# data[].attributes.body
Although a contested word 'masking' has become a explanation for people who are able to able to 'hide' autistic traits. This article talks about the difficulty of supporting children when they have been able to behaviour in a certain way at school but when at home, in their safe space, they need to release or let go of their self restraint or control. This can be very difficult for families and it is important for us to recognise and offer support

# data[].attributes.attachment_link.title
When “fine” at school isn’t fine at home: the hidden cost of autistic masking on families — Special Needs Jungle

# data[].attributes.attachment_link.description
When “fine” at school isn’t fine at home: the hidden cost of autistic masking on families. The difficulties of parenting a child who masks

# data[].attributes.body
Autism in girls can look very different and not be noticed or apparent until they are much older - even though it is argued the signs are still there. Much of our understanding has been led by a male representation and lots of signs are missed in girls where they camouflage/mask in public, and actions or behaviours happen internally or in privacy or safe spaces. This is a area of research that is becoming more prevalent. This is not an EY website but does give helpful information.

# data[].attributes.attachment_link.readable_text
4 times as many boys are diagnosed autistic as girls. This is not an accurate picture.

Frequently, for many reasons, girls are diagnosed later (on average up to 6 years later), missed or misdiagnosed, causing long term mental health problems with too many girls feeling too anxious to attend school as a result.

Currently the assessment tools used to screen for autism are male-centric. We want to see tools in place that reflect multiple presentations and needs so that no child's need goes unrecognised or unsupported. We are currently pilot-validating the Internal Presentation of Autism Checklist that sits within our white paper Autism, Girls and Keeping it All Inside , so expect that to change soon. Our survey had 1123 responses in a week, so there are many people who feel strongly about having screening tools which feel representative. Our vision is for a system that enables autistic girls to thrive, to feel understood and to achieve the best educational outcomes.

Our aim is to raise awareness of autism in girls and others who present in an internal way with health, social care and educational professionals and to bring change. Not only to the way that autistic girls are assessed and subsequently supported but to the narrative, with updated and positive terminology used to describe autistic traits.

Our private Facebook group supports both autistic girls and women and their extended families, but there are many more who need our help. We are now a registered charity, fundraising to enable us to both fund projects which offer face to face support and campaign for real change.

# data[].attributes.attachment_link.description
We are a small registered charity working to support, educate, and bring change. Here you will find lots of resources.

# data[].attributes.body
This webinar takes what we know about Autism and ADHD and talks about what AuADHD is and what is looks like. It is not a formal diagnosis but we are seeing more children who are presenting with AuADHD. However, the way we research and look at Austism and ADHD is historically separate. This webinar looks at what the combination might look like and how we can support it. The information is about older children so not all will be necessarily appropriate for children in early years

# data[].attributes.attachment_link.title
AuDHD: Practical Strategies For Co-occurring Neurodivergence

# data[].attributes.attachment_link.description
In this webinar, we share practical strategies for supporting children with AuDHD, exploring its complexities, overlapping neurodivergence, and the AuDHD profile.

# data[].attributes.body
This is a free resource from Play Move Improve website and shows some of the exercises to support reflex integration.

# data[].attributes.body
This infographic is from the Young Wellbeing hub and recognises that ADHD presents differently from person to person. Remember that Autistic and ADHD girls will present differently too.

# data[].attributes.body
Another point made to add to this was the experience of intense curiosity especially for new experiences!

# data[].attributes.body
Too often, play is shaped by invisible expectations, or we impose on play to correct, fix, or intervene. Much of this comes from what we have been taught about play: that it should be functional, appropriate, or that children must demonstrate a standardised repertoire of play skills for it to be considered valuable. But what happens when a child’s play does not fit these expectations? Freedom in play means facilitating environments that are free from neuronormative expectations, free from the pressure to perform, progress, or conform. Freedom in play is not about the absence of boundaries, it is about creating spaces where play can expand, move, and belong in all its forms. So as we think about what play should be free from, we can also reflect on what we want play to be rooted in.

# data[].attributes.body
Many approaches in education, therapy, and parenting circles now describe themselves as being “interest-led.” It sounds positive on the surface and it can be but too often, this language is hiding something less affirming underneath. When being “interest-led” is reduced to using a child’s passions as tools to get a child to comply, to build eye contact, or to meet neurotypical goals, it stops being neuro-affirming – it becomes coercion dressed up as kindness and is no longer child-led.

