Building a framework of strategies

Overview

PDA, like other profiles of ASD, is dimensional. This means that some children will be affected by their PDA to a greater or lesser extent than others. The degree to which a child is affected can also be variable during different stages of their lives. Therefore, strategies will need to be flexibly adjusted at different times. You can read more about PDA here.

Remember, there is no wrong or right way to do things. It is about learning as much as you can about PDA, using a variety of different strategies at home and finding out what works best for you and your child.

The information provided below is in clear, bite size sections, supported with signposts to further resources for a more in-depth look into each area if you wish to read more.


Strategies snapshot

Our giant panda ambassador gives a snapshot overview of PDA and suitable strategies. This animation provides a great starting point:

giphy1


Understanding the behaviour – recognise anxiety as the driver for avoidance

There are many aspects of day-to-day living that may be difficult, confusing, overwhelming and therefore anxiety-provoking for children with PDA, some of which we will explore in this factsheet. It is important to view the strategies, behaivours and responses your child may use (either consciously or subconsciously) to avoid these unpleasant sensations and feelings as an instinctive defense mechanism to reduce their anxiety and prevent overload. 


Difficulties and triggers for children with PDA

Let’s have a look at some of the triggers and difficulties which underpin the 'anxiety driven' need for children with PDA to avoid demands and to remain in control of their environment.

The demands, suggestions and expectations of others – e.g. being directly told or asked to do something, the expected social responses such as saying please & thank you, plus the additional demands, pressure and expectations associated with certain events such as Christmas and birthdays.

Difficulties in processing language – e.g. may not be able to process verbal communication quickly enough to keep up during a conversation, may be confused by non-specific and vague questions or instructions.

Difficulties and confusion in social situations – e.g. not always understanding that different social situations and different people require different behaviour and responses i.e. the unwritten rules of social interaction.

Confusion regarding the emotions of other people – e.g. may be able to see that other people are upset, sad or happy but may not understand why, what or who has caused these emotions; what their role may have played in this or how this will affect them.

Fear of uncertainty and the intentions of other people – e.g. not knowing or understanding how things will ‘pan out’, what different people will expect of them, where a conversation will lead to, where any given situation will lead, when a situation will end and how they will cope with this transition.

Sensory overload – e.g. too much noise, too many people, clothes itching, intolerable smells etc…. can all contribute to anxiety, overload and avoidance.

Emotional overload – e.g. some individuals can literally take on the feelings and emotions of others to such an extent that it can be overwhelming, affect their own mood and their tolerance for coping in social situations.

Remember that anxiety can manifest and be expressed in many different ways such as avoiding, anger, shouting, crying, restlessness, boredom, fidgeting, rocking, ticks, repetitive actions, obsessing, skin picking, swearing, hiding, running off, withdrawing, throwing things and lashing out at others, to name but a few.

Further information

Please view part one of our webinar ‘Understanding PDA’


Adjusting your mind-set

Looking at your role and relationship with your child – A more equal relationship  between child and parent, based on collaboration and respect, is more likely to build trust and reduce less desirable behaviours. Our role is to facilitate our children to be the best that they can be, and to enable them to access as many opportunities as possible. We are often their bridge between ‘their world’ and an outside world that they may not always intuitively understand or cope with.

Look beyond the surface level behaviour – Remember that the behaviour you see on the surface is just the tip of the iceberg. Below the surface, hidden from view, are many difficulties which result in acute levels of anxiety. The tip of the iceberg (the behaviours that you see and experience), are often underpinned by the culmination of the difficulties that lie beneath the surface. Therefore, instead of concentrating on the end behaviour only, try to focus on addressing the triggers and difficulties that cause the behaviour in the first place.

Don’t take it personally and keep a cool head –  The strategies your child uses to reduce their anxiety may be quite elaborate, and seem calculated and hurtful. Sometimes it may feel like your patience is wearing thin. Please try to keep in mind that your child ‘can’t help won’t’ and that this behaviour results from their efforts to control their environment and therefore reduce their anxiety levels.

Treat every day as a fresh start – Don’t let what happened yesterday drag over into today, it has no benefit to your child or yourself.  Following a difficult incident, try to wipe the slate clean and begin again.

Further information

Please view part two of our webinar ‘Understanding PDA – helpful strategies and your personal mind-set’


Provide the optimal social environment

Balance tolerance and demands – Accept that some days a child’s anxiety is so high they will struggle to accept any demands, even ones others might not view as a ‘demand’, so reduce your expectations. On days where your child’s tolerance is higher, try increasing demands.

Choose your battles – Have flexibility in your approach at home, think – is this worth my child having a meltdown?  But this is not the same as letting a child do what they like. Where a boundary is very important (for example to ensure the safety of themselves and others) it is important to reinforce the boundary.

