Pathological Demand Avoidance – why learning about PDA has helped me to help my son

Posted on May 15, 2013 by Aspie in the family

As it is PDA Awareness Day I thought I’d write a bit about Pathological Demand Avoidance and why reading up about it has helped me to help my son.

Pathological Demand Avoidance or PDA for short is a lifelong disability that is increasingly seen as part of the autism spectrum.  The main characteristic of PDA is an obsessive avoidance of everyday demands due to high anxiety levels and the need to be in control but there are other symptoms.  These are summarised by The National Autistic Society as follows:-

  • obsessively resisting ordinary demands
  • appearing sociable on the surface but lacking depth in their understanding
  • excessive mood swings, often switching suddenly
  • comfortable (sometimes to an extreme extent) in role play and pretending
  • language delay, seemingly as a result of passivity, but often with a good degree of ‘catch-up’
  • obsessive behaviour, often focused on people rather than things.

    •  

    It was the issue of  control and fantasising that drew me to learning more about PDA as my son has particular difficulties with these things.  My son can become so anxious that he is unable to cope with demands from other people, notably us.  If told to do something he can become aggressive to the point that he is close to meltdown.  He also regularly escapes into a fantasy world where he takes on a particular cartoon character and where conversation is dominated by the world this character lives in.   Whilst I sometimes worry that he loses touch with the world around him, it is less of a problem compared to the behaviour brought on by his need to control.

    However, we have found that he rarely behaves like this at school (he has learnt to mask his difficulties whilst there) and so it’s hard getting people to recognise these aspects of his behaviour.  Whilst school recognise his autism and anxiety, they don’t have much of an idea of how controlling he can be at home.  This was particularly a problem when he was school refusing because many people thought it was simply a case of telling him to go to school.  The situation was much more complex than this of course and as I have written on here many a time it was a case of gradually exposing my son to his anxiety and empowering him  to make the decision to go back to school.

    Whilst there is no question that my son has an autism spectrum disorder I have often felt that I haven’t received an adequate explanation for his controlling behaviour.  Whilst the diagnosis of an anxiety disorder may explain his anxiety issues, I never felt it explained his demand avoidance which got so bad at one point that we became wary of asking him to do anything!  Instead I was often made to feel by professionals that it was my parenting at fault; that somehow I was a weak mother who had allowed my son to trample all over me!

    The reality is that we have had some very tough times as a family but slowly we have turned things round.  Learning about PDA and some of the techniques used to manage demand avoidance has given me the confidence to negotiate with my son but it is far from straightforward.  Whilst my son needs routine (without it he becomes even more anxious) I also have to be creative when dealing with his refusal to comply.  Simply telling him to do something doesn’t work and I have to resort to different techniques to motivate him which varies from day to day depending upon his level of anxiety and how his autism is affecting him.

    One of the more successful techniques is negotiation and this often takes the form of guided choice ie I give my son two or three things to choose from.  This has worked well as it has enabled our son to feel in control and for us to achieve a particular outcome.  I have also tried to adjust my behaviour so that I don’t come across too demanding because I know my son will pick up on this and feel under a lot of pressure as a result.  This isn’t to say I don’t set boundaries though.  I do but I try and establish boundaries through explanation and/or negotiation rather than “you must do as I say” for example.  However, it is not easy.  There are days when the slightest demand will create a backlash and then there are the days when our son is unable to interact with us.  These are the days when I simply back off and let him unwind.  Any more pressure will simply overwhelm him to the point of meltdown.

    As to whether my son has  PDA I can not say because people with an autism spectrum disorder can also have demand avoidance issues as well.  Nevertheless learning about PDA has enabled me to acquire a new set of skills which I may not have acquired if I had just focused on the strategies for autism.