# data[].attributes.attachment_link.title
Why “Interest-Led” Isn’t Enough: Embracing Monotropism & Neuro-Affirming Practice | Autistic Realms

# data[].attributes.attachment_link.description
Many approaches claim to be “interest-led,” but true neuroaffirming practice goes deeper. Being monotropism-informed means honouring Autistic attention, aut…

# data[].attributes.headline
An Introduction to Neuro-affirming practice in EY

# data[].attributes.subject
An Introduction to Neuro-affirming practice in EY

# data[].attributes.body
EmpathyLab develops, activates, and celebrates the power of stories to increase real-life empathy. Through reading, we help children and young people understand others, grow emotionally, and thrive

# data[].attributes.attachment_link.description
Research Our strategy is built on two key areas of scientific research – that empathy is a learnable skill and that reading builds real-life empathy Meet the team Our values Our impact What is empa…

# data[].attributes.body
Sensory circuits are structured activities designed to help children regulate their sensory systems so they can be more ready to engage in learning, play, and social interaction. Circuits for school children can be adapted to early years provision and pedagogy.

# data[].attributes.body
" This is a piece of work that has come out of many years of playing working with and alongside Autistic children, young people, and adults with a hug range of interests experiences, needs and ways of being."

# data[].attributes.body
This article explains spoon theory, how we can understand energy levels in Autistic children, an what this might mean in relation to their everyday experiences and behaviours

# data[].attributes.attachment_link.readable_text
My friend @AnnMemmott who blogs at Ann's Autism Blog first introduced me to the Spoon Theory in relation to autism. It was originally created by Christine Miserandino when asked about her chronic illness, ( you can read the original post here) but is a great way of helping us understand why school is such hard work for children with autism. @aspiemusings has also written a good post about how it relates to her as an autistic adult.

Let's imagine that the social and intellectual energy a child has each day can be measured in spoons....

A child with autism can start the school day with a full drawer (which may be only half as full as a typical child) or with some of their spoons already used up in dealing with the demands of getting to school. Depending on various factors such as whether they slept, if mum remembered to say goodbye the right way, if their clothes are itching their skin, if their routine was changed, or any number of other seemingly incidental events...they may be starting the day with, say, only 5 spoons instead of 10.

Then they need to start using their spoons. Each set of instructions, each set of work demands, each time they have to organise themselves, follow a complex set of instructions or cope with change, and each social interaction may cost the child a spoon. If there are sensory sensations that are overwhelming, then another spoon is used up in regulating and keeping calm. If the child has to work in a group more than one spoon may be needed. Break times are not relaxing, another spoon or two is used up in coping with all the social interaction, noise and lack of structure. Some children manage to save a spoon by shutting off, taking the time to be alone, so that they can cope with the next set of lessons.

I hope you can see what might be happening here.

When there are no more spoons...

Do you have a child who seems okay in the morning but always seems to lose it in the afternoon? Or you have a child who won't join in anything at break times and paces around the perimeter of the playground? Or a child who seems to be having frequent meltdowns some days but is fine on other days? Or parents ask you what you are doing to their child as they always have a meltdown as soon as they come out of school? And getting them to do homework is impossible.

You might assume you need more structure in the afternoons. You might assume you need to teach the child some social skills so they can make friends at break times. You might assume the parent isn't disciplined enough. You might put all kinds of practical support in place, but it doesn't really work.

Or it may just be that the child has used up all their spoons. They have no communication, organisation, sensory, social or intellectual energy left. They might just be able to keep it together in the morning, but then are far too exhausted to carry on in the afternoon. Some days there may be no spoons to deal with the things they usually seem okay with. They might even be able to keep it together through the day but cannot contain themselves in the safety and familiarity of their home. Some children even manage to borrow spoons from the next day but there will be a day when there are no spoons left to borrow and the child has a major meltdown.

Credit: Adapted picture from https://musingsofanaspie.files.wordpress.com/2014/10/my-spoons.jpg

We can help by recognising the limited amount of spoons a child with autism may have. We can help them conserve their spoons to last through the day and we can help them find ways of finding ways to add to their supply (not as easy as it sounds). Through:
Essentially, we can boil these strategies down to one key component: Think about adjusting the demands on the child according to the tolerance and energy they have available, (i.e., spoons they may have left)!
If you understand the child and they can trust you, they will feel safe, they will feel understood and they will be able to cope with more challenges than you might have thought possible. Maybe you should keep a couple of spoons on your desk with the child's name on, and remove one when things are not going so well for them. Then think about how you would cope with just one spoon left and no way of buying any more...
Autistic children and young people often face a range of challenges in school often putting them at additional risk of experiencing Emotional Based School Avoidance (EBSA). If EBSA is an area which you're supporting Children and Young People with, we've been fortunate to work with Dr Jerricah Holder on her EBSA Horizons courses for Educational Psychologists and School Staff.
- New ** EBSA Horizons | School Training

Stay connected with news and updates!

Sign up to receive updates, resources, inspiring blogs and early access to our courses.
Don't worry, your information will not be shared.

# data[].attributes.attachment_link.description
Spoon Theory is a useful analogy that can be used to help us understand how much more effort can be required for autistic individuals to negotiate everyday demands in comparison to neurotypical individuals.

# data[].attributes.body
The expression of emotion tends to be seen through a neuro-typical lens meaning the alternate and different ways children who are neurodivergent express themselves can be dismissed or miunderstood. This article from Stimpunk explains 5 ways of expressing emotions that do not include hugging or kissing but just as meaningful and deep.

