If you read back you would have read how my child required 3 adults and sedatives to restrain him for a medical appointment and then an emergency mdt meeting to decide to give him ketamine to get him safely to theatre so they could give him general to do what they needed to do. We cannot currently access a GP surgery and are getting specialist help because of the level of overwhelm and fight/flight even a mention of medical apo creates. 2 weeks ago I caught a bus with him and another supporting sdult. We hadnt realised at one point on the route the bus went past the hospital. Cue child in fight flight hurting me and trying to get off a moving bus in sheer panic.
Firm boundaries absolutely do NOT work.
We do get 'compliance' or rather cooperation? Im other ways. That has meant total reduction in demands. Letting his nervous system repair from trauma caused by school. A team of specialists involved.
I am safery restraint trained i actually work in a complex needs school for pupils age 4-19 in a class with 16-19year olds who are fully grown men sized. I can do consistency, all the autism strategies and compliance based techniques its my bread and butter at wirk. Absolutely none of it worked with my youngest.
Connection, PACE techniques, meeting him where he is at, coregulating etc. We have made anaxing progress with a great team around is and CWD involvement now and staff who are appropriately trained. But its a journey built on trust, he must tryst, be listened to and be in control (or feel in control). I liken it to curling it may look like doing nothing but it takes constant smoothing of his path, of adapting the environment, forseeing sensory issues (a nightmare as he has a 'profoundly complex sensory profile'. Reducing demands or the feel of demands. Understanding his communication, the signals he is giving. The tics, tourettes, the pda shock language and all those tiny body signs (which i am sure you understand with your own child how subtle those signals are). And even with that we just cant get everything right all the time.
He is learning to manage his own capacity, to verbalise his needs in safe ways. He can be amazingly capable when supported correctly. But sometimes he just CANT and no amount of boundaries can make him. It will do the opposite.
Someone asked re teeth cleaning we always do them before bed. Not in the morning, he also uses a flavourless toothpaste, a particular brush. I still clean them for him he is 10. We also use special teeth wipes. We have a lot of strategies. Declarative language, modelling, power in momentum. It is a process. But teeth cleaning has been a line we have generally kept to once a day and his teeth are ok, he doesnt like it when they have plaque on and will scrape it of with a teeny little teeth cleaning device then I brush.
He has 2 to 1 support at home for all education, plus a 3 rd adult for safeguarding.. It took them over 2 hours the other week to get him out he was out for 10 minutes and legged across road 🙄. We OT provision, ongoing support from Ed psych. All trained in pda, sensory processing and tourettes. This was all the local authority Ed psych/OT recommendations after assessments.
The relief tbh of getting diagnosis and professionals saying actusaly its X, Y, Z he needs was huge.
There is tricky and not compliant and then there's NOT compliant. Give me 100 autistic kids (i have 4 other autistic children myself, 3 adhd as well) but 1 pda child with the other co occurring conditions small has... is more than enough 🤣 he is an amazing boy but its been THE steepest learning curve.