Choosing non negotiable boundaries – The quantity and nature of non-negotiable boundaries will vary depending on the extent to which a child is affected by PDA, combined with the priorities of any individual family. For some children, non-negotiable boundaries may need to be reduced to very few, and may include only the bare minimum relating to health and safety. However, these can gradually be increased to include more non-negotiable boundaries as a child’s anxiety levels become lower. This may also need to be variable to take into account fluctuating levels of anxiety that can occur in children, in different situations and at different stages of their life.

Provide your child with clear reasons for non-negotiable boundaries – Your child may be more likely to adhere to a boundary if they have a clear understanding of why it is important. Don’t make it personal to them, try to explain the reason for the boundary in more general terms. It can also be helpful to blame this on a higher power e.g. “people aren’t allowed to steal because it is against the law of the land, if people ignore this law they can get into trouble with the police.”

Enforcing non-negotiable boundaries – A non-negotiable boundary, for example, may be not to hit other children. A way to enforce this boundary can be as simple as removing the child from the situation or removing the other child from the situation. This enforces the boundary, but is unlikely to exacerbate the situation in the way that trying to enforce a boundary with rewards or threats of punishments or consequences may do.

Imposed rewards and consequences – Traditional methods of behaviour modification do not tend to be successful for children with PDA, although there may always be exceptions to the rule. The use of these methods can increase the perceived expectation and demands of others and gives control to the person who is offering the reward or threatening the consequence. This can seem unfair and unjust if the child simply can’t rather than won’t. Some children may also view the use of rewards as ‘blackmail’.

Natural rewards and consequences – The use of natural rewards e.g. “Because you have watched a film this morning I have got a lot of housework done, now I have more time to play with you.” and natural consequences e.g. “we can’t go to the park until you have put your shoes on” can be more successful. This way the child learns naturally that certain types of behaviour produce pleasant results and vice versa.

Keep exposure to busy social occasions manageable – Try to keep social outings in small bite-size chunks that are manageable, provide as much one-to-one support as possible and think of quiet zones your child can go to if things become too much e.g. return to the car for a quiet period to relax and listen to music etc.  Try to have a flexible approach if possible i.e. for your child to know that they can return home at any time if they become unable to cope.

Fear of Uncertainty – Plan ahead so that your child knows what to expect. Provide them with visual information of where they are going e.g. a leaflet or a youtube video of the venue, and make a timetable of the days events. Do this together so that you are working as a team. Be prepared to change and be flexible with any arrangements that you have made to accommodate your child’s fluctuating anxiety levels. If they can’t do something, offer reassurance and certainty e.g. “don’t worry if you can’t cope with going to the cinema today, we can try again tomorrow.”

Further information

Please view part two of our webinar ‘Understanding PDA – helpful strategies and your personal mindset’

PDA Guidance provides information explaining why traditional methods of behaviour modification don’t tend to be successful for children with PDA.


Adopt an indirect style of communication to reduce and disguise demands

Use indirect commands to disguise demands and make them fun – Try challenges e.g. “Bet I can get my coat on before you!” or “Can you show me……..”

Try to make them feel useful which also helps to maintain emotional well-being – e.g. “It would be really helpful if you could just……”

Pretend you don’t know / get it wrong and ask them to teach you – e.g. Mis-read words in books, or ask them to show you how to do a certain task that you want them to do.

Offer limited choices to give the child a sense of control & autonomy –  e.g.  “Do you want to have a bath or a shower tonight?” followed by “would you like to have your shower at 6.00pm or 7.00pm?” Be prepared to negotiate e.g. your child may say that they will have a shower at 6.30pm to retain a sense of control. N.B. offering too many choices or open ended choices can increase a child’s anxiety. Or use the ‘when… then’ philosophy – e.g. “when I have done my boring housework, then we can bake some cakes”.

Voice control – Use a calm, even tone of voice, especially when they are demand avoiding. If you convey anxiety, stress or anger in your tone of voice your child will pick up on this, their anxiety will increase and their tolerance for demands will decrease.

Indirect praise – Praise may be perceived as a demand or an expectation to perform at the same level again. It can be helpful to give a child indirect praise e.g. talk to a relative about something good your child has done while they are in earshot – may be more easily accepted than directly praising them. Praise the object instead of the child e.g. “what an amazing picture, the colours are beautiful” instead of “you have drawn a wonderful picture”.

Use role play and props – Sometimes it can be easier and less direct to attempt communication with your child through toys and props e.g. using a cuddly toy e.g. “Teddy has asked if we can go to the shops today and if he can have an ice-cream?”. Another option can be constructing a conversation within earshot “I wonder if Ryan would like to go to the park on Saturday”. As children grow older this could involve text messages, Facebook messages, leaving notes around the house and so on.

