PDA is a complex autism spectrum condition which is best described as an “Anxiety Based Need to be in control” Children with PDA still have significant difficulties associated with the Triad of Impairment, however, they are highly skilled at avoiding demands and masking their difficulties. Children with PDA often behave very differently in different settings and it is often hard for parents to get a diagnosis as many professionals are unable to diagnosis it without clear autistic traits.
These are the characteristics of Behaviour Associated with PDA as described by Elizabeth Newson et al: (Newson 1998, Revised 1995, Second Revision 2000, Third Revision 2001)
• Resists and avoids the ordinary demands of life
• Appearing sociable, but lacking depth in understanding
• Excessive mood swings and impulsivity
• Comfortable in role play and pretend, sometimes to an extreme extent
• Language delay, often with good degree of catch-up
• Obsessive behaviour, often focussed on people, either loving or loathing them
• Can be domineering and overbearing
• Parents often describe a “Jekyll and Hyde” personality
• Bossy and controlling
• Often more comfortable with adults than children
• Often hypersensitive to other’s voices, facial expression etc
• Can be over familiar with adults and peers
• May take on the persona of others, i.e. teachers.
• May go into role in order to comply
• May have a panic attack or meltdown if highly anxious – these may result in aggression towards others
• Unaware of impact of behaviour on others
• Can behave very differently at school /college to home
• Unable to follow routines if set by others
• Often have sensory issues – noise, touch, brightness etc
Children with PDA are highly complex and often display behaviours which are very challenging to those around them. There is also a significant impact on the rest of the family when a child has PDA.
Although it is recognised by many as being an autism spectrum condition, individuals with PDA do not respond well to traditional autism strategies and far more flexible approach which allows the individual with PDA to believe they are in in control is far more effective. The following strategies can be helpful when supporting children with PDA:
Remember that ANXIETY is what drives the behaviour of an individual with PDA. If you always consider the anxiety rather than the behaviour you are more likely look for solutions and try to help. Also remember that sometimes anxiety stops individuals with PDA doing the things they want to do as well as the things they don’t.
Use a flexible, non-directive approach. Use phrases such as, “I wonder how we might……..”, “I wonder if anyone can do this?”
Be aware of your facial expressions. Individuals with PDA can be hyper sensitive to tone of voice and facial clues, which can often cause them anxiety.
Offer choices. This gives the illusion of control and lowers anxiety. “Would you like to do X or Y first?” “Would you like to sit here or here to do your work?”
Use challenges: I bet you can’t finish this work before me!”
Praise indirectly: Let them hear you talking about them in a positive way. Or send postcards home to celebrate success.
Use areas of interest to engage and motivate: Look for ways to weave hobbies and interests into work.
Reduce pressures and pick your battles. There will be days when anxiety is too high for an individual to comply with any demands. This is fine. You will have good and bad days. Look for ways you can support so that work gets done, i.e. offer to scribe, or finish things for them.
· Have a sense of humour! Be prepared to take the mickey out of yourself too!!
· Depersonalise Rules. “I am afraid you can’t go outside as its slippery and our Health and Safety rules forbid it” or “It’s the law”
· Show empathy and sympathy: “I know you find maths really hard. I do too. Shall we work on this together?”
· Try to find a balance between routine and spontaneity. This will be dependent on the individual’s mood and anxiety levels. But lots of individual’s with PDA like surprise and don’t like routine if too rigid or set by others.
· Use Complex Language. Sometimes it is possible to disguise a demand by wrapping it in complex language and making suggestions which allow the individual with PDA to think that they are in control.
· Rewards need to be individualised, quick and personalised. Often group rewards are ineffective and don’t motivate the individual with PDA. You need to make sure they are motivational and change regularly.
· Use surprise or spontaneous rewards. “I love the fact you have worked hard, you can go on the computer now!
· Most importantly! Remember that everyone with PDA is different and should be treated with an individual approach!
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