# data[].attributes.attachment_link.description
The 5 neurodivergent love languages: infodumping, parallel play, support swapping, Please Crush My Soul Back Into My Body, Penguin Pebbling

# data[].attributes.body
This is a very informative website it you are new to the idea of montropism to support play.

# data[].attributes.attachment_link.title
Monotropism and Autistic Play | Autistic Realms

# data[].attributes.attachment_link.description
All play is ok! There is no right way to play! All play is ok! There is no right way to play! To embrace Autistic play is to embrace the theory of monotropi…

# data[].attributes.body
This handout provides an initial explanation of the relational and playful approach of Intensive Interaction. The links in the handout and the Just One Norfolk website will provide more information and videos too.

# data[].attributes.body
Athough the evidence on discrete formal stages of Gestalt Language Processing is under debate, we can agree that being neuro-affirming and respecting children's preferred communication style is important.

# data[].attributes.body
Intersectionality is a term used to describe how different aspects of a person's identity—such as gender, race, class, disability, and sexuality—interact and overlap, often creating unique experiences of discrimination or disadvantage. It is important that we are able to reflect and consider intersectionality to support inclusive practice.

# data[].attributes.attachment_link.title
A Beginner’s Guide to Intersectionality in the Early Years | Tapestry

# data[].attributes.attachment_link.description
This free document has been created to support childminders, nurseries and schools interested in having conversations about intersectionality

# data[].attributes.body
Autistic girls often show different traits than autistic boys, which has led to many people being overlooked or misdiagnosed. We also need to be aware of our own biases and assumptions when we consider how gender affects the way autism presents. It's equally important to think about intersectionality—how different aspects of a person's identity, like gender, race, or disability, can combine to create unique challenges, especially for those who are not neurotypical. Warda Farah is a trustee of Autistic Girls network. have a look at her download from Tapestry on Intersectionality.

# data[].attributes.body
This is an excellent 5 minute video that explains the double empathy theory of Damien Milton and the empathy gap that appears between non-Autistic and Autistic people - and how it is Autistic people that suffer the most.

# data[].attributes.attachment_link.title
An introduction to the Double Empathy problem

# data[].attributes.body
If you feel that sometimes you are not sure of the right language to use this handy infographic goes through the do's and don'ts of certain phrases and language and more importantly why.

# data[].attributes.body
We know how important play is and this booklet talks about the relevance and importance of play for Autistic children. It covers lots of points and gives some great tips to support play.

# data[].attributes.body
This booklet is a excellent go-to if you want to find out about the do's and don'ts when talking about Autism. If offers explanations around why certain language is undesirable and alternatives to ensure as a society we are talking about people as individuals in a positive way

# data[].attributes.body
This is a great video by Witherslack with Colin Foley at the ADHD foundation to explain DCD/dyspraxia and how we can support children in settings. It is underdiagnosed but it is important to recognise what it might look like and the co-occurring issues which can overlap with other learning difficulties.

# data[].attributes.body
This blog by Kerry Murphy talks about mirroring play, parallel play and looking for play patterns. Looking at how play is developmentally meaningful for the child helps us to support it.

# data[].attributes.body
This podcase from Early Excellence talks about the importance of repetitive play and schemas. It makes clear that we will be seeing children in settings with schemas later than perhaps we might expect because of the pandemic and that this part of play and development is vital and needs to be supported.

# data[].attributes.body
This website offers some ideas around transitions which we know can be difficult for our little ones. This website also has other information and resources including help for potty training!

# data[].attributes.attachment_link.readable_text
Do you want to facilitate a smoother transition for your child or student with autism? I'm sure you have wondered why transition breakdowns occur so often and how you can help! These 7 strategies can help make transitions smoother for your little ones with autism. First things first. As an educator or therapist, it is imperative to start by building a positive relationship with your student. If you don't have a positive relationship, helping a child do hard things (like transition) is going to be even more challenging. Next up, what is a transition? A transition can look like: a child moving between activities, moving between different areas in the classroom, or between different areas in or out of the building. Sometimes the breakdown in the transition occurs when it is a move from a highly motivating activity to a less preferred activity. Sometimes the transition might break down when a child doesn't understand where they are going. At home, transitions can include: waking up in the morning, getting dressed, having to be done playing with certain toys, leaving the house to go to school, and getting ready for bed. Fostering a smoother transition requires some special techniques, consistency, and patience.

WHY ARE TRANSITIONS HARD FOR LITTLE ONES WITH AUTISM?

Transitions and change can be difficult for ALL children (and adults!). But, for autistic children who have the tendency to become very engaged in the activity that they are doing, transitions can trigger meltdowns. It can be hard to "switch gears", especially when they thrive on consistency and routine. When autistic children are forced to switch gears without support, it can cause extreme stress and anxiety. Our job is to figure out how to prepare children for a smoother transition. We can help make transitions more predictable and routine-based. Some of the visual supports included in these tips can be found at no cost here.

