Managing children with PDA is not easy. The key to this is reducing demands and trying to allow them some control in a situation. For instance giving them choices of things.You may need to practice ways of ?asking? without asking eg:
?I wonder if you can help me do.....? ?Lets see if there is a way to do...?
?You can?t do this can you, I?m hopeless at it??
?I bet you can?t do this before I come back....?
Making a game out of doing things can help especially if it incorporates something they enjoy doing.
Realising the anxiety comes from the demands makes things a bit easier to understand although not necessarily easier to deal with as it challenges the traditional parenting methods which do NOT work for a child with PDA. But you will get better at this the more you practice.
A classroom is filled with DEMANDS which often leads to high ANXIETY levels for children with PDA. Instructions should be given in a NON CONFRONTATIONAL style and you may need to practice ?asking without asking? eg ?I wonder if someone might be able to help me do this.......? Try to present CHOICES, so the child feels in control of the situation. Use a neutral tone and body language, giving the child space. Have a SAFE space with nothing in it. Have areas where the child can go to himself. Restraint should always be a LAST RESORT. When a child ?melts down? use quiet tones, give lots of REASSURANCE even if they are swearing obscenities at you and lashing out. Try to think of it as a PANIC ATTACK. Children with PDA will have poor spells when demands must be decreased accordingly and VICE VERSA. Some children with PDA avoid by using more subtle techniques and if not recognised will be an obstacle to their learning
The quality of relationship(s) is fundamental. A keyworker system is usually most effective in the early stages. The keyworker can build up an intimate knowledge of the child and know when to pursue an objective and when to reduce pressure, making continual adjustments as needed. The relationship works both ways and the child builds up and accumulates trust in the individual worker, becoming more confident in their ability to adapt accordingly. It is usually best to sit back and observe at first, and to place few demands while the relationship develops. In practice a single relationship of this sort can cause organisational problems for a school, put undue pressure on the adult concerned and lead to dependency. As time progresses, it is best if this role can be shared among a small group.
The style needs to be highly individualised but less directive and more intuitive than would ordinarily be the case with children with autism. ?I wonder how we might...? or ?I can?t quite see how to do...? is likely to be more effective than ?Now let?s get on with your work?. Adults need to empower the child by giving more choices and where possible allow a feeling of self-control.
Adults need to keep calm and level in their own emotions in the face of challenging or disruptive behaviour and situations that they may find frustrating. The child with PDA is adept at reading these reactions and gains satisfaction from the excitement that their behaviour can bring about.
It may be best to work alongside or behind the child in one to one sessions, and more group work can be effective, but there is a need to monitor the impact of this on other members of the group.
Novelty and variety is often effective because the child may exploit routine and predictability. Variety in the pace of presentation and personal style can intrigue the child. Creating a sense of mystery and suspense can be helpful; many teachers describe the value of ?pulling rabbits out of the hat?. Building on a child?sstrengths and interests (however odd these may seem) provides opportunities for incidental learning.
Drama and role play make use of the child?s interest in imaginative play and can be used to depersonalise requests and teach morality.
The visual clarification methods (symbol strips, written messages, cartoon drawings etc) that are so successful for children with autism can also be useful for children with PDA, but often for slightly different reasons in that they can be used in a way that depersonalises demands.
Expectations should be disguised where possible and reduced to a minimum. Confrontation should be avoided where possible. This should be underpinned by an understanding of the condition; the child with PDA doesn?t make a ?deliberate choice? not to comply and cannot overcome the situation by ?an act of will?. He may, though, begin to make a series of achievements towards this end as trust and confidence build.
Ground rules need to be as few as possible but maintained using techniques such as passing over responsibility (eg ?I?m sorry but it?s a health and safety requirement?), depersonalising (through the use of imaginary characters, visual clarification, etc) and giving choices that allow the child a feeling of autonomy.
For children with explosive behaviour, having a den or safe haven can be very useful. Somewhere the child can have space and time. It can allow the staff a pause for breath and give the child dignified privacy to compose themselves before they rejoin the group.
Be flexible and adaptable. Strategies need to be changed much more frequently than for a child with autism. What works one day, may not work the next, but it may be worth coming back to in the future.
Using quite complex language can often be effective. This may go against the commonly accepted use of concise language styles for children with autism (based on an understanding of some of their processing and receptive language difficulties). Concise language can come across to the child with PDA as confrontational, while more complex language tends to feel more negotiative and may also intrigue the child. Humour can also be helpful and be used to coax and cajole the child.
Develop strategies that reduce anxiety. Many of the above are aimed at doing just this by reducing the feeling of pressure that the child senses. Other techniques such as teaching relaxation, increasing the amount of physical exercise and giving the child a physical and psychological refuge within the school can all be valuable.
Try to build personal understanding and self-esteem. The UK curriculum now gives a much higher priority to the concept of ?emotional literacy?, which presents real opportunities for children with complex social and communication differences. Mentoring sessions (at Sutherland House these are described as personal tutorials) can be constructive. Techniques that have been developed for children and young people with autism and Asperger?s syndrome can be adapted for use. Sessions draw on principles that include cognitive behaviour therapy (Greig and MacKay, 2005), social stories (Gray, 1998) and developing self- awareness (Faherty, 2000). One pupil (aged ten), when asked during a session what he thought PDA meant replied ?Well, the clue?s in the words! It means if someone asks me to do something I?m likely to say no... that?s me all over, isn?t it??. But sometimes children with PDA enjoy this sort of activity enormously, yet have real problems in identifying that it applies to them.
The way things are phrased or proposed does make a huge difference to DC.
eg rather than "this is how you should do this" it needs to be "this is how it's done" so that he takes charge of testing out that skill for himself.
Rather than "tidy up your lego, then you can use the computer", make the less likely to be complied with instruction implicit "when your lego has been tidied away, you can use the computer."
This can only apply for a child who reads well or can decipher diagrams, but a set of written directions is far less than being told to do something (plus, it's there to refer to, rather than having to be retained, which he struggles with). Teacher training often focuses on tell them what you're going to tell them, then tell them, then tell them what you've told them. For DC, that adds to the general blah blah blah going on and is perceived as nagging. It's far better to ask him how it's done.
The above approach is also helpful because he's a good but reluctant reader. He has a lot more going on, with PDA behaviour just being once facet, so it's rare that he'll enjoy fiction. Giving him opportunities to read for information circumvents this.
Similarly, he's more likely to engage with a task if a part of it involves setting work for other kids or produce his own display.
Actually I've had some great advice on the other thread, some of which I'll copy and paste here as it's not child specific. 