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3 year old suspected ASD/PDA and escalating aggression. Feeling really lost

32 replies

charlotte444 · Yesterday 09:11

My DS has just turned 3 and we're currently on the ASD pathway. We've suspected autism for a while due to some speech differences, repetitive play, rigidity etc but more recently I'm wondering about PDA too...

He's always been an intense child even as a baby, but the last few months things have got a lot harder. He's become v controlling, lots of telling us where to sit, what to do, not to look at him, don't touch his toys etc. Transitions can be really hard, getting dressed, bath, bedtime etc although sometimes he's absolutely fine with all of these things which is confusing!

The hardest thing atm is the aggression. He can be absolutely lovely and happy one minute and then suddenly furious over something tiny. This morning we had a lovely half an hour playing together, I touched one of his toy cars and he immediately started hitting me, calling me names and throwing toys. He then went into another room and carried on throwing things. Last night he was hitting DH when it was time for bed.

He's also incredibly rigid about his toys and how things are done. It's like we're constantly walking on eggshells and I'm becoming quite anxious around him which I hate admitting.

The confusing thing is nursery say he's generally fine. He e does have some additional support for his speech and sensory needs but they don't see the level of aggression we get at home. He also sleeps pretty well and can manage days out, parks, cafes etc, so it's not like he can't cope with anything.

We also have a new baby (4 months) and things have definitely got worse since he arrived. I know that's a huge change for DS and could be contributing but I'm worried about how things are escalating.

I guess I'm wondering if anyone had a similar child at 3? Particularly the extreme rigidity, controlling behaviour and sudden aggression. Did things improve as they got older? Was it ASD, PDA or something else?

We're trying a lower demand approach but I'm finding it hard to know where to draw the line, especially with the hitting and throwing. I don't want to make things worse by constantly accommodating everything but equally don't want him distressed all the time.

I'm feeling v overwhelmed atm and would really appreciate some positive stories or practical advice from parents who've been through similar. We are looking for specialist support too but it's hard to know where to start.

OP posts:
EverMerge · Yesterday 09:23

I work with primary school children age. PDA is used a lot but I have one child who most definitely has it. The only advice I can give is to start thinking about how you can help him regulate.

EverMerge · Yesterday 09:27

Sorry I did write more!

Use pictures to help him identify his anger. Don’t get pulled into tit for tat arguments (I struggle with this!) The throwing about, if he’s safe, let him. It’s him regulating. No consequence will work to change his behaviour. But you could use a time out to reflect on what he could have done differently.

Nightmanagerfan · Yesterday 09:30

So sorry to hear. I have a 7 year old who is being assessed for ADHD and ASD and we think has PDA. At 3 he showed some of what you are describing. I remember saying to a friend that he was the kind of child that could never be persuaded to do something he didn’t want to do. Low demand is good. At peace parents on instagram is very helpful - she is an educational psychologist who has two PDA children. They are older but we have found the content helpful.

He might be masking at nursery and saving it all up for you at home. It’s exhausting. You have my sympathies. At this age it’s hard to reason.

spoon theory might help make sense of why he can sometimes cope and sometimes not. My son can be absolutely fine doing an activity or play date one week and the next week it can be a complete disaster.

you have a small baby too so it must be very difficult. Be kind to yourself. My advice would also be not to compare to other families and to find others in the same situation, on here or preferably in real life, who can empathise and won’t give you trite parenting advice that doesn’t work, or say “but he’s fine”.

HotGrapefruit · Yesterday 09:30

I'm assuming you've tried discipline approaches? What happens if you give consequences for hitting etc. e.g. removing him

iwonderificould · Yesterday 09:36

I am absolutely unequivocally not saying he does not have autism or PDA, but equally I will advise caution. Three year olds can be extremely controlling and bossy, and new babies definitely create havoc. My ds was awful at three (when dd was born.) He’s fine now.