SUPPORTING TRANSITIONS IN CHILDREN WITH AUTISM

The best way to start thinking about how to support transitions in autism is to plan ahead, be prepared and be consistent. When the following strategies are implemented and used on a regular basis, it adds some structure and predictability to transitions. It doesn't mean that you will never see another meltdown or resistance during transitions, but you should certainly see a reduction in stressed reactions during transitions. I always like to look at it like this...if I was sitting down reading a really good book and someone came and grabbed the book out of my hand and took it away without warning, I would be pretty upset. Quite often, this is how our students with autism feel....like we pulled out the rug from underneath them during many transitions throughout the day. We need to PREPARE our students/children for transitions ahead of time when possible. When you think about parenting a typically developing child, you might give a verbal warning of "two minutes, then clean up". But, for children who aren't processing auditory input effectively, this cue may be totally meaningless. That is where visual supports come into play. Each of the 7 strategies that I will share have a visual component to them. This is because we know that autistic children tend to be visual learners. We need to provide the preparation for transitions in a visual and predictable format. It is also very important to have these visual supports in several places around the classroom or home so they are easily accessible to you. Then, you will be prepared.

TRANSITIONS AND AUTISM STRATEGY #1:

Use a first-then board or visual schedule. A first-then visual support shows children the sequence of what they will be doing. It can be the starting place, before using a longer visual schedule. Simply bring the first-then board to your child/student, point to, and say what is on each picture. This is a great way to prepare them for the upcoming transition. For example: if my student is at the table eating a snack and I know we will be transitioning to a 1:1 learning time next, I will have the first-then near them and bring it to their attention a couple of times during snack. "First snack, then green table". A visual schedule will have a longer sequence of activities. Many students start with a "first-then" board and then move on to a visual schedule that shows a sequence of 4-5 activities. Beyond that, many children are able to move to a half-day or full-day visual schedule.

TRANSITIONS AND AUTISM STRATEGY #2:

Utilize a transition object. A transition object is just an object of any kind that can be carried in one hand by a child. It could be a toy or other favorite object (stuffed animal, matchbox car, brush, etc...). The student may have a favorite little toy that they bring to school, or it can be something from school. They could use the same transition object all day long, or you could offer something different for each transition that you anticipate could be difficult or stressful. Simply show your student the picture of what is next, and hold out the transition object for them to hold as they make that transition. Transition objects can reduce stress and anxiety, as well as shift the child's attention from the activity they were doing.

TRANSITIONS AND AUTISM STRATEGY #3:
Use a wait mat. What do you do when your student is carrying a transition object, but it is getting in the way of paying attention during a 1:1 learning session? Using a "wait mat" can provide a structure/system and create a routine around letting go of the object during learning time. This is different from the all-done bucket (strategy #6) because the child doesn't have to be all done holding the object. Instead, it is just a short break from holding it. Simply set the object on the wait mat and let the toy "watch" your student do his or her work. Once they are done, they can have the object back again!

TRANSITIONS AND AUTISM STRATEGY #4:
Give some wait time. Why are we always in such a hurry? I know, I know ... in the classroom, you have some pressure to keep the schedule moving along. However, if your student has dropped to the floor and isn't moving to the next activity or place, sometimes the best approach is to wait. Let them have their moment to be upset, regroup, and calm down. This is a great time for you to brainstorm what other strategy might help redirect them to thinking about something else. Sometimes they just need a hug. Sometimes they just need some quiet. There is no harm in just waiting them out for a while and moving on when they are ready. This is a very under-utilized strategy!

TRANSITIONS AND AUTISM STRATEGY #5:

Use a timer. As an activity is coming to an end, it can be very helpful to use a timer to signal that it is finished, thus time to transition. This can help provide that consistency and predictability for students, which leads to a smoother transition A beep from an inexpensive kitchen timer works great (unless your student exhibits sensory defensiveness and the sound is too much for them). Usually, the kitchen timer works well because the beeping provides that cue to help the student shift their focus. You can use a visual timer if that is what works best for the child.

TRANSITIONS AND AUTISM STRATEGY #6:

Make and use an all-done bucket. The all-done bucket is a magical strategy! Once a child learns how to use it, it can help SO much! When it is time to be all done with a toy or an activity, bring the all-done bucket to your child or student and help them put the object in the container. This works with toys, tablets, playdough, crayons...almost anything! After you have facilitated the use of this consistently, all you will need to do is put the all-done bucket in front of your student and they automatically place the object into it. I've seen it work over and over again. The key is to introduce it and use it consistently so that it becomes a predictable routine. The use of an all-done bucket has greatly reduced stress over being "all done" with certain items with my students.