    However, challenges remain in that professionals who come into contact with my son don’t understand what lies behind his controlling behaviour and often there is a sense that they are blaming him for having a character flaw.  This upsets me a lot.  There is nothing worse than hearing your child being coldly described as manipulative and controlling.  Understanding what lies behind these behaviours is so important because once you see that it is anxiety that is driving the behaviour then you can become more sympathetic and adopt the right approach.

    This is why I urge professionals (particularly teachers and teaching assistants) to learn more about PDA as well as autism because it is likely that they will meet children with some degree of PDA.  For parents who also have children with some or all of the symptoms  of PDA, I would also encourage you to read up on PDA and explore some of the strategies that PDA parents use.  As I have found, it is reassuring to know you are not alone dealing with this sort of challenging behaviour and that there are some effective strategies out there.

    For further reading try these resources:-

    Understanding Pathological Demand Avoidance Syndrome in Children: A Guide for Parents, Teachers and Other Professionals – this book was recommended to me be another autism parent and I wasn’t disappointed.  The book offers a complete overview of Pathological Demand Avoidance Syndrome (PDA) and provides practical advice for overcoming the difficulties experienced at different stages of a child’s life and into adolescence and adulthood.  Case studies are used throughout the book and there is also a list of resources for further information and advice.  Essential read for anyone caring for and working with children with PDA, autism or other behaviour issues that do not respond to ordinary parenting techniques.

    Cerebra – what is pathological demand avoidance (PDF) – http://www.cerebra.org.uk/SiteCollectionDocuments/PDA.pdf

    NAS – PDA, Pathological Demand Avoidance

    The PDA Contact Group - advice and information for those living and working with a child or adult with PDA.

    The PDA Resource – an excellent list of resources on PDA that is really worth checking out.  Lots on here for everyone.

     

    Posted in Parenting, Pathological Demand Avoidance | Tagged , , | 3 Comments

    Recovery from school refusal

    Posted on May 8, 2013 by Aspie in the family

    I’m not sure if there is such a thing as recovery from school refusal but for us we’ve got to a point where my son is now spending nearly 4 whole days in school.  It’s a remarkable achievement because this time last year my son was struggling to leave the house, travel very far or engage with anyone outside the family.  It was so difficult that I started to doubt whether my son would ever return to school or indeed have any sort of quality of life.  It was so worrying that the psychologist suggested more assessments but I said “no” because I felt that whatever was happening to my son was a temporary blip that he could recover from given time.

    And I have been proven right.  With lots of support we have helped our son take those first intrepid steps into the school grounds and from there into the school building and then into lessons.  It was hard work as it meant us going over and over each stage until he was confident enough to move on to the next stage.  And so it went on, months and months of  building up his confidence until he suddenly declared that he “loved his school” and could he do “more lessons please”.

    To hear these words was amazing.  It was the breakthrough we were waiting for because it showed us that he was feeling happy, confident and in control.  It has also meant that I’ve been able to take a step back.  For the last six months or so I’ve spent large chunks of time in school whilst my son sat in class.  I was happy to do this because I knew my son was less anxious knowing I wasn’t very far away but I still hoped that one day he would manage without me.  Even though my son has an autism spectrum disorder, I still have to work towards him becoming an independent adult so stepping away from his school life became an important aim of mine.  Now that moment has arrived and I’m just like any other mum taking her child to and from school.  It really is fabulous.  Watching my son enjoy going to school is not something I ever thought I would see again.

    Posted in Autism Spectrum Disorder, Mental Health, Parenting, School, School Refusal | Tagged , , , , | 4 Comments

    From grief to acceptance

    Posted on May 5, 2013 by Aspie in the family

    I read an autism article the other day.  It was in one of our national newspapers and attracted a lot of heated discussion.  One thread that caught my attention was a series of exchanges between people about the impact of learning about your child’s autism.  The exchange went along the lines of a parent saying how sorry she was that another parent had received an autism diagnosis for their child.  However the condolence was seen as insulting by another person who felt that saying sorry was a slur against autistic people.

