Education, Health and Care Plans for PDAers

These sections describe a child or young person’s educational (B), health (C) and social care needs (D). They may not have needs in every section.

For Section B, you could consider the following questions: 

• What are their main strengths and challenges in:
  -Communication and Interaction?
  -Cognition and Learning?
  -Social, Emotional and Mental Health?
  -Sensory and Physical?

• How does their demand avoidance affect their education?
• How do they feel about themselves and how do their needs affect their self-esteem?
• What were the results of any professional assessments? Including standardised assessment scores can be helpful, including if they are unable to sit formal tests because of their PDA.
• Do they have any formal diagnoses? Are they aware of these?
• How do they feel about having their differences documented or known by others?

More specifically, do they have challenges around:

• Processing information?
• Executive functioning and its impact?
• Attending educational settings?
• Anxiety – impacting on daily life and learning?
• Receptive language (understanding what people say to them)?
• Expressive language (making themselves understood)?
• Being selectively mute?
• Making and keeping friendships?
• Interacting with peers or adults?
• Social communication techniques?
• Building and maintaining self-esteem?
• Emotional regulation?
• Vision/hearing?
• Independent living skills?
• Fine/gross motor skills?
• Sensory processing/integration?
• Certain sensory experiences?
• Masking their difficulties at school?

It is important to make sure that for each need identified here there is an equivalent support provision mentioned in Section F to enable them to meet the outcomes in Section E.

Outcomes should focus on your child’s aspirations and balance what’s important to them with what’s important for them.

Families and professionals need to work together to make meaningful outcomes that could improve the child or young person’s life.

It’s essential to make sure that outcomes are SMART (specific, measurable, achievable, realistic and timebound) so what the child is working towards is clear and everyone can see if the provision is effective.

Here is an example of a SMART outcome: By the end of Year 4, [student’s name] will have developed an alternative method for recording her work. She will be able to independently use her laptop with the Clicker programme, to produce short pieces of writing of up to 400 words.

Sometimes outcomes are arranged with main aims followed by smaller short-term targets.

After setting outcomes, the next step is to identify the support needed to meet your child or young person’s special educational needs to be able to meet those goals.

When writing recommendations, is can be helpful to begin by considering best practices for children with PDA and then adjusting them to suit your child.  Not all suggestions will work for every PDAer.

The support in this section must be detailed, specific and quantified. Try avoiding vague terms like “access to,” “opportunities to,” “regular,” or “may benefit from”.  These are unclear and cannot be enforced.

Suitable provisions are likely to include things like: personalised learning; flexible timetables and lesson objectives; trusted relationships with key members of staff; PDA trained professionals; provision of key professional input such as SALT, OT; staff access to ongoing training, guidance and advisory input; a lead professional; and perhaps an emotional wellbeing and social curriculum.

• Create chances for them to work with peers, especially those who share interests with them.
• Focus on building trust between peers and between adults and students.
• Be aware that they may be vulnerable to bullying.
• Whole class training on diversity in all its forms, with a focus on neurodiversity, to encourage understanding and acceptance.
• Create a school buddy system for mutual support.
• Help [student’s name] to understand the benefits to them and their peers of social skills such as give and take, turn-taking, cooperation, respect, following rules etc. whilst also encouraging self-advocacy and being accepting of difference.
• It may be easier for [student’s name] to take part in structured group activity if each child is given a role, and/or [student’s name] is given a role where they feel in control (e.g. timekeeper).  
• Model and teach strategies for handling difficult situations with peers e.g. walking away, having a named adult to seek out, producing ‘scripts’ for in the moment and to help repair relationships.
• Provide optional chances to interact with peers without pressure.

• [Student’s name] will be supported by staff who understand autism and pathological demand avoidance and who can be flexible in approach and use alternative learning opportunities to engage.
• [Student’s name] will have a key adult they can trust will listen to them and support in problem solving.
• [Student’s name] should have light touch support from an adult who can ensure they remain focused and can judge when they need an alternative approach.
• [Student’s name] will benefit from support from a member of staff who:
  • Attunes to their emotion and pace.
  • Recognises and supports their own strategies, behaviour, language and metacognitive strategies to self-regulate.
  • Recognises dysregulation and mindfully offers support.
  • Offers breaks from interaction when necessary.
  • Facilitates re-engagement unobtrusively.
  • Offers choices verbally and non-verbally
  • Waits for and encourages initiation.
  • Provides a balance of responses.
  • Respects [student’s name] wishes and need for independence but equally is available to respond and help before they become overwhelmed.
  • Is flexible and offers solutions.
  • Allows for breaks.
  • Offers time for problem solving, task completion, mistakes to be made and recovered from.
  • Interprets “behaviours” as communication.
  • Honours [insert student’s name] requests or refusals when appropriate.
  • Uses appropriate proximity, non-verbal behaviour to encourage engagement.
  • Provides guidance for interpreting the feelings and opinions of others.
  • Models appropriate behaviours.
• Ensure all staff working with [student’s name] know and understand the adjustments they should make when communicating.
• Teachers and TAs to be creative and resourceful in the development of activities, using surprise as a positive engager.
• Teaching staff to be skilled at negotiating and suggesting rather than expecting participation.
• Teachers and TAs to give [student’s name] choices so that they can feel some sense of control .
• Ensure [student’s name] is taught by teachers and TAs who have received specific in-depth PDA training and who have experience of working with pupils with PDA.
• It is important that staff promote a sense of belonging within the school and that [student’s name] feels they are working in collaboration with staff and the school.
• Provide a confident and familiar staff team at all times.
• Staff to be flexible and adaptable in their approach, providing [student’s name] with a balance of control within the parameters they can meet.
• 1:1 support should be delivered by a key member of staff who can develop a rapport with [student’s name] so they feel understood and respected as an equal. Staff should focus on supporting [student’s name] to build trust in themself and the school. It is important that the key adult builds up an intimate knowledge of [student’s name] such that they know when to pursue an objective and when to reduce pressure, making continual adjustments as needed. It is also important that the relationship develops so that trust is built up.