Model desirable behaviour – Reinforce acceptable, desirable and alternative behaviour in your own actions, but don’t instruct your child to do the same. It can be more productive to let them observe without the expectation that they should do this also e.g. “I feel so stressed and angry right now, so I am going to lie down in a quiet room and listen to some music to help me calm down”.

Further information

Please view part two of our webinar ‘Understanding PDA – helpful strategies and your personal mind-set’

Autism West Midlands have produced a helpful factsheet on strategies for indirect styles of communication 

PDA Guidance provides an illustration of how these strategies can be incorporated into day to day life.


Identify and address any sensory differences

boy with headphones looking out the window at the airport

A person with sensory differences may be hyper-sensitive (over sensitive) or hypo-sensitive (under sensitive) to any of the senses listed below. However, this can vary with anxiety, stress, illness, surroundings etc. If a person is hyper-sensitive they will seek to avoid the sense, conversely, if a person is hypo-sensitive, they will seek our more stimulus for the sense.

A person with sensory differences can also be both hyper and hypo sensitive to the same sense. e.g. a child may enjoy their own noise (their voice or music/tv volume turned up very loud) but ill avoid areas with background noise like shopping centres.

  • Auditory
  • Visual
  • Oral
  • Smell
  • Tactile
  • Vestibular (the sense of movement and balance)
  • Proprioceptive (the sense of ‘position’ of your body in space and the input from muscles and joints to the brain)
  • Interoception (internal senses from your body, such as hunger, thirst, pain and needing to use the toilet)

Please find below a few ideas of how to address a child’s sensory issues. This is a very large topic in itself, more reading would need to be conducted by parents to identify and address all of their child’s sensory differences.  It would also be worth asking your GP for a referral to an Occupational Therapist who is trained in sensory integration for a full sensory assessment with a view to providing your child with a sensory diet.

  • Chewy toys for those who seek oral sensory input
  • Headphones playing a child’s favourite music for those who become easily overstimulated by noise and crowded places.
  • Carrying a scented candle, soap or pillow for those who become distressed by unfamiliar or unpleasant smells. Some children may want to be more discreet, putting a favourite scent on a sleeve or hankerchief works well too.
  • Seamless socks, wide fitting shoes and cutting labels out of clothes for those who are over sensitive to touch.
  • Ask before touching / hugging your child as some children are sensitive to touch.
  • Wearing sunglasses for those who are over sensitive to sunlight, bright lights and so on.
  • Taking a packed lunch, when you are out an about, containing food and snacks that your child can eat if she / he is a fussy eater.
  • Weighted blankets for those who are under sensitive to touch and seek the comfort of deep pressure.
  • Access to messy play e.g. play dough, finger painting and so on for children who  seek tactile sensory input.
  • Plenty of opportunity for movement e.g. scooter, trampoline, peanut ball and bike rides for those who seek plenty of movement.
  • Rough and tumble play, playing in ball pits and sensory toys (such as a body sock) can be helpful for children who have sensory differences relating to proprioception.

Further information

Please view our webinar on sensory processing with Occupational Therapist Alison Hart

Please find a full checklist of the types of behaviours that may indicate sensory issues in your child.  Sensory Processing Checklist

The National Autistic Society provide lots of useful information about sensory differences in their article ‘Sensory World’

PDA Guidance provides information about sensory issues and how to approach these for a child with PDA.


Support difficulties with social communication and  interaction

Here are a few ideas of how to address a child’s communication difficulties. But, to fully understand your child’s difficulties you may need an assessment by a qualified speech and language therapist (SALT).

Communicationquestion bubble

Allow extra processing time so that your child can make sense of what you have said and have time to think about how to respond.

Don’t ask multiple questions in one sentence, space them out one at a time. Allow the time for you child to answer your first question before asking a follow up question.

Be clear and precise with any requests, but ask in a non direct style E.G. “I wonder if you could help me.  I need four blue cups, from that cupboard, placing on the table in the kitchen”, avoid ambiguous instructions E.G. “I wonder if you could help me, I need the cups placing on the table” because this leads to confusion and avoidance (which cups, where are they, how many, which table? I’m just going to get it wrong, then I’ll feel embarrassed and so I’ll just pretend that I haven’t heard)

Social Interaction

Young Children Dressing Up As Professions

Role Play – can be used to help children with PDA better understand the perspectives of other people, how a persons actions can make another person feel at an emotional level and how this can affect peoples views and opinions about each other and personal relationships.

Drama Classes – can be another fun way of helping children with PDA develop better social awareness of themselves and others. This may also play to their strengths and be a lot of fun.