    I can understand this.  I think no matter how well meaning someone may be, saying sorry can imply that autism is a bad thing to have.  Of course, that depends on the severity of the autism.  Some people can lead  full and purposeful lives (not without difficulty of course) but for others it is a very disabling condition.  In these circumstances, expressing sympathy to a family can be an attempt to offer support and friendship.  It is rarely meant with malice though I can understand the unintended consequences at the use of such clumsy language.

    However, the fact is that many parents go through an emotional period following their child’s diagnosis.  I know I did.  The realisation that my children had a lifelong condition led me to experience a wave of emotions  as I adjusted to their diagnoses.  You can read more about it here but essentially it was a time of letting go of my expectations of family life and embrace a whole new way of thinking and doing.  It took a while to adjust but eventually I came to see what a wonderful family I had.

    Nevertheless back then (5 years ago now) I did not expect to feel the way I did and neither was I prepared for it.  Disability was not something I was familiar with.  Except for my grandmother who suffered from alzheimers and my near life-changing car accident I knew little about disability.  At the time disability was something that happened to someone else, notably an older someone else.  It couldn’t possibly happen to us, right?  Wrong, it did and when it happened I felt a sense of shock and sadness as  I grappled with what it meant for my children.

    I know a lot of people doubt that SEN parents can experience any sort of loss but this was how I felt, a very real experience that some say is akin to grief.  It may sound strange to non-parents but the bond between parent and child is so entwined that whatever happens to our children we feel very acutely too.  We love our children unconditionally and we want the best for them and we aspire for the best for them and when things happen that challenge those dreams we can sometimes feel a sense of loss.  It’s the way it is; it is not a slur on autism or  autistic people but a way of adjusting to a different life.

    For me acknowledging my feelings has helped me to move to a better place when I can truly say “do you know what, this life I have been given is so much better than the one I dreamt of”.  I have come to accept my children for who they are, not what I hoped they would be and in doing so I have learnt so much about the wonders of ASD.

    Posted in Aspergers, Autism Spectrum Disorder, Disability, Parenting | Tagged , , , | 4 Comments

    The academy and the admissions policy – an update

    Posted on April 23, 2013 by Aspie in the family

    You may remember this post in which I told you about the academy that is proposing to change its admissions policy.  It wanted to alter the criteria in favour of pupils in two Church of England schools rather than those living in the catchment area.  The proposals have caused huge controversy and have been publicly criticised by parents and councilors.  As a result the academy has agreed not to give preference to one of the schools.  However, this is only a small concession.  Children coming from the other faith school will continue to have precedence over those children living locally.

    Not surprisingly, there continues to be massive criticism about the way the academy is behaving.  What was considered to be a fair admissions policy that served the local community is now in danger of becoming one that is influenced by religion.  Indeed concerns have been raised that if pupils living further away from the academy get priority over those living closer because they attend a CoE school then that might constitute discrimination under the Equality Act.

    However, all is not lost.  The organisers of the local campaign group are taking the matter further and will be appealing to the Office of the Schools Adjudicator.  I will let you know the outcome as I feel it is important that as parents we are aware of the power of academies and what we can do if they step out of line.

    Posted in Campaigns, School | Tagged , | 2 Comments

    Blogs v Books – what makes a good blog?

    Posted on April 19, 2013 by Aspie in the family

    I don’t know what makes a good blog (it’s all very subjective in my opinion) but what I have learnt is that the writing I enjoy in a blog is very different to that in a book.

    When I read blogs I look for a quick read, something to do during a coffee break or lunch hour, something that is informative, opinionated or tells a short story.  What I don’t want to read is a lengthy description about what something looks like or how someone feels.  I don’t want lots of dialogue either.  I don’t have the time.  Neither do I look for a big audience around a blog to pull me in.  It doesn’t bother me if a lot of people don’t comment on an article; to me this isn’t necessarily a bad reflection on the blogger or their writing.  It may simply be due to the author not promoting their blog enough.

