Consultant recommendations for PDA/ autism

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My 8 year old DD's behaviour is becoming increasingly difficult to manage and I think we may need professional help. She is perfectly behaved at school, glowing reports etc, but is having frequent violent outbursts at home, during which she is completely out of control. It is horrible for her and for all of us.

From the research I've done it seems like this may be PDA or autism. She doesn't tick many of the other autism boxes - she's socially confident and has no difficulty in forming friendships - but I'm open minded.

Looking for recommendations for someone in the SE who may be able to help us, and also some insight (out of curiosity - not pre-empting) into what kind of interventions they might suggest. Most of what I've read is focused on support at school and that's not really needed here. I've just started reading through The Explosive Child which is already helping - would it likely be that kind of approach?

We would go private if needed to avoid delays.

Thanks for any suggestions.

Our DD has autism with a PDA profile, which to my knowledge is the only way to get PDA acknowledged in any kind of diagnosis, as PDA is yet to be a stand alone diagnosis. The long and short of that is, you cannot have PDA without an autism diagnosis. If you don't think she meets the requirements for autism then I think you need to start at the very beginning with your GP to refer her for generalised diagnostics which may point you towards something else or be able to identify other autistic traits.

Our daughter struggles with the demands of every day life, its almost like the diagnostic criteria for PDA was written about her. It affects every part of her life, home life, school life, social life, and even hobbies and things she enjoys. She cannot cope with the feeling that she must do something, whether that be brush her teeth, eat, school work, go to school, follow through with a play date, enjoy holidays, everything. Today she wanted to go to the 2nd hand shop to find some old books, when I said OK but we need to go at X time because there is a storm coming, it didn't happen.

The only way to help her is to remove as much pressure as possible, make as few demands on her as possible. We have had to really take a look at what is important in life and save those things for our 'nagging'. Things like her health, sleeping, eating, cleanliness. Honestly it is so incredibly frustrating at times but ultimately the more you nag the worse it will be. I had to stop nagging her about brushing her teeth, and with time she has started doing it, on her own terms. Thankfully we now have a diagnosis and her school is finally offering support. Giving her choices really helps, but the biggest thing is accepting that sometimes you just can't have what you want, if she does it great, if she doesn't she doesn't. I could go on and on about all the things we do to help her, but that is the short version.

Why do you think support in school is not needed? Being well behaved at school and exploding at home doesn’t mean further support at school isn’t required and it doesn’t mean the problem is at home. It’s called the coke bottle effect. Support in school can improve home life too. Things like OT, SALT, support that reduces anxiety/improves regulation can also help. You could look at some PDA strategies. Some people find Yvonne Newbold’s strategies helpful.

Thanks and yes I'm not averse to getting support through school. I just feel it might be a battle to (a) persuade them that it's needed given she doesn't display any of these behaviours at school although I know this is not uncommon for girls with autism, and (b) actually obtain support given the pressures that GP and schools are under and the lack of resources they have. I had just assumed that going privately would avoid these issues and would probably be quicker.

Thank you - I didn't know that about the PDA/ autism connection. I am not opposed to having her formally assessed/diagnosed if I felt it would benefit her, it just seems that a lot of the support I have read about is tailored to school life rather than home life. Part of me feels that school is actually her happy place, she genuinely enjoys it, so there's a reluctance to interfere I guess. But perhaps I am being too simplistic.

Thanks for the strategies as well, they are very similar to those suggested in The Explosive Child and from my limited experience they do make a difference. I know it's largely about resetting my own expectations but as you say it can be very frustrating.

Yes you are likely to have to push for support, but sadly DC whose parents know the system and advocate get better support. It shouldn’t be like that, but isn’t going to change any time soon.

Do read up on the coke bottle effect. Paying privately for support without changing the support at school as well is unlikely to solve the coping ‘fine’ at school but exploding at home. Improving support at school is likely to improve home life.

One of the key differences between PDA and ODD is that PDA also affects the things they enjoy, ODD rarely. With PDA the pressure comes from actually enjoying something, knowing that there is a reward in something and so you must do XYZ to get that, ie getting up and ready in the morning. With ODD also there is an aspect of pride, or embarrassment and not wanting to others to see the meltdown, with PDA that doesn't apply. So maybe ODD could be something you look into.

I absolutely understand why you wouldn't want to interfere with any aspect where there appears to be no issue, and getting support from schools where they will report no evidence of issues is difficult.