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

[charlotte444]

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.

If you haven't already, I'd join some PDA-specific support groups. Standard parenting approaches and standard strategies for autism very often make things worse for PDA children. However, things can massively improve with the right mindset and approach. I'd recommend the PDA Community and the Pathological Demand Avoidance (PDA) support group on Facebook.

It is also possible to have demand avoidance / controlling behaviours in response to stress without being PDA. A new sibling is a big stressor for many children.

I don't have many specific suggestions as my PDAer wasn't too difficult at that age (though there were definitely signs).

It is possible that he is doing it to get attention. He has observed that there is a new child in the family and everyone is paying attention to that one child rather than him. His attention has got diverted and when he behaves this way, he observed that everyone pays attention to him so maybe he has linked the attention seeking behavior with his agression.
Repetitive behavior signals that he might be having Autism but that cannot be said as children can do this behavior at this ago. It also depends since how long this behavior of your child is being observed.

Besides, the most important thing is to try some things

Agree with @Phineyj on this. OP don't get caught up in the terminology. Try some things. Don't worry if they come under 'low demand parenting' or not. If it doesn't work, try something else.

Just re-read your post about forest school OP. My 6 yo went to forest nursery from the age of 1 to school age. He did love it but it was frankly terrible preparation for the classroom environment and we had a tricky Reception year as a result. What age does your local forest-type school go up to? My worry would be that you could end up just kicking the can down the road in terms of coping with school.

Definitely request an EHCNA.

What support is the nursery already providing? What have they already tried that hasn’t worked?

As well as the inclusion funding, has the nursery asked for advice from the Area SENCO &/or, if your LA still has them, the specialist teaching service.

In some areas, there are SALT and OT drop in sessions for early years DC. You might want to check if your area has these.

Some elements will be too old for you to use with DS yet, but some may still be relevant for you to use, you might want to read the Declarative Language Handbook, the Out of Sync Child and The Explosive Child books.

Sometimes providing sensory input can help with wider issue too even if DC aren’t displaying obvious sensory issues. You might want to look at this booklet and some of the Occuplaytional Therapist’s resources.

Oh yes YY defo agree with Linda K Murphy's books and The Occuplaytional Therapist.

sorry for the slow reply. Yes he goes to school, mainstream primary, he has friends and is clever and does well academically. But he masks at school and has no capacity outside of school to do much at all - eg has to spend the whole of Saturday in PJs doing very little. Last year was better but this year he has daily meltdowns, spits and can be violent, he doesn’t sleep until 10:30/11pm. I am grateful he can do school but I worry what it’s doing to him.

My big regret is that we didn’t introduce a regular babysitter/nanny type person when he was younger, he can only be left with one family from school at the moment, and never overnight. Friends with similar children had a part time nanny/mother’s help who stayed with them and their lives are much easier as they can leave the children with her. It’s expensive but worth every penny to have that option

I had really good advice when my dd was 3, she was diagnosed as having autism at 2 years 8 months and I saw a paediatric neurologist via my insurance (USA) who said i needed to have firm boundaries, don’t let her rule the house and that I shouldn’t give in for an easy life. I didn’t and i won’t claim life was easy, it wasn’t but despite having now a wide range of 3 letter disorders including pda, life is good for her, she did complete school, she is working (pt) she is married. Non verbal until 4. She had 4 years of aba therapy which i think really helped because her outcome is so different to friends whose children were in the uk where it wasn’t available