    The big turn off for me is long posts.  If I come across a blog that is too long (for me, usually over 1500 words) it doesn’t matter how well written it may be, I switch off because I simply don’t have the time to read it.  For me reading blogs is akin to reading newspapers and magazines when information and opinion is more important than description and dialogue.  That is best kept for a novel in which I can give time to sink into a storyline and live it for a while.  Books are my emotional escape, blogs are my source of information and a place to discuss things.  There’s a difference which doesn’t mean to say one is more superior than the other.  They’re just different.

    What about you?  What you do look for in blogs?

    Posted in Blogging | Tagged | 1 Comment

    #kevsautismcampaign

    Posted on April 13, 2013 by Aspie in the family

    Bullying is a subject close to my heart.  My son was badly bullied a few years ago by a crowd of young people who lived down our road.  It was an awful experience for him and for us and not one I wish on anyone.  You can read more about our experience here.

    Unfortunately bullying is commonplace in our society, whether at school, in our communities, online or in the workplace.  Bullying can happen to anyone, anywhere and at any time but unfortunately it is a particular problem experienced by people on the autism spectrum.

    Kevin Healey who is on the autism spectrum knows only too well what bullying is like.  He has been bullied as a child, teenager and now as an adult.  More recently he has been the target of cyber bullying and death threats.  As Kevin writes in this article, things became so serious that he couldn’t leave his house for three months and he was forced to get help from the police and a solicitor.  Fortunately he has found a way of dealing with the trolls and has now moved on from those dark days to continue to campaign for the rights of adults on the autism spectrum.  Indeed such is his success as a campaigner that he has won various awards including Charity Champion of the year 2007 and Stoke on Trent Citizen of the year 2006.

    More recently he has set up an anti bullying autism campaign which aims to change the law on bullying whether it’s bullying in the workplace, university or online.  I am pleased to support Kevin’s campaign.  Our children are only children for a short while; they will soon become adults with autism and who will be there to protect them when we’re not around?  This is why it’s imperative that we shout out about the bullying of autistic people and work towards getting laws passed that will protect these people from cruel and inhuman treatment.

    But to do that we all need to support  Kevin’s campaign and there are many ways we can do that.  We can:-

    1. Sign the petition on twitter: http://twitition.com/x76kf/

    2. Use hashtags in our tweets #kevsautismcampaign #antiautismbullying #autismbullying

    3. Follow the live tweets on http://twubs.com/kevsautismcampaign

    You can also follow Kevin on twitter @kevin_healey and read more about his campaign on http://www.autism-campaign.co.uk/autism-bullying-campaign/

    So please, if you have a moment, spread the word and help get Kevin’s campaign trending.

    Thankyou.

    Posted in Aspergers, Autism Awareness, Autism Spectrum Disorder, Bullying, Campaigns | Tagged , , , , | Leave a comment

    Reflections on Autism Awareness Month

    Posted on April 12, 2013 by Aspie in the family

    Every April I question whether I should join in with world autism awareness month or not.  It feels a tad uncomfortable when I see tweets filling my computer screen and I can’t help but wonder whether people will click on a link and learn more about autism.  In fact I often wonder how many people switch off when they see their timelines full of autism tweets.  I reckon there are quite a few.  But then when I look at my children I’m reminded that I have a responsibility to them.  They haven’t got the interest or the ability to self advocate so it’s up to me to speak for them and defend their right to a life free from misunderstanding and prejudice.

    But the question is how do I, how do we, educate others about autism and aspergers in a society that is becoming increasingly divided?  As uncomfortable as autism awareness can feel, hiding away is not the answer because to hide away means we’re not there to challenge the myths about autism that circulate in society.

