this was great thank you! Do you have specific recommendations for autistic adults with PDA? My husband is very high functioning autistic, has a good job and makes it to work but the PDA can come up sometimes and be challenging.
With PDA, anxiety really drives the avoidance of demands, such as anxiety about meeting expectations or losing control. This anxiety is pervasive so we want to ensure that any therapeutic approach targets that anxiety. We initially want to modify how we communicate demands and expectations. Along with parental training and family therapy (which is an essential part of the treatment plan!), we would want to look at incorporating: • Adapted Communication. At least initially, we absolutely need to modify how demands are communicated to reduce the perception of demands and build success/momentum. • Low-arousal Approaches. Over aroused kids = emotional outbursts. Because we want to encourage adaptive behaviour, we want to keep the emotional arousal low. • I LOVE Ross Green, so using Collaborative Approaches. Methods like the Collaborative and Proactive Solutions (CPS) model emphasize identifying unmet expectations and solving problems collaboratively. Now, for CBT, yes, it can be helpful to address the underlying anxiety. The components of things like distress tolerance and mindfulness are important. HOWEVER, traditional CBT might be too structured. Therefore, we need to ensure we are modifying it to meet the child’s needs adequately. So, using things from above like reducing perceived demands and framing activities as choices (which a good therapist should be doing anyway). We need to be flexible for the child’s needs.
What do you mean by “not accommodating their anxiety”? That doesn’t make sense to me in light of you saying their main problem is anxiety and “their battery of tolerance”. Also arent choices/rewards a type of manipulation?
I believe she means it during the process of building tolerance. Something like that: 1st you do an anxiety "detox". So do only accommodations, no pressure at all, so the person can regulate and get out of the constant stress zone and feel calmer and more comfortable around you and close people. Once the person has achieved this "relaxed zone", you can build a collaborative plan, probably better with the therapist and parents involved somehow, to let the PDA person experience dosed challenges (so in this stage not accomodate all the anxiety, but let the person experience it in a moderate/low level). With this, the goal is that the person can develop better coping skills and be more functional. It just needs to me done in a "natural" way, not forced, in a more "go with the flow" style. If the PDA person can feel like they are being able to navigate through small steps it can be very rewarding and make a very positive impact on their behaviour.
About the choices/rewards it can definitely come across manipulative but I think it will depend in which mind state the person is and how you present them. If you are able to internalize a non-expectative/non-demanding type of comunication and behaviour you will probably be succesfull with this aproach. It's more about feeling comfortable around eachother
Maipulation is not a bad thing, you can use it for bad things but manipulating means just coveret influence. The good or bad part is something that is in their human using it. Parent manipulate children all the time. Kid whining, parent helping to stop cry?-> Manipulation in most cases same for partners, family etc
I agree it seems super difficult. I think that as a late diagnosed autistic person who is trying to navigate this with my son the thing that is helping me is to remember how much harder it is for them as a child and not having any context or experience and even less control of their environment. Having that empathy I feels helps me.
@@janetostergaard598how do you feel when you envision your future? I recently started caring for a 19 year old with this and he has never been able to have the opportunity to build upon his life experiences because of these symptoms. He can’t go out and get a job and learn how the world works. So when I think “poor baby he just doesn’t know how the world works” I then get more depressed knowing he will never change because he can’t get out and experience the world.
@@Brandi_Hill I suggest reading the book The Essential Guide to Raising Complex Kids. It talks a lot about shifting your own views so that you are able to help yourself and the child recognize their accomplishments. Even if they may not seem like a big deal you have to view it through the lens of where they are coming from and then you can recognize growth. I know for my own kid it doesn't ever seem like he makes the connections of cause and effect based on where I am but if I look at where he is and what he has done I glow with pride knowing what he has overcome. My child is also gifted, so to the world he is lazy or uncaring or without direction because they don't see the inner struggle. They just think he is smart so why isn't he doing this thing that he is perfectly capable of. I as his mother know that is not the case at all. I see when he has these moments where he is so stressed because of demands that he either lashes out (verbally or physically), shuts down completely and will sleep for 18-20 hours straight, or just starts crying. He can't express what is going on for him. That fight, flight, fawn has completely taken over all of his mental capacity and he needs to reset. It doesn't necessarily happen quickly. I try to reduce these triggers at home.
@@Brandi_Hillhave u been able to try any occupational therapy..? Our occupational therapist is the one who finally recognized it in my 16 year old. Also At Peace Parenting is a great resource. Wish you the best!
this was great thank you! Do you have specific recommendations for autistic adults with PDA? My husband is very high functioning autistic, has a good job and makes it to work but the PDA can come up sometimes and be challenging.
A very helpful resource. Thank you.