My DD is now three and not as bad as no new baby. But she is bossy and I hate playing with her as I always get it wrong!

startthedaywithkindnesd · Yesterday 09:36

A 3 year old who is hitting and throwing things needs to realise there are consequences for such behaviour. A sanction that he will immediately equate with the message that hitting and throwing are serious and unacceptable social behaviours. He doesn’t need a name as an excuse for it , nor does he need understanding and negotiation. You are the parent. Positive reinforcement for good behaviour, stickers, soft play etc. Bad behaviour , and this has to be recognised by you as the sort of behaviour that is unacceptable in all environments. must not be tolerated.
So standard autistic behaviour, such as rigidity in play, intensity are not bad behaviours and need understanding and patience. If my autistic son was hitting anyone he would be immediately removed and placed in an area where there is no fun or attention. Until he apologised. Autism is not an excuse for antisocial behaviour. The reason he manages at nursery is because they have rules which he obviously sticks to. You need firm boundaries and also to stick to them

Ilovemyfam · Yesterday 09:41

Granny of two young children/ family members with DLD and ADHD. Profession - Speech Language Therapist here.

My opinion is that at the moment you don’t need to be thinking about whether it is PDA or not, just use the strategies while you are seeking advice and getting a diagnosis. It must be hard for all of you with a young baby around. You are all exhausted and have so many changes.

If you are in UK (I am not) I would suggest looking into the National Autistic Society training. Their Early Birds Programme has helped a number of families I have worked with. I’m not sure if you need a diagnosis though.

I think that support in some areas of UK can be poor, so if you don’t get 1:1 SLT you might find a private therapist to help you. You could just sign up for 6-8 weeks and see how it goes ( that is what I offer my families)

Namechangingagain12345 · Yesterday 10:54

My ds has asd and very controlling. At 2-3 he was very aggressive, hitting, throwing and punching walls. Massive meltdowns.

one child with asd is one child with asd. What helped me might not help you so I'm only suggesting for you to try.

visual timetable. We have this one
https://www.createvisualaids.co.uk/collections/bundles/products/the-routine-bundle-for-children
for my son it helps knowing what's next and how his day is going to be. If there was anything different he needed pre-warning. So for example dad was picking up from nursery when it's normally mum. Days that have no fixed routine absolutely still need a visual timetable and anytime he is stressed he will timetable everything. We are now at a stage where he finds a whiteboard and pen easier because he can detail as much as he wants and allows for things we don't have a visual for.

I have a zero tolerance for aggression. Especially towards another person. I would remove him to a boring place usually with supervision. He had a play tent for a while that worked. It wasn't a punishment it was a you need to calm down space. I would hold his arm if he was punching me and say you are allowed to be cross/angry/upset but you are not allowed to hurt people. We did a lot of conversations (when calm not in the moment) about would you like to be hit/kicked/hurt? No? Neither do I/sibling. It's ok to feel things but you need to express that in an appropriate way. He was allowed to punch his pillow. Stamp his feet, scream. (He was non verbal at this point) was not allowed to hurt people.

I had no idea if this was the right approach but it seems to of been effective for us and the violence has significantly reduced.

The Routine Bundle for Children

A complete bundle to help your child at home, our Routine Bundle for Children contains: A Visual Timetable for Children (35 visual symbols based around life at home printed with two green backing boards). (Usually £20) A green Now and Next board. (Usua...

https://www.createvisualaids.co.uk/collections/bundles/products/the-routine-bundle-for-children

Cherrycola4 · Yesterday 11:05

I work with a child with PDA. What worked at school was lots of connection, co-regulation, lots of humour, short bursts of tasks with longer periods of play using a timer.

If these strategies didn’t work, I would very calmly wait it out, sometimes having to give very minimal attention until they were ready to connect again. Needs endless patience though.

They’re in a great place now - able to participate in everything at school, strong friendships etc. One of the loveliest kids I’ve ever worked with.

charlotte444 · Yesterday 11:35

EverMerge · Yesterday 09:23

I work with primary school children age. PDA is used a lot but I have one child who most definitely has it. The only advice I can give is to start thinking about how you can help him regulate.

