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Being Extraordinary For The Extra Ordinary!


How to successfully maintain a school placement for a child with pathological demand avoidance.

Being Extraordinary For The Extra Ordinary!

A significant number of children with pathological demand avoidance (PDA) have an educational history that is punctuated by multiple and often lengthy periods of expulsion. This can vary from internal expulsion with limited access to a usual classroom or special activities to permanent expulsion with long periods at home while parents seek a school placement that can meet their child’s needs. Over time, this leads to a lack of positive peer relationships for the child with PDA, resulting in poor self-esteem and a child functioning way below his/her educational potential. 

Whilst this is a common problem, some schools are developing a deeper understanding of demand avoidance and are putting into practice a flexible approach for these children that is proving successful at maintaining a quality placement. Some simple adaptations can be made that can make life-changing and sustainable differences for children and their families.

We’re all in this together

Firstly and most importantly, children with PDA need to be supported by a consistent team of professionals with a deep understanding of the condition. This starts with a commitment from school leaders who give time to share family stories, ensuring that staff understand that the unusual behaviors are anxiety-driven and not a result of “naughty behavior”. 

Enrolling every member of staff into this positive understanding of the condition, whether they are hands-on workers or staff that just pass in the corridor, is vital to providing a whole-school approach. Equally important is the honest approach required to grow the understanding of the condition with peers. Simple explanations of unusual behavior bring acceptance and empathy that enable children with PDA to grow through their mistakes and minimize future anxieties.

Creating a specialized team

Not every member of staff is cut out to work with such extraordinary children, but identifying those that are is a key to long-term success. Leaders need to pick staff carefully at the recruitment stage and prepare and train staff well before they begin their role. Even for staff with high emotional intelligence, regular support and reflective practice is a must. Knowing and accepting adult behavior that instigates or exacerbates anxiety behavior in children with PDA is another key to maintaining the long-term culture needed for success.

Building relationships that promote emotional wellbeing

An emphasis on building positive relationships above curriculum planning is a vital component to maintaining a school placement. Staff need to spend time becoming an expert in each child’s special interest and skilfully learn to use this knowledge to engage them. Over time, relationships change from just having fun together to being able to use the special interests to teach all kinds of curriculum knowledge and personal skills.

Children with PDA have a heightened awareness of adult thinking and intentions in a way that is not apparent in children with ASD without demand avoidance. Speaking with a child or young person as an equal is an important part of the relationship-building process. Learning to depersonalize rules also goes a long way to building a trusting relationship with a child.


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Shifting the blame for a safety rule to a government statute or community law helps to maintain the relationship with the adult that has to enforce the rule in the school setting.

Fixed rules and behavior programs are normally not successful for children with PDA. Instead, a flexible approach, based on knowledge of the child’s anxiety levels and how these relate to a child’s level of demand avoidance, is a much more productive method. A simple tolerance/demand synchronization slide aids staff in understanding and implementing this important approach.

It is important to identify what a child’s behavior looks like when their anxieties are low, medium, or high. Once this is known, staff members can increase demands when tolerance levels are high but reduce demands when they are low. Flexibility above consistency sees better long-term results.

Adaptations to the environment

Permission to adapt the school classroom or wider environment is also a necessity to lower anxiety levels in children with PDA. 

Most children require their own learning area or safe space within a shared classroom, and those at the severe end of the demand avoidant spectrum will most likely need their own classroom. Preparing and laying out learning equipment will probably be seen as a demand, and therefore having equipment stored close by and ready to include once a child has been drawn into an activity is a more effective approach. 

Environmental adaptations should never be seen as a failure but as a necessary strategy for effective access in the same way that a child with a physical disability may need a wheelchair, or a child with a visual impairment a pair of glasses. 

Once environmental adaptations are seen to work they should be shared with the entire team. Sharing successes helps to encourage and support the team and promotes a sense of achievement—often accompanied by an ongoing commitment to the young person.

Conclusion

Children with PDA have exactly the same entitlement to education as any other child. Schools that insist on the child fitting into the school behavioral, teaching, and learning model will never succeed with these extraordinary children. 

Educational provisions willing to adapt to the child’s individual needs and learning style and to ensure these approaches are fully understood by the whole school community will stand a good chance of providing an effective long-term placement. 

The journey is never an easy one, but it is always rewarding for the school and for those children and families that are so often misunderstood or forgotten by our school systems. It really can be life-changing!

This article was featured in issue issue 123 – Autism in girls

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