ASD to PDA.....why the shift?

[lougle]

For ages on here, we would have threads saying 'I think it's ASD' . Suddenly, there is an influx of 'is it PDA' ....why the shift?

interesting about NAS.

My ds has so many indicators of both and there seems to be such a crossover that its hard to distinguish one from another. I personally don't know if I should be pushing for asd or PDA and scared to get it wrong for ds. He does the demand avoidance all the time, whereas dd (with expected dx of asd this weekend) only does this when extremely anxious and has a change of routine.

I'm just as confused as ever :)

See...DD3 is 3.10. She can be described as follows:

Extremely bright
Inquisitive (Mummy, how do we make wool?)
Competitive
Very stubborn - she'd rather refuse a sweetie than take one she hadn't chosen herself.
Very persistent - her tantrums can last a looong time

She can be persuaded to do things if the persuasion is very subtle, but if you put a foot wrong you are back to square one.

Last night, for example. Settling for bed. DD3 has a sore bottom, she's worried that going for a wee will make it even sorer. She won't go for a wee. She won't wear cream because if she goes for a wee it will come off. She won't put pants on because she doesn't have cream on yet. She won't go to bed with a nappy because she hasn't worn one since she is 2. She won't go to bed without a nappy because she might wet the bed because she hasn't had a wee.....there is no solution.

Getting angry doesn't work - she gets hysterical. Persuasion doesn't work. Ulitimatums don't work. Bribery doesn't work. The only hope is that by distracting her and ignoring the issue, she becomes so tired that she wants to go to sleep.

Now that's nearly four year old, right?

How would PDA present?

Well, I'm going to be controversial now...

I absolutely think the PDA profile exists. But I think an autistic child who is too much in control for whatever reason can look PDAish. For example, 5 year old undiagnosed at start of school, in a local school who in the notes had started reception in mainstream reasonably biddable, but school failed to use any autism strategies, didn't expect anything from him, and were slow to coordinate paperwork for statement etc, by the time I saw him end of reception he was totally self directed and almost impossible to engage in 'work', though there was evidence from the beginning of the year that he had been easier to sit down with.

Many autistic children, if not most, will seek control. One of the major factors in PDA is control. So I think a lot of parents with autistic children who are seeking control will see a lot of resonances with PDA. I see controlling autistic children, demand avoidant autistic children etc etc and sometimes you have to start with PDA type approaches (or ABA) because that is where the kids are, but you can move them on over time onto more traditional approaches as they feel secure etc etc. I have also seen a few children whose autism presentation (and they have all met autism criteria if you use unusual in scope, intensity or duration for triad) is very particular and where the demand avoidance and control is much more entrenched and pervasive and doesn't get better over time.

That's just my opinion.

lougle, cross posted ,wasn't answering your post immediately above mine.

The standard approaches often used with kids with ASD fail spectacularly with DS1. Even the then area ASD advisor advised throwing away the good practice rule book as early as year 1. We do think that ASD is the correct diagnosis for him, since he has extremely poor social skills and has the pragmatic language delays associated with ASD. Learning about PDA has been eye opening, though. It's confirmed for us that he's not just a special snowflake who thinks visual timetables are beneath him and that he should have the same privileges as staff at school because he's spoilt, but that his behaviour follows a pattern that is recognised and that his tyrannical need to control comes from within rather than from conditioning.

I have noticed too was quite excited to go and read up on something else as hadnt heard of PDA before, ive already read up on asd, aspergers, dyspraxia, adhd, i still cant figure out what ds is if any at all its definatly not PDA though, its as if there is nothing that fits but dosnt seem NT either, oh well back to more reading.

I checked it out because initially Dd3 was going to be given an Atypical autism dx, which according to some reading I did can be described as PDA. However through more reading I realisd that actually she doesnt meet the criteria for Pda and actually quite clearly has Asd but with plently of demand avoidance thrown in.

So it seems the psychiatrist we saw was spot on when she decided to go with Asd instead of Atypical autism.

I totally get though why others are looking into it because some of us have been messed about so much and told so many different things that we want to make sure that we have covered everything.

At the end of the day it does make a difference because the strategies are different and Inknow the Pda ones wouldnt work with Dd3 but they might work with some Dc's where Asd strategies have failed.

I agree with zzzzz. DS has a dx of ASD. I don't think his ASD is much a problem for him or anyone. It's his language.

I feel his ASDness and obsessiveness are just 'normal' things that every child has that have become extreme due to language issues.

I'm just talking about ds here. And I'm NOT saying he doesn't have ASD, just that ASD is as above, for him.

zzzzz I think ilikemysleep was making a distinction and saying there are some for whom control issues are 'entrenched and don't get better over time', so I don't think she is saying that 'PDA is mismanaged ASD'. Rather that it can look like that when ASD is not recognized/accommodated.

lougle, you are a much nicer mummy than me because with Dd3 I would have just sat on her and put the cream on

What I am saying is that is the kind of thing she would have done at that age but not being able to decide which would benefit her most would have sent her hysterical, so I would have had to step in and make a decision for her.

We still have issues like this but they are getting less stressful and she is getting better at deciding what will help her most.

zzzz not at all I have seen pda children with my own eyes, it's very real. What I am saying is that children who don't have pda but are autistic and controlling can have similarities that I think resonate with parents and others but the difference is that it isn't as entrenched and pervasive. I think saying 'mismanaged' is a bit harsh but trying to parent any autistic child, or school them, is hard and sometimes things can slip over into ceding too much control to the autistic child. I include myself in this.

I have a pal whose aspergers teenage boy is SO controlling that she says to me "don't talk to me till we're out of his sight, he doesn't like me talking to anyone". He absolutely rules their household, everything is gered to what he wants and they have never ever told him 'no' . She is actually now scared of her own son. I often wonder how things would be for her if she'd done ABA with him early on , or even just told him no a few times and put her foot down.

My boy has always been a bit more flexible/biddable, but before ABA showed me how to control him, we were pretty much dancing to his tune when he was a stroppy 2 year old.

But his issues are far more about LD and delayed speech, with not a hint of PDA.

Just thinking aloud really, they are all such a different mix.

Geared

I have also seen this boy hit and scratch his mother, for tiny "misdemeanours" on her part. I had zero tolerance for violence from age 2 , and am v glad I did that. She is heartbroken when he hits her, it is like domestic abuse.

I have also seen this boy hit and scratch his mother, for tiny "misdemeanours" on her part. I had zero tolerance for violence from age 2 , and am v glad I did that. She is heartbroken when he hits her, it is like domestic abuse.

Yes pip my boy doesn't like me on phone either, but accepts it now when I tell him "tough, I'm gabbing all I like!"

hothead yes! The other thing that is so hard for some pda parents is the home/school mismatch where school sees a child with hardly any problems and the stress of conforming then spills into terrible anger at home. That happens less with 'ordinary autism', the child may behave well at school but they don't tend to have that superficially good social skills thing, it's mostly more obviously unusual, either too much or too little, so there is less of that 'it's all parenting' guff than with pda kids, schools can usually see more clearly that the child has issues.