Thank you

How is that child at school? I'm worried my son won't be able to go to school having phone down a rabbit hole on Mumsnet and Reddit about the rates of children actually there. I don't think I have the capacity mentally to home school 😢

OP posts:
charlotte444 · Yesterday 11:37

Nightmanagerfan · Yesterday 09:30

So sorry to hear. I have a 7 year old who is being assessed for ADHD and ASD and we think has PDA. At 3 he showed some of what you are describing. I remember saying to a friend that he was the kind of child that could never be persuaded to do something he didn’t want to do. Low demand is good. At peace parents on instagram is very helpful - she is an educational psychologist who has two PDA children. They are older but we have found the content helpful.

He might be masking at nursery and saving it all up for you at home. It’s exhausting. You have my sympathies. At this age it’s hard to reason.

spoon theory might help make sense of why he can sometimes cope and sometimes not. My son can be absolutely fine doing an activity or play date one week and the next week it can be a complete disaster.

you have a small baby too so it must be very difficult. Be kind to yourself. My advice would also be not to compare to other families and to find others in the same situation, on here or preferably in real life, who can empathise and won’t give you trite parenting advice that doesn’t work, or say “but he’s fine”.

Thank you. Does your child go to school? Have things got better since he was 3?

OP posts:
charlotte444 · Yesterday 11:41

HotGrapefruit · Yesterday 09:30

I'm assuming you've tried discipline approaches? What happens if you give consequences for hitting etc. e.g. removing him

That's doesn't work unfortunately. He either gets more angry or seems to look through you and not hear what you're saying. Or he might say sorry but do it again the next day

OP posts:
charlotte444 · Yesterday 11:41

Cherrycola4 · Yesterday 11:05

I work with a child with PDA. What worked at school was lots of connection, co-regulation, lots of humour, short bursts of tasks with longer periods of play using a timer.

If these strategies didn’t work, I would very calmly wait it out, sometimes having to give very minimal attention until they were ready to connect again. Needs endless patience though.

They’re in a great place now - able to participate in everything at school, strong friendships etc. One of the loveliest kids I’ve ever worked with.

Thank you this is what I needed to hear! Do you know how they are at home?

OP posts:
Phineyj · Yesterday 11:42

My daughter was rather like that at 3. She's certainly not the easiest 13 year old but she's managed primary school and secondary school.

Don't panic about school just yet. Although have you applied for an EHCP?

The resources on the PDA Society website are good. You don't need a diagnosis to try out suggestions and see if they help.

A book I like is 10 Days to a Less Defiant Child (Bernstein).

charlotte444 · Yesterday 11:44

Phineyj · Yesterday 11:42

My daughter was rather like that at 3. She's certainly not the easiest 13 year old but she's managed primary school and secondary school.

Don't panic about school just yet. Although have you applied for an EHCP?

The resources on the PDA Society website are good. You don't need a diagnosis to try out suggestions and see if they help.

A book I like is 10 Days to a Less Defiant Child (Bernstein).

Thank you. Did she grow out of the violence? Did you do low demand parenting?

OP posts:
Phineyj · Yesterday 11:46

The only thing that ever worked with DD was proactive planning to avoid the situation/avoid triggers. Conventional discipline approaches just made things worse. Ten years later, she does occasionally respond to a more conventional approach.

Find things that regulate him. Do lots of them.

For DD that was water in any form, and jumping on a trampoline.

Phineyj · Yesterday 11:50

charlotte444 · Yesterday 11:44

Thank you. Did she grow out of the violence? Did you do low demand parenting?

Yes eventually. We took part in a study. Most grow out of it by 10 as their skills develop (sorry!)

There is a charity called Capa First Response that you might find useful. They have free online seminars.

I don't know if you'd call our approach low demand exactly. It was more divide and rule (between me and DH) and do lots of what works.