TRANSITIONS AND AUTISM STRATEGY #7:

Use a star chart. This star chart is used to count down time. It is NOT a chart to "earn" or "lose" stars. Using a star chart is a form of duration mapping. It provides a visual way to countdown time to something. I use this every day on the playground and during our gym class when we have free time. This is how it works: take all of the stars off, and place the picture of what is next at the end of the chart (this could be a "check" to indicate "check schedule", or it could be a picture of the activity that comes next). Then, as time goes on, my staff and I walk around and show our students, "one star....four more then ____" as we place a star on the chart. The nice thing about counting down time with the star chart is that we can make it go as slow or fast as we want to. We aren't bound to a timer with an exact number of minutes. This comes in handy when a student is showing signs of stress and we need to end the activity on a positive note. We can hurry up and put the stars on and move to the next activity. The opposite is also true. If everything is going smoothly, we can extend the activity by putting the stars on more slowly. Continue putting the stars on and showing all of your students when each new star is on the chart. With repetition and consistency, they will start to understand what this means and it will better prepare them for the transition when it is time to shift gears. I LOVE this strategy!

COMBINING THESE STRATEGIES FOR SMOOTHER TRANSITIONS FOR STUDENTS WITH AUTISM
As you may have guessed, many of these strategies can be used in tandem when supporting transitions in your students with autism. For example: If I am working 1:1 with a student, I show them the first-then board. First learning time, then toy cars. Once they finish their work, I say "learning time is done, time for cars!", as I refer to the first-then board again. After a few minutes, I set the timer for 2 minutes and say "two minutes, then check schedule". Once the timer beeps, I offer the all-done bucket for them to put the cars in and hand them a picture of a "check" to go check their schedule.

Click here to grab a free set of visual supports that include the visuals for a first-then board, all done bucket, star chart, and wait mat!

Click here to watch the free FB Live mini-training on the topic of encouraging smoother transitions in young children with autism.

If you haven't checked out these resources from Autism Little Learners yet, you definitely should! They will help your child or students with communication and self-regulation skills:

If you found this blog post helpful, you may also like these blog topics from Autism Little Learners:

Click here to watch the Facebook Live Mini-Training titled "7 Ways To Encourage Smoother Transitions In Young Children With Autism".

# data[].attributes.attachment_link.title
7 Ways to Encourage A Smoother Transition in Young Children with Autism

# data[].attributes.attachment_link.description
Do you want to facilitate a smoother transition for your child or student with autism? I'm sure you have wondered why transition breakdowns occur so often and how you can help! These 7 strategies can help make transitions smoother for your little ones with autism. First things first.

# data[].attributes.body
This is a booklet that summarises the Key Legislation for SEND including links.

# data[].attributes.body
These are recent webinars for parents and teachers. Although they are talking about children from 4, there is lots of information about neurodivergence that would be helpful.

# data[].attributes.attachment_link.description
Edinburgh Psychoeducation Intervention for children and young people

# data[].attributes.headline
An interest based brain - not importance based¬ 

# data[].attributes.subject
An interest based brain - not importance based¬ 

# data[].attributes.body
In the infographic column we have a simple illustration of what motivates an interest based brain (ADHD) and an importance based one. Motivation is a tricky aspect of ADHD. Children are accused of not being motivated, being lazy, and the classic "if they wanted to do it they would - they just don't want to". If you have worked with or have children with ADHD you will know how hard it is to dis-spell or attempt to explain this myth.This article explains how an interest based brain works and how supporting an interest based brain can help behaviour and executive functioning and motivation.

# data[].attributes.attachment_link.readable_text
ADHD motivation can be a finicky thing. It's a hard thing to trust. One of the reasons I fall into hyperfocus and struggle to task-switch is that I don't believe the interest and motivation will return should I decide to leave that task! The inconsistent motivation of ADHD can make it difficult to plan and to trust ourselves. We'll dive into all that in a minute.

In our last post, we explored the concept of the interest-based nervous system and how it differs from the more common importance-based system. If you missed it, you can catch that here. Today, we will dive deeper into the role dopamine plays in motivation and break down the core motivators that drive the ADHD brain. Understanding these motivators is key for learning how to work with our natural tendencies rather than against them.

Motivation Systems: Interest-Based vs. Importance-Based

An importance-based system prioritizes tasks based on responsibility and external pressures. People with this system are driven to complete tasks because they are significant to them personally, important to someone else (like a boss or teacher), or tied to clear rewards or consequences. For instance, tasks may be deemed important because they are:

Personally significant (Importance)

Important to someone they care about (Secondary Importance)

Tied to rewards or consequences (Rewards/Consequences)

In contrast, those with an interest-based nervous system might understand the importance of tasks but still struggle to initiate them until they become urgent. Our motivation hinges on factors like interest, novelty, play, and challenge-elements that stimulate dopamine production.

The ADHD brain thrives on several core motivators. Dr. Dodson originally coined the acronym ICNU to describe these; but it has since been popularized as PINCH, a more memorable acronym. PINCH stands for:

Passion (and Play): Engaging in activities that are enjoyable and intrinsically motivating.

