PDA autism and not wearing clothes

[NotJustAnotherDad]

Its been about 6 months now where my eldest (6yo) has not been in school and will not wear anything more than her pants.
Before reaching the point of writing this, i feel like we have tried everything, from incentives, to buying as many soft clothes as possible to even suggesting to wear swimwear. We quite literally are stuck! stuck at home all the time because there's no where you can take a child that is literally in pants without the world staring at you and probably getting into some kind of trouble through a Karen reporting you. Apologies i digress.

Is there anyone else going through the same troubles that i am?
I try on occasion to drop into a conversation softly about the idea of just wearing some shorts, sometimes received well but the truth is we never really get to the point where shorts are worn.
I feel in my mind now she may view putting clothes on as a weakness, she currently has her way, there's no way we can take her to school as she is. Mum is working hard in the background to get more support too. I would love to be able to get her back outside riding her bike or playing football or just even going to the park.
It's started to effect her younger sister (4yo) she's coming up to going to school and she's realised that if older sister doesn't go to school then why should she have to currently go to preschool. I'm doing my best to manage the situation but I'm definitely starting to run out of new ideas.

More than anything id like to know I'm not alone with this.

I'm a sen mum too, so not saying this to be a dick or criticise your parenting at all 💕

Have you tried insisting that clothes stay on? Just putting them back on after shes taken them off?

sorry if it seems obvious that you have

My dd tried this with various items of clothing and I've just insisted, as a hard boundary, that the essential item of clothing stays on and taking them off isn't allowed - so for us,

it's knickers,

a coat and trousers when we go swimming (she wants to go in just her costume)

Socks/tights in the winter

She's got seamless socks/tights and the tags cut out of her clothes etc - she doesn't make a fuss about these anymore as I reinforced the boundary but respected others - ie, seamless stuff, nothing that will make her too hot

I know it's a tough road, the main thing though is that she feels safe enough with you to be herself x

What support is DD receiving? Has DD had a sensory OT assessment?

Would DD try a poncho? What about a dressing gown?

Education wise, does DD have an EHCP and is alternative provision in place?

It's so hard when they reach this point, op, i know exactly how it feels. My dd was 6 when she entered a period of ebsa and some days wouldn't get dressed at all and lay in bed naked saying even her hair annoyed her. Invariably she could tolerate a soft dressing gown or Onesie, so on those days I just got her outside exactly as she was dressed and ignored the disapproving looks.

We enlisted support from a private specialist who spent 3 or 4 one hour sessions with us. Dd's clothing issues were both sensory and control based. Both linked to heightened anxiety. We essentially had to repair her mental health by addressing the triggers of her anxiety (school was hard for her). Only by addressing that did things improve in the long term. I also self referred to OT. They wouldn't see dd, but they did provide some resources to read. I essentially removed all demands while she recovered, just focused on being nurturing, walking away from explosive situations (with the help of Kalms tablets for me!), spending time being led by her on the activities she wanted to do, trying to keep things as calm as possible.

Over time her general mood improved, which meant I was able to use immediate rewards to gently reintroduce some rules and smaller demands. We talked about which clothes were the most/ least tolerable and started with the most tolerable. For example, PJs instead of a Onesie. We set a timer and made a game of it, so when she was able to keep them on for 5 mins or whatever we agreed together she got a reward of some kind and was then allowed to remove them. We built up from there. It sounds like a slow process (and is at first) but once she was back in one set of clothes reliably things accelerated. You have to rebuild the brain's connections with her through limited exposure - i.e. that every time she's able to tolerate clothing a little bit and realises it wasn't that bad, she's more willing take it further. Lots of praise, and we also worked hard on emotional literacy. Dd's interoception was lacking so if she was too cold, too hungry or she was uncomfortable in some way she wasn't able to articulate then her irritability prevented progress being made. She was back in two or three sets of clothes within a couple of weeks.

The only thing that is a mainstay with dd is socks and shoes, but she's so much better now at explaining how she feels and working with me to problem solve. Some of that has come naturally with age, some with hard work on negotiation and teamwork. I also found a book called The Explosive Child was incredibly helpful too at providing strategies to support this. Mornings before school were/ are trigger points for dd, so I now put her socks on her the night before!

Thanks Both.

That hard boundary ship has unfortunately sailed already, knickers are the only thing she she will wear these days. We have to wrap her up in a blanket to go anywhere.

As parents we are no longer together, I do my very best to listen to my daughters needs and try to push on occasion to get another item of clothing onto her, it’s usually met with a no as she no longer feels comfortable with any clothing. I agree that we too also buy seamless stuff and the softest clothes we can possibly find.

I believe OT assessment has been completed but we are not receiving any support due to funding currently.
EHCP is in the works, it’s been a difficult battle since school started but things have progressively gotten worse. The school however, now it’s reached this point are being more supportive.

we currently have routine video calls with the school and mum has spoken with Ed psych and resource based options are now being looked into.

Whatafustercluck - one big question, how did you get dd to be vocal? If I ask what ever varying question around clothes. I don’t ever get given a reason, more or less just a simple no.

i would love to receive some kind of response that can tell me what I’m missing from her. The thing I think most that is connected to it now is fear and anxiety. I don’t know what she could be fearing or anxious about without her being able to tell me.

Dd is able to explain all of her needs but when it comes to clothing there’s nothing there.
Dd did go through autistic burnout and is finally back, she would hide away when relatives would visit but I have always reassured her that she can be herself and no one will say anything to her. The confidence inside of her has grown so much that she no longer hides away and is very much in the room being her happy self.

i will definitely look into that book you suggested.

You say you’ve suggested swimwear - have you put her in stretchy swimwear like outfits - my dd wore that the majority of the time at this age when not in pants at home. Lots of outlets for SEN sell Lycra compression vests etc because of the feeling of relaxation they give.

sounds really hard.

@NotJustAnotherDad at 6 they often just can't explain unfortunately, because they may not know as they've not developed the self reflection/ insight. Which is why interventions can't just focus on the more obvious sensory overload (kids are often good at being able to say 'it's too scratchy' or whatever) but on emotional overload too, leading to control-based reactions. My dd wouldn't have known that part of the clothing related challenges were about her internal feelings and emotional state, so we worked on developing her emotional literacy. I also found that rather than asking her directly, I'd have to be a bit of a detective and observe her really closely - her sensory preferences, whether certain emotional reactions were more obvious when certain triggers occur. I also found that taking a less direct approach to questioning helped her - the Explosive Child has some great examples how certain approaches elicit a better response than others. I'd say things like "I wonder if..." and "I've noticed this, I wonder if...." seemed to get better responses than "what is it you like/ don't like/ struggle with".

Have you seen https://www.instagram.com/a_peep_into_pda/ ?

They're dealing with similar issues.

Where in the EHCP process are you? Is the LA sticking to the timescales?

Check if the OT included a sensory integration assessment. Not all do.

Also, a SALT assessment. DD might not even know why she feels as she does. Let alone understand it enough to be able to communicate it or have the ability to verbalise it.

If alternative provision isn’t in place, you can request that. On their website, IPSEA has a model letter you can use.

Some people find the book the Out of Sync Child helpful.