She had some play therapy around age 8 which was helpful.

charlotte444 · Yesterday 11:58

Phineyj · Yesterday 11:50

Yes eventually. We took part in a study. Most grow out of it by 10 as their skills develop (sorry!)

There is a charity called Capa First Response that you might find useful. They have free online seminars.

I don't know if you'd call our approach low demand exactly. It was more divide and rule (between me and DH) and do lots of what works.

She had some play therapy around age 8 which was helpful.

Thank you. Was your daughter given a diagnosis with a PDA profile?

My DS gets inclusion funding at nursery currently but that was based on the ASD social communication differences. I'm now wondering if a formal type school would work for him if it is PDA. There's is a forest type school near us that I might look into

Good to know abt the play therapy and regulation ideas. It's hard because he can't communicate his needs yet we don't really know what's regulating for him

OP posts:
SatinHeart · Yesterday 12:06

Yes I have a now 6 year old who at 3 had uncontrollable rage and would thro things (including chairs). Things are getting better - he still gets very worked up but is better able to articulate why, which helps us to diffuse the situations.

I have wondered about PDA, but where I live they don't diagnose it, not even as a profile of ASD. In my (admittedly limited) experience a lot of NHS medical professionals don't really believe in it. So rather than focusing on the label, we have taken each behaviour as it comes and worked on strategies to manage it.

There's a book called 'The Explosive Child' which I found really helpful.

charlotte444 · Yesterday 12:20

SatinHeart · Yesterday 12:06

Yes I have a now 6 year old who at 3 had uncontrollable rage and would thro things (including chairs). Things are getting better - he still gets very worked up but is better able to articulate why, which helps us to diffuse the situations.

I have wondered about PDA, but where I live they don't diagnose it, not even as a profile of ASD. In my (admittedly limited) experience a lot of NHS medical professionals don't really believe in it. So rather than focusing on the label, we have taken each behaviour as it comes and worked on strategies to manage it.

There's a book called 'The Explosive Child' which I found really helpful.

Thank you I'll download the audible for that

Has your son got an ASD diagnosis?

OP posts:
SatinHeart · Yesterday 12:24

charlotte444 · Yesterday 12:20

Thank you I'll download the audible for that

Has your son got an ASD diagnosis?

No but my older DS does (very different traits though) so I suspect it's on the cards. We're being more watchful second time round, as with DS1 the formal diagnosis didn't unlock any additional support compared to what he was already receiving.

BertieBotts · Yesterday 12:44

Personally I think 3 is too young to call on PDA, although I agree that the framing of the behaviour as stress-related rather than wilful choice is vv helpful. It is unlikely you'll get very far with time out, for example. Some online representations of low demand are unhelpful, IME. I don't think it's usually helpful to bend absolutely everything around the child's feelings, and as you point out, sometimes accommodating anxiety behaviours can make the anxiety worse. However, it can help a lot particularly temporarily to reduce pressure by dropping unrealistic demands or expectations.

I do wish the word accommodation wasn't used both in the context of accommodating anxiety behaviours/compulsions and accommodating needs in the case of things like autism. It's confusing and it sets up this weird thing where accommodation is seen as a negative in certain contexts and a positive in others.

I find quite a useful framing rather than accommodation is around autonomy and responsibility. So I would avoid accommodating demands which threaten somebody else's autonomy - ie, I have sat down and child says no, you can't sit there, you need to sit here - I would say no, it's my choice where I sit, or I might say ask nicely and then I'd be more likely to follow the request. I know this seems like a very small thing to let them win on, it's just to me about being clear where their autonomy ends (dictating the behaviour of another person). We are generally clear when it's a situation that you can ask/request the thing from the other person, and when it's not (and when it is an ask/request, that the other person is also allowed to say no).

