Possible PDA-Perspectives and next steps to take

[Mamantraileuse]

Hello, im looking for some perspective and advice on bext practical steps we could take refarding our DD, ahout to turn 5. She is out first so i dont have perspective on what might be age typical behaviour.Apologies in advance for the length!

Ive come to realise that she has a very sensitive and reactive nervous system, and although we've been muddling through and adapting as we go, im wondering if we need to think about referral.

She appears to have many PDA trait. I've read the resources of at peace parents but i don't think its as severe as many of the examples so am questioning myself.

For several years now daily demands have been a real struggle, and routine charts and rewards dont work (or do for 1 or 2 goes out of novelty). The demands she resists changes over time, from getting dressed, toothbrushing to bathing. After months of struggling to get her to have a bath once a week we've had a recent break through where we play the "mummy forbids you to bathe" game and she delights in breaking the rule.

Behaviour escalated last year (end of nursery and start of school) with lots of hitting (mostly me). Stopping all stimulating TV e.g Peppa, number blocks, even if only very short, and switching to low stimulation shows made a huge difference very quickly.

She needs undivided 1:1 attention, and if not playing with her then we have to be physically next to her at all times. As parents its very hard to manage to get daily tasks done.

We had a private OT assessment and she has sensory processing challenges (noise, smell, procioception) but these do seem to be improving a little with time and support.

She is a very happy child, very affectionate sociable and seems to make friends easily. She is very emotionally reactive however, and still cant share. No concerns at nursery or school, and her concentration is good. Multiple food allergies but these are well managed.

We have been applying the PDA society PANDA approach, mostly naturally adapting our parenting style to this. It does make a difference, however the nervous dystem reactivity challenges, and need for 1:1 engagement seem to be getting more apparant with time.

Im wondering about asking for GP support, but not quite sure what to ask for with this profile.

Has DD been referred for an autism assessment? If not, that would be the first step. The school or GP will be able to. The assessment process varies from area to area. In some areas, it is via community paeds, in some it is via CAMHS, and in some it is a standalone service.

Have you spoken to the SENCO at school? What support is the school providing? You say there are no concerns there but there will be signs and there will be support they could provide, e.g. with sensory issues and emotional regulation. The school doesn’t need to wait for a diagnosis before putting support in place.

For the sensory difficulties, some people find the book the Out of Sync Child helpful. Also, some of the ideas in this booklet and some of the Occuplaytional Therapist’s resources.

Some parents of DC with PDA find non-violent resistance resources useful. As DD gets older, The Declarative Language Handbook and The Explosive Child book may help.

Thanks @ChasingMoreSleep ....no referral for an autism assessment yet, mainly as it wasn't something that I had thought of until quite recently as she hadn't displayed many of the more obvious signs (appart from sensory) that are often cited, even in girls (though recognising this can present very differently in different individuals). Although I now see many PDA traits in her im still unsure as it feels less 'severe' than many of the descriptions and case studies I read online, so interested if others have experiences of this

I would speak to the school &/or GP about a referral.

Schools are generally rubbish with girls and noticing anything, in my opinion. Have you considered adhd? I say this because you mention traits but like you said not a huge amount of autism traits. My girl has autism which is diagnosed - I took her out of school. My younger one I suspect adhd but haven’t done anything with regards to diagnosis. You describe yours and it reads much more in line with my younger one - sensory, constant 1:1 displays pda which is actually ODD (oppositional defiance disorder) with ADHD. We use that tactic on lots - I bet you can’t go for a wee before me etc - it is still a huge struggle!

anyway any questions just ask.

Thank you @Clangershome thats really helpful- I'd started off thinking ADHD but then wondered if this was possible as her concentration seems so good at school (teacher remarks on it and no sign of issues of not absorbing information), but perhaps this is just masking.

Have you found any strategies that particularly work day to day? We do hold gentle but firm boundaries but have had to move towards low demand (with firm boundaries in place for really key or safety areas) as it just doesn't seem to work. We're mostly struggling with the need for constant 1:1 and sometimes just getting things done!

We've also found we have to read to her constantly through meals and snacks (and many tasks such as hairbrushing) im wondering if thisows her to stay regulated enough to eat.