Interest: Focusing on tasks that are inherently fascinating and captivating.

Novelty: Seeking out new, shiny, and exciting experiences to maintain engagement.

Competition (Cooperation or Challenge): Adding an element of competition, working cooperatively, or turning tasks into challenges to make them more engaging.

Hurry (Urgency): Completing tasks under time pressure to create a sense of urgency.

Unfortunately, many societal systems, including schools and workplaces, are structured around importance, creating a conflict for those of us with an interest-based nervous system. This misalignment often leads to tension and burnout. Let's take a detour to understand dopamine's role in this dynamic.

Dopamine and an Interest-Based Nervous System

To understand the interest-based nervous system, it is helpful to understand the role dopamine plays in our motivation. Dopamine is a neurotransmitter that plays a key role in both our reward circuit and motivation. It motivates us to move toward things we anticipate being rewarding - so much so that when dopamine was depleted in mice, they stopped eating because they no longer found it rewarding or motivating. Dopamine is essential for normal "wanting" and motivation.

Dopamine and Motivation

The ADHD brain regulates dopamine differently than the neurotypical brain, which likely contributes to the motivation drivers of our interest-based nervous system. While the dopamine theory of ADHD is sometimes criticized for being overly simplistic, brain scan studies have uncovered differences in ADHD dopamine activity. In fact, one of the reasons stimulant medications work for ADHD is that they block dopamine reuptake, thus allowing dopamine to stay in the system longer.

For me personally, the dopamine theory has been helpful. Before understanding my ADHD, I often talked about having a "broken dopamine system." I found myself aimlessly searching for dopamine, which I called the "dopamine scroll"-looking for chocolate or snacks, scrolling social media, or searching for dopamine in more unfortunate ways. I was looking for something to motivate me, and scratch the dopamine itch.

Dopamine drives brain activity and, like other neurotransmitters, helps neurons communicate with each other over short distances. When we have enough dopamine in our system, our brain can learn more efficiently, mobilize for action, and communicate and alert the necessary brain regions. Dopamine is like lubrication for the brain neurons; so it just makes sense to me that the ADHD interest-based nervous system depends on activities that activate dopamine to get things going! Initiating a task without the support of dopamine is like trying to start a car in the middle of winter and go from 0 to 100 at the getaway.

ADHD Motivation Is Difficult

The inconsistencies in ADHD motivation can be particularly challenging. It's the variability in our motivation that often confuses people (others and ourselves) and leads to the anguished question: "But you could do this last week, why can't you do it today?!"

Let's revisit the ADHD motivators to see why they can be so elusive:

Novelty

By nature, novelty and newness are time-limited. Things that are novel and new only remain novel and new for a period of time. Notice how your organizational "ADHD hack" has to keep changing to be shiny and new? Once the novelty wears off, we often need to find new "hacks" and supports. This is the reason Dr. Dodson recommends having 60-100 different techniques that can be rotated so old ones are revisited and feel new again.

Challenge

Once we have risen to a challenge and conquered it, it's no longer challenging. Unless we build scaffolding to stretch it a bit further, the motivation around it will stop once we have completed the challenge.

Urgency

Urgency substitutes for importance. A person with ADHD cannot get engaged with a task merely because it is important. As Dr. Dodson notes, sometimes a person will create crises and chaos because they have found that helps them get engaged and get things done. This pattern of creating chaos to motivate can be mistaken for Borderline Personality Disorder.

Interest and Passion

Passions and interests can spark and fade quickly for ADHDers, but can be more enduring for ADHDers who also have the autism sidekick. This is why I often say I have empathy for ADHDers who haven't been gifted with the autism bonus pack. For ADHDers, interests and passions can rotate quickly-today it's knitting, tomorrow it's learning the ukulele. For AuDHDers, we often have some enduring interests and passions that can help weave our attention together (although we still need to get creative with harnessing those passions).

Because these motivators can be fickle little things; our attention, focus, and engagement can often feel unpredictable. This is one of the enduring frustrations for many people with ADHD (and those in our lives who are also impacted by these inconsistencies). The more we try to fit into an importance-based system, the more strain, burnout, and inconsistency we may experience, which is why it is important to learn how to work with the system we have rather than trying to fit into a system that doesn't align with us.

Conclusion

Next week's post will focus on how to work with our interest-based system to align with our motivators more effectively. By aligning our activities with our natural motivational pulls and forces, we can reduce burnout and increase our sense of agency.