Thank you! Glad it was helpful.
Great video 😀
Thanks!
Do you have advice for when a child refuses to watch video modeling?
What kind of therapy would best help PDA kids? Would CBT be a good fit?
With PDA, anxiety really drives the avoidance of demands, such as anxiety about meeting expectations or losing control. This anxiety is pervasive so we want to ensure that any therapeutic approach targets that anxiety. We initially want to modify how we communicate demands and expectations.
Along with parental training and family therapy (which is an essential part of the treatment plan!), we would want to look at incorporating:
• Adapted Communication. At least initially, we absolutely need to modify how demands are communicated to reduce the perception of demands and build success/momentum.
• Low-arousal Approaches. Over aroused kids = emotional outbursts. Because we want to encourage adaptive behaviour, we want to keep the emotional arousal low.
• I LOVE Ross Green, so using Collaborative Approaches. Methods like the Collaborative and Proactive Solutions (CPS) model emphasize identifying unmet expectations and solving problems collaboratively.
Now, for CBT, yes, it can be helpful to address the underlying anxiety. The components of things like distress tolerance and mindfulness are important. HOWEVER, traditional CBT might be too structured. Therefore, we need to ensure we are modifying it to meet the child’s needs adequately. So, using things from above like reducing perceived demands and framing activities as choices (which a good therapist should be doing anyway). We need to be flexible for the child’s needs.
Thx
What do you mean by “not accommodating their anxiety”? That doesn’t make sense to me in light of you saying their main problem is anxiety and “their battery of tolerance”. Also arent choices/rewards a type of manipulation?
I believe she means it during the process of building tolerance. Something like that: 1st you do an anxiety "detox". So do only accommodations, no pressure at all, so the person can regulate and get out of the constant stress zone and feel calmer and more comfortable around you and close people. Once the person has achieved this "relaxed zone", you can build a collaborative plan, probably better with the therapist and parents involved somehow, to let the PDA person experience dosed challenges (so in this stage not accomodate all the anxiety, but let the person experience it in a moderate/low level). With this, the goal is that the person can develop better coping skills and be more functional. It just needs to me done in a "natural" way, not forced, in a more "go with the flow" style. If the PDA person can feel like they are being able to navigate through small steps it can be very rewarding and make a very positive impact on their behaviour.
About the choices/rewards it can definitely come across manipulative but I think it will depend in which mind state the person is and how you present them. If you are able to internalize a non-expectative/non-demanding type of comunication and behaviour you will probably be succesfull with this aproach. It's more about feeling comfortable around eachother
Maipulation is not a bad thing, you can use it for bad things but manipulating means just coveret influence.
The good or bad part is something that is in their human using it.
Parent manipulate children all the time.
Kid whining, parent helping to stop cry?-> Manipulation in most cases
same for partners, family etc
This sounds utterly impossible. Do everything, anything, or nothing…they will take it as a demand.
I agree it seems super difficult. I think that as a late diagnosed autistic person who is trying to navigate this with my son the thing that is helping me is to remember how much harder it is for them as a child and not having any context or experience and even less control of their environment. Having that empathy I feels helps me.
@@janetostergaard598how do you feel when you envision your future? I recently started caring for a 19 year old with this and he has never been able to have the opportunity to build upon his life experiences because of these symptoms. He can’t go out and get a job and learn how the world works. So when I think “poor baby he just doesn’t know how the world works” I then get more depressed knowing he will never change because he can’t get out and experience the world.
@@Brandi_Hill I suggest reading the book The Essential Guide to Raising Complex Kids. It talks a lot about shifting your own views so that you are able to help yourself and the child recognize their accomplishments. Even if they may not seem like a big deal you have to view it through the lens of where they are coming from and then you can recognize growth. I know for my own kid it doesn't ever seem like he makes the connections of cause and effect based on where I am but if I look at where he is and what he has done I glow with pride knowing what he has overcome. My child is also gifted, so to the world he is lazy or uncaring or without direction because they don't see the inner struggle. They just think he is smart so why isn't he doing this thing that he is perfectly capable of. I as his mother know that is not the case at all. I see when he has these moments where he is so stressed because of demands that he either lashes out (verbally or physically), shuts down completely and will sleep for 18-20 hours straight, or just starts crying. He can't express what is going on for him. That fight, flight, fawn has completely taken over all of his mental capacity and he needs to reset. It doesn't necessarily happen quickly. I try to reduce these triggers at home.
@@Brandi_HillI struggle with this. My parents never understand and try to force me to be “normal”
@@Brandi_Hillhave u been able to try any occupational therapy..? Our occupational therapist is the one who finally recognized it in my 16 year old. Also At Peace Parenting is a great resource. Wish you the best!