Television – can be a good way to learn about social relationships, interactions and dynamics (providing it is a suitable and age appropriate programme). This can provide a child with the opportunity to observe social situations calmly, instead of trying to navigate complex social interactions during periods when they may simultaneously be confused and overloaded by too much additional stimuli, as is often the case in real life interactions with other people.

Children’s story books – can be a great way for children to learn about the feelings of others as these are often expressed in detail in books. This can be especially helpful for children as they grow older.

Be inventive – make activities fun, something that happens naturally through life and use their interests to engage them e.g. you could play school with your child where the lesson for the day is for your child to teach her favourite toys a social story, or you could make a poster with your child about how to behave in different social situations. Tell your child that this is to help other children so that they don’t feel that the learning aspect of the activity is directed at them.

Further information

Please view our webinar with speech and language therapist Libby Hill.

Social Thinking has free resources on their website.


Dealing with challenging behaviour

Meltdowns – Sometimes, even when we have tried all of the above approaches, meltdowns can still occur. Try to view ‘meltdowns’ as a panic attack and treat them as such with a few calm words of reassurance. As you continue to develop your framework of strategies, the frequency and intensity of meltdowns should gradually begin to reduce.

Reflect – Following a situation that has been tricky to handle, which may have resulted in challenging behaviour, it can be helpful to reflect back and think of ways to avoid a reoccurrence of this situation.

Problem solving as a team – Try to solve problems, difficult situations or undesirable behaviour collaboratively with your child. First, express understanding and empathy, then work together and involve the child in coming up with solutions e.g. “I understand why the birthday party was difficult for you, I wonder how I could help you in these situations?” Think about what you could do differently next time, how you could support your child and different strategies that you could put into place.

Recognising their own emotions and finding acceptable solutions – Children with PDA can have real difficulties in recognising and regulating their emotions. This can improve with age, but you can also find ways to help. When your child is young you may need to be hyper-vigilant for signs that they are not coping and act accordingly. As they grow older they may be able to develop their own coping skills e.g. when my tummy feels like I have butterflies, it would help if I went to a quiet room.

Further information

The PDA Society’s guide to understanding and managing meltdowns.

Managing Meltdowns, a short video by the parent of a child with PDA and former PDA Society Trustee.

PDA Guidance provides a short factsheet for understanding and supporting meltdowns.

Dr Ross Greene’s Philosophy to understanding and dealing with challenging behaviour can be viewed on his website ‘Lives in the Balance’ or you can order a copy of his book ‘The Explosive Child’. 


Support emotional well-being

Mother comforting her crying little son

 

Individuals with PDA also have many positive qualities and strengths which can be channelled by parents to capture their interest, reduce anxiety and promote positive engagement and experiences with others, i.e. they are often very creative, imaginative, passionate, determined and enjoy humour.  It is important to support your child’s emotional wellbeing by focusing on these many positive aspects as well as trying to support them with areas that they find difficult.

Regularly remind your child that they are loved and valued for who they are and that it is ok to be different.

Some children may benefit from lots of physical affection such as hugs and kisses. Other children may appreciate little notes saying ‘I love you’, affectionate looks or for you to blow them kisses.

Support your child with the things that they can cope with rather than trying to impose on them what you feel they should be doing.

Ensure that you often speak about them in positive terms to other people e.g. “Millie has an amazing imagination; she always think of really good games to play”, “Luke and I went swimming yesterday and I really enjoyed myself” and “Rosie really makes me laugh, she is such good fun to be with”.


Moving forward

Learning all about PDA, understanding the behaviour and developing an individually tailored framework of strategies is a steep learning curve. But, this will eventually become second nature and flow more naturally as you become more in-tune with your child’s strengths, difficulties and needs.

Eventually you will develop and have a full toolkit of strategies at your disposal. Remember that what works one day may not work the next. Keep a file of all of your strategies so that you don’t forget ones that have been helpful in the past. Mix them up and alternate them so that they remain fresh and novel.

You will soon be able to use your deeper level of understanding and toolkit of strategies to address many other areas of difficulty. This is illustrated in the following articles written by PDA Guidance.


Further reading and information about PDA

Please visit the resources area of our website for further information about PDA collated from a variety of sources including a recommended reading list of books.

The National Autistic Society has produced useful information about the PDA profile.

Autism specific resources – there are an abundance of resources available that you can share with your child, or read and watch yourself for further ideas, such as social stories, books, games, activities, computer games and apps. Many of these can be found online by Googling for autism specific products, books and resources. Remember, that you may need to be inventive in how you deliver this information and engage your child.


Please note that the PDA Society are not making any recommendations nor is responsible for the content of sites and links that are external to the PDA Society.

Please contact us if you discover any broken links.