Citations

Bromberg-Martin, E. S., Matsumoto, M., & Hikosaka, O. (2010). Dopamine in motivational control: rewarding, aversive, and alerting. Neuron, 68(5), 815-834. https://doi.org/10.1016/j.neuron.2010.11.022

Szczypka, M. S., Rainey, M. A., Kim, D. S., Alaynick, W. A., Marck, B. T., Matsumoto, A. M., & Palmiter, R. D. (1999). Feeding behavior in dopamine-deficient mice. Proceedings of the National Academy of Sciences of the United States of America, 96(21), 12138-12143. https://doi.org/10.1073/pnas.96.21.12138

Dr. William Dodson, HOW ADHD SHAPES YOUR PERCEPTIONS, EMOTIONS & MOTIVATION, Presentation. Retrieved from: https://adhd.dk/wp-content/uploads/sites/2/2022/05/Dodson-How-ADHD-Shapes-Your-Perceptions-Emotions-.pdf

ADHD motivation can be a finicky thing. It's a hard thing to trust. One of the reasons I fall into hyperfocus and struggle to task-switch is that I don't believe the interest and motivation will return should I decide to leave that task! The inconsistent motivation of ADHD can make it difficult to plan and to trust ourselves. We'll dive into all that in a minute.

In our last post, we explored the concept of the interest-based nervous system and how it differs from the more common importance-based system. If you missed it, you can catch that here. Today, we will dive deeper into the role dopamine plays in motivation and break down the core motivators that drive the ADHD brain. Understanding these motivators is key for learning how to work with our natural tendencies rather than against them.

Motivation Systems: Interest-Based vs. Importance-Based

An importance-based system prioritizes tasks based on responsibility and external pressures. People with this system are driven to complete tasks because they are significant to them personally, important to someone else (like a boss or teacher), or tied to clear rewards or consequences. For instance, tasks may be deemed important because they are:

Personally significant (Importance)

Important to someone they care about (Secondary Importance)

Tied to rewards or consequences (Rewards/Consequences)

In contrast, those with an interest-based nervous system might understand the importance of tasks but still struggle to initiate them until they become urgent. Our motivation hinges on factors like interest, novelty, play, and challenge-elements that stimulate dopamine production.

The ADHD brain thrives on several core motivators. Dr. Dodson originally coined the acronym ICNU to describe these; but it has since been popularized as PINCH, a more memorable acronym. PINCH stands for:

Passion (and Play): Engaging in activities that are enjoyable and intrinsically motivating.

Interest: Focusing on tasks that are inherently fascinating and captivating.

Novelty: Seeking out new, shiny, and exciting experiences to maintain engagement.

Competition (Cooperation or Challenge): Adding an element of competition, working cooperatively, or turning tasks into challenges to make them more engaging.

Hurry (Urgency): Completing tasks under time pressure to create a sense of urgency.

Unfortunately, many societal systems, including schools and workplaces, are structured around importance, creating a conflict for those of us with an interest-based nervous system. This misalignment often leads to tension and burnout. Let's take a detour to understand dopamine's role in this dynamic.

Dopamine and an Interest-Based Nervous System

To understand the interest-based nervous system, it is helpful to understand the role dopamine plays in our motivation. Dopamine is a neurotransmitter that plays a key role in both our reward circuit and motivation. It motivates us to move toward things we anticipate being rewarding - so much so that when dopamine was depleted in mice, they stopped eating because they no longer found it rewarding or motivating. Dopamine is essential for normal "wanting" and motivation.

Dopamine and Motivation

The ADHD brain regulates dopamine differently than the neurotypical brain, which likely contributes to the motivation drivers of our interest-based nervous system. While the dopamine theory of ADHD is sometimes criticized for being overly simplistic, brain scan studies have uncovered differences in ADHD dopamine activity. In fact, one of the reasons stimulant medications work for ADHD is that they block dopamine reuptake, thus allowing dopamine to stay in the system longer.

For me personally, the dopamine theory has been helpful. Before understanding my ADHD, I often talked about having a "broken dopamine system." I found myself aimlessly searching for dopamine, which I called the "dopamine scroll"-looking for chocolate or snacks, scrolling social media, or searching for dopamine in more unfortunate ways. I was looking for something to motivate me, and scratch the dopamine itch.

Dopamine drives brain activity and, like other neurotransmitters, helps neurons communicate with each other over short distances. When we have enough dopamine in our system, our brain can learn more efficiently, mobilize for action, and communicate and alert the necessary brain regions. Dopamine is like lubrication for the brain neurons; so it just makes sense to me that the ADHD interest-based nervous system depends on activities that activate dopamine to get things going! Initiating a task without the support of dopamine is like trying to start a car in the middle of winter and go from 0 to 100 at the getaway.

ADHD Motivation Is Difficult

The inconsistencies in ADHD motivation can be particularly challenging. It's the variability in our motivation that often confuses people (others and ourselves) and leads to the anguished question: "But you could do this last week, why can't you do it today?!"

Let's revisit the ADHD motivators to see why they can be so elusive:

Novelty

By nature, novelty and newness are time-limited. Things that are novel and new only remain novel and new for a period of time. Notice how your organizational "ADHD hack" has to keep changing to be shiny and new? Once the novelty wears off, we often need to find new "hacks" and supports. This is the reason Dr. Dodson recommends having 60-100 different techniques that can be rotated so old ones are revisited and feel new again.