• Offer a small, safe learning space where they can build confidence.
• Provide a peer group they can identify with.
• Create a learning environment that supports sensory needs, for example where noise levels are kept to a minimum and a quiet personalised space away from distractions is made available.
• Provide access to a safe base.
• Make a quiet area available for regulation and focused work.
• Allow them access to a quiet space to rest between intense learning times.

• Create an individualised learning programme based on their special interests and strengths.
• Match curriculum to their needs with short, visual, interactive tasks.
• Offer a broad curriculum as they become more engaged, following their lead.
• Personalise and differentiate the curriculum for their learning style.
• Break activities into small steps.
• Provide personal tutorial time.
• Maintain a flexible approach.

• Traditional praise, reward and sanctions should be avoided.
• Use indirect praise.
• Analyse [student’s name] responses and make adjustments as needed.
• Support [student’s name] in making decisions without pressure. Avoid coercing or encouraging. It is important that they don’t feel pressured into following others’ ideas.
• Include [student’s name] in decisions so that they feel able to make suggestions, participate in discussions and have the final say.
• Show respect and value for [student’s name] in all interactions.
• Focus on positive interactions with an unmentioned emphasis on academic potential, to collaboratively develop a range of activities that will provide positive experiences. 

• Talk [student’s name] through daily and weekly activities which will include assembly, playtime and lunchtime arrangements.
• Offer a variety of equipment in the classroom to help meet sensory and learning support needs. An EHC assessment can help identify the most appropriate aides.
• Use visual prompts to help them understand their day (though visual timetables and “now and next” boards can often go down badly with PDAers).  
• Offer alternate sitting tasks with movement activities.
• Provide regular breaks as needed.

• Provide a limited number of achievable activities each day.
• Offer a choice of activities.
• Work beside or behind them rather than face-to-face.
• Adults working with [student’s name] will need to work sensitively to help them manage demands. They will choose language which does not cause additional anxiety.

• Staff will have a highly developed understanding of what triggers distressed behaviours for [student’s name]. They will monitor for stress and anticipate triggers; staff should actively support and intervene to prevent distress.
• If [student’s name] becomes distressed, staff will move others away or offer a quiet place without further questioning until they feel calmer. Lessons can be learnt later.
• If [student’s name] wants to explain what has happened, staff will listen and offer reassurance/action to help them to regulate.
• [Student’s name] to have a safe space in school where they can work with adults on a 1:1 basis or independently if they become overwhelmed in a classroom/group learning environment. They should be supported to access this by a trusted adult.
• Adults to keep calm and level in their own emotions, including facial expressions.
• Avoid confrontation.
• Do not restrict [student’s name] movements or prevent them from leaving a classroom as this is likely to increase distress.
• Use Dr Ross Greene’s Collaborative & Proactive Solutions model to identify lagging skills and solve problems together once they are calm.

• Provide a system for [student’s name] to communicate feelings (for e.g. Zones of Regulate or the 5-Point scale).
• Adults to model noticing and talking about emotions, explicitly linking cause and effect.
• Use activities that increase emotional literacy. For example, interoception work can help students to understand how emotions feel in the body and therefore help to identify how they are feeling.
• Weekly dedicated sessions to work on social and emotional curriculum e.g. personal tutorials.
• Daily opportunities for individual and small group work to develop positive social and learning experiences supported by a PDA trained adult who has a positive relationship with [student’s name].
• Regular time with a trusted adult to discuss worries.

• Include all students equally in the school community.
• Train all school staff in PDA.
• Maintain good communication with home.
• Ensure all staff use a similar approach which will be individual to that child but could include for example:
  • Providing choices.
  • Allowing extra take-up time.
  • Reducing staff talking and questioning.
• Make playground staff aware of needs so they can be ready to “unpick” misunderstandings or support collaborative play. 
• Maintain a familiar staff team.
• Assign trusted key workers.
• Provide a familiar trusted keyworker who they can build a positive relationship to minimise anxiety and present learning in a low-demand way.
• All staff working with [student’s name] must have received in-depth training and experience in supporting children with PDA and with any associated anxieties and sensory needs.
• Seek and act on advice from mental health professionals.
• Ensure staff are aware of [student’s name] needs so expectations are appropriate and demands minimised.
• Ground rules need to be as few as possible (i.e. linked to safety) but then maintained using techniques such as passing responsibility (e.g. “I’m sorry but it’s a health and safety requirement”) de-personalising (through the use of imaginary characters, visual clarification etc) and giving choices that allow a feeling of autonomy.