But if child says they want to wear shorts in the middle of winter I would probably try to accommodate that in pursuit of supporting their autonomy. Perhaps it means we don't go out - fine if we don't need to go out that day. If we do need/someone wants to go out and toddler needs to come with, then we'd look for some kind of win-win problem solve where toddler maintains control over their clothing, but I ensure they are not at risk of frostbite (responsibility) - which might look like different clothing options, or bringing a back up option, or using a blanket in the buggy or staying in the car as long as possible.

Then there are situations like child lets me know (perhaps in a not ideal way) that they are struggling with the sensory input of me singing/humming. At 3 I'd probably take it as info and try to stop humming. For an older child I might look at it more from the other people's autonomy thing where they can choose whether to go elsewhere, use ear protection, etc, or request the person stop more nicely.

Do not accept home education if you don't want to do it. Keep pushing for education which meets his needs. The LA has a duty to provide it, though their budgets are empty so they will be constantly triaging which DC have the highest potential consequences if they don't get this, which means the majority of DC miss out. This is unsustainable, so do use every resource you can for this. Contact local MP, look at appeals charities, support groups, anything.

Mona Delahooke and Conscious Discipline will probably be your most helpful resources at this stage. Conscious Discipline is a pain to navigate (their website) because they are aimed mostly at schools but they do have content or advice which is transferable to parents, and it's very well presented.

IME, at 3 regulation is close to 100% co-regulation, which means that he needs time and space to build close, trusting relationships with new adults and he may need proximity to a trusted, safe adult close to 100% of the time. I think this is why it tends to work well in 1:1 situations like therapy but can be trickier in group situations.

And at this age your co-regulation is almost 100% physical. If you think about the body language you'd use to approach a frightened child, or a wild animal, it's this. It's understanding where his behaviour is coming from so that it is less likely to trigger your own threat response and put you into fight or flight, and then consciously modifying your body language so that it communicates safety - being small, moving slowly, voice should be low in pitch, volume and speed, avoid demands, avoid threats. Physical touch may help or not, try to see. Eye contact may help or not, try to see. Don't expect actual words to go in, so don't talk very much or just say validating/soothing phrases.

Keep modelling things like deep breathing rather than asking them to do it etc.

Once calmer, they can often problem solve better anyway or they have moved on from whatever the issue was. Try to pre-empt hunger, toilet need, tiredness, physical exercise need (all easier said than done!)

Cherrycola4 · Yesterday 12:53

charlotte444 · Yesterday 11:41

Thank you this is what I needed to hear! Do you know how they are at home?

Things have been complicated at home by parents splitting up, but yes, so much better at home now with two very patient, loving parents.

Ilovemyfam · Yesterday 13:21

I need to add from my earlier post that you should avoid being too focused about the future.

I have been in the fortunate position of being able to keep receiving updates of a number of young people who I knew when they first had their difficulties and prior to diagnosis. Without revealing anything confidential I would say that no outcome in terms of tertiary education and career should be ruled out.

Just stay hopeful. Seek professional support.

Phineyj · Yesterday 13:33

charlotte444 · Yesterday 11:58

Thank you. Was your daughter given a diagnosis with a PDA profile?

My DS gets inclusion funding at nursery currently but that was based on the ASD social communication differences. I'm now wondering if a formal type school would work for him if it is PDA. There's is a forest type school near us that I might look into

Good to know abt the play therapy and regulation ideas. It's hard because he can't communicate his needs yet we don't really know what's regulating for him

Her diagnosis of ADHD and ASD does say with a PDA profile, yes, but you can't be "diagnosed with PDA" because it's not in the DSM (the guidelines that psychologists work within).

Besides, the most important thing is to try some things.

Forest school will still need him to follow instructions.

You say he can't communicate what's upsetting him but you must notice things he finds regulating, whether that's bouncing, baths, hugs, etc? And things he finds upsetting like noise, crowds, transitions?

(I'm just picking random things here).

I think 3 is a particularly difficult age as most 3 year olds are a bit bonkers! It definitely took us longer to realise we had issues due to having an only child, as well.