![]() Allow warning and extra time for transitions. Have a buddy (classmate? older student?) to help. ![]() If aide not available all the time, at least have aide available for transitions. (Primarily with 1st grade teacher, less time with specials/unfamiliar people/setting) Organize schedule so when Oliver is at school there are the minimum number of transitions possible. Meet or at least see photos of teachers, aide, resource room teacher ahead of time Sensory room: big, gross-motor movements (swinging, jumping, etc.) Resource room: screen time is calming for Oliver Have places to retreat to when classroom environment is too much. Start with reduced schedule and increase according to tolerance. ![]() We know with certainty that for him to be able to build on success, we go slowly, we help to alleviate pressure in every way possible, namely: reduced schedule (with intention to increase as tolerance allows), choices in little ways can make a big difference (“You may choose a pencil or pen to write your name on your paper” helps him feel in control and avoid the demand of one limited direct instruction), the option to leave the classroom when he feels overwhelm increasing - the option to use a screen in the resource room, or take a sensory break in the sensory room or outdoors will all be very helpful in managing cumulative anxiety. The reason we have chosen to pursue the opportunity for Oliver to attend first grade at _ is because he wants to be able to go to school, he is eager to learn, to make friends, to do the things he sees his younger brother and peers in the neighborhood doing as well. With so many demands and so much sensory input, school presents an incredible challenge for children with PDA autism, and without the proper support, many of these children end up homeschooling. Oliver exhibits all of these behaviors and expressions. As distress increases, the level of support required to de-escalate increases, and once a high level of distress has been reached, regulation becomes much more challenging and there is a tendency to return back to a higher level of stress. Conversely, PDA-specific strategies focus on minimizing demands: allowing the child to have as much control as they can whenever possible, presenting choices and allowing the child to provide input, turning tasks into games or races, using indirect/declarative language, giving extra time and support for transitions, introducing novelty and surprise, using humor, and paying attention to when dysregulation has visibly started to occur and giving space, distance, and quiet. Things such as set/recurring routines and behavioral approaches (rewards and consequences, charts, etc.) are all interpreted as demands. The types of strategies that are typically employed in autistic children produce anxiety in PDA children and can actually make things worse. The feeling of hunger (needing to eat), or the urge to use the bathroom can at times be overwhelming experiences for Oliver. An additional note about the perceived demands: these can also be from internal sources as well. The anxiety is cumulative, and when coupled with sensory processing differences, the distress can appear seemingly out of nowhere. ![]() Avoidant strategies from the child might include distraction, negotiation, distressed behaviors such as yelling or aggression, and can lead to full-blown fight or flight responses. can lead a PDA child to attempt a variety of strategies to avoid those demands. Daily tasks and routines like riding in a car, brushing teeth, getting dressed, sharing attention, waiting, etc. At its core, the A in PDA (avoidance) is due to extreme anxiety caused by everyday demands. PDA also differs significantly in the types of support needed and the types of strategies that are effective. These capacities are present in Oliver, but can fluctuate greatly depending on his overall state of regulation. Oliver is autistic and he presents a sub-type of autism called Pathological Demand Avoidance (PDA), which is a subcategory of autism where the presentation differs substantially: kids with PDA (tend to) make (more) eye contact, appear social, and have strong expressive language capacities as well as the ability to read other’s emotions well. ![]()
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