    On the other hand tweeting stats and pretty pictures seems a rather empty guesture too.  I mean if I publish the autism ribbon on my blog or tweet some statistics (and I have done) will people understand what autism really means or will they just look at it and think “thats a pretty picture” or “mmm that’s interesting”.  Its a question that has also got Katrina at Kats Cafe thinking.  As she explains in this post, switching on a lightbulb, sharing a photo or ribbon and spreading statistics may make us feel as though we are spreading awareness but are we?  She argues that though our actions may be well intentioned this sort of awareness spreading is passive.  Displaying a picture or statistic may represent what we believe in or what we  are passionate about but it’s not active awareness building.  It doesn’t tell someone the realities of living with autism, it doesn’t educate them or attempt to break down stereotypes.  As Kat goes on to explain “building awareness is writing about perceptions and stereotypes, its reading those posts and intelligently reacting and responding to the ideas they represent.”

    I agree and indeed there are many many articles written by both self advocates and parents and carers that do this.  They have certainly  helped me to feel less isolated and to learn more about autism but the challenges remain: how do we reach those outside the autism communities; the employers, the policy makers, ordinary people, those who think they know autism but actually don’t.

    Well, in my opinion, online autism awareness campaigns are not enough. We also need to get out into our own communities and actively work to dispel the misconceptions about autism.  It’s about educating those close to us; family, friends, neighbours and colleagues and those that work with our children.  It’s about finding the confidence and the courage to explain why we or our sons and daughters do this and that.  It’s about challenging people who stare, make comments or who complain about us or our children.  Of course I realise there are times when we practically cannot do this but when an opportunity presents itself then we must try and grab that moment to educate someone.  A great illustration of this is when Four Sea Stars talked to her son’s class about autism – you can read about it here.  It is an inspirational post which shows what can be achieved.

    The point is that relying on a global online initiative is not enough for spreading  awareness no matter how active it may be.  We also need to educate those closest to us and that starts at home.

    Posted in Autism Awareness | Tagged | 5 Comments

    Moving on

    Posted on April 9, 2013 by Aspie in the family

    We’ve had the funeral and we’re trying to move on but it’s hard.  We all have our own memories and we’re all missing my mother-in-law in different ways.  It doesn’t help that we still don’t know why she died; the PM was inconclusive and now we’re awaiting the results  of further tests.  There is still a lot of shock amongst family and friends but at least we’ve said our goodbyes.  The funeral was simple; a celebration of her life and the things she had achieved.  It was well attended.  The weather was also stunning.  Snow still clung to the edges of the fields and yet masses of tiny daffodils were bursting into life along the grass verges.  As cold as it was it felt as though spring was on its way.  It made the day a little bit easier.

    Thank you to everyone for their kind comments; it is much appreciated.

    Deb x

    Posted in Family Life | Tagged | 3 Comments

    A book for Autism Awareness Month

    Posted on April 1, 2013 by Aspie in the family

    As its Autism Awareness Month, why not buy a copy of All Said and Done, a collection of poetry about ASD that has been compiled to raise money for the UK’s National Autistic Society.

    The 130 page book contains contributions from poets across the world and is split into three sections reflecting the triad of impairments associated with autism.  It contains poems to amuse and entertain you as well as more thought provoking pieces about the issues faced by autistic people.  Above all, this is a book that can help educate others about autism and I, for one, can’t wait to get a copy.

    Posted in Autism Awareness | Tagged | Leave a comment

    Sad News

    Posted on March 22, 2013 by Aspie in the family

    Fords Of Isen near Wellington, New Zealand - taken by my MIL during her latest trip

    Today we were told the news that my mother in law had passed away.  It happened this morning, unexpected and somewhat premature.  It has left us reeling with shock and  bewilderment as to why she has passed away so suddenly.  No doubt in time we will get some answers but for now we are hurting.  The thought that we won’t ever see her again or that she won’t see her grandchildren again is too painful for words.  For now though we are holding on to the thought that the last weeks of her life was spent doing the thing she loved so much – travelling across New Zealand with her husband.  It’s a little bit of comfort during these sad days.

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    Posted in Family Life | Tagged | 9 Comments