2016).…”