Challenge

Once we have risen to a challenge and conquered it, it's no longer challenging. Unless we build scaffolding to stretch it a bit further, the motivation around it will stop once we have completed the challenge.

Urgency

Urgency substitutes for importance. A person with ADHD cannot get engaged with a task merely because it is important. As Dr. Dodson notes, sometimes a person will create crises and chaos because they have found that helps them get engaged and get things done. This pattern of creating chaos to motivate can be mistaken for Borderline Personality Disorder.

Interest and Passion

Passions and interests can spark and fade quickly for ADHDers, but can be more enduring for ADHDers who also have the autism sidekick. This is why I often say I have empathy for ADHDers who haven't been gifted with the autism bonus pack. For ADHDers, interests and passions can rotate quickly-today it's knitting, tomorrow it's learning the ukulele. For AuDHDers, we often have some enduring interests and passions that can help weave our attention together (although we still need to get creative with harnessing those passions).

Because these motivators can be fickle little things; our attention, focus, and engagement can often feel unpredictable. This is one of the enduring frustrations for many people with ADHD (and those in our lives who are also impacted by these inconsistencies). The more we try to fit into an importance-based system, the more strain, burnout, and inconsistency we may experience, which is why it is important to learn how to work with the system we have rather than trying to fit into a system that doesn't align with us.

Conclusion

Next week's post will focus on how to work with our interest-based system to align with our motivators more effectively. By aligning our activities with our natural motivational pulls and forces, we can reduce burnout and increase our sense of agency.

Citations

Bromberg-Martin, E. S., Matsumoto, M., & Hikosaka, O. (2010). Dopamine in motivational control: rewarding, aversive, and alerting. Neuron, 68(5), 815-834. https://doi.org/10.1016/j.neuron.2010.11.022

Szczypka, M. S., Rainey, M. A., Kim, D. S., Alaynick, W. A., Marck, B. T., Matsumoto, A. M., & Palmiter, R. D. (1999). Feeding behavior in dopamine-deficient mice. Proceedings of the National Academy of Sciences of the United States of America, 96(21), 12138-12143. https://doi.org/10.1073/pnas.96.21.12138

Dr. William Dodson, HOW ADHD SHAPES YOUR PERCEPTIONS, EMOTIONS & MOTIVATION, Presentation. Retrieved from: https://adhd.dk/wp-content/uploads/sites/2/2022/05/Dodson-How-ADHD-Shapes-Your-Perceptions-Emotions-.pdf

# data[].attributes.attachment_link.title
How the Interest-Based Nervous System Drives ADHD Motivation

# data[].attributes.attachment_link.description
Explore how the Interest-Based Nervous System drives ADHD motivation. Understand the unique ways ADHD brains find engagement and motivation.

# data[].attributes.body
Anxiety and how it is affecting children is in the news a lot. Mental health for children is a real issue and one that is so vital, particularly in the early years. Anxiety has a tendency to be co-occurring for Autists, children with ADHD, developmental trauma, and other neurodivergence. This little toolkit has some nice ideas that you can use and share with parents about reducing and dealing with stress and anxiety in little ones. Although it says it is for children with developmental difficulty, some of these ideas will be helpful for all children. You can also look at some of the other ideas in this Padlet to help with anxiety such as building relationships, priming, visuals and social stories.

# data[].attributes.body
This website works with the Book 'Building Bridges Through Sensory Integration (Therapy for Children with Autism and other Pervasive Developmental Disorders)' by Yack et al (2015) It offers some simple checklists to see where there may be sensory needs - It does not replace the advice of a health professional.

# data[].attributes.attachment_link.title
Building Bridges Forms and Exercises - Sensory World

# data[].attributes.attachment_link.description
Brought to you by Building Bridges through Sensory Integration

# data[].attributes.headline
Transitions - Why Kids Struggle with Transition

# data[].attributes.subject
Transitions - Why Kids Struggle with Transition

# data[].attributes.body
This quick read goes through some of the reasons children find transitions hard. You will notice that the behaviour is similar but the thinking behind it will be different depending on whether the child has ADHD, is Autistic, suffers with anxiety or has sensory processing issues.

# data[].attributes.attachment_link.readable_text
Humans are creatures of habit. Even when we welcome it, change takes more energy. So perhaps it's not surprising that children often find it difficult to make transitions between activities, places and objects of attention. Being asked to stop one thing and start another is a very common trigger for problem behavior, especially for kids who have emotional or developmental challenges.

"Transitions are hard for everybody," says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. "One of the reasons why transitions may be hard is that we're often transitioning from a preferred activity - something we like doing - to something that we need to do."

Difficulty with transitions can manifest in a number of ways depending on the child and the setting. It can take the form of resistance, avoidance, distraction, negotiation or a full-blown meltdown. Some of these reactions are the result of kids being overwhelmed by their emotions. And some are what they've learned works to successfully delay or avoid the transition.

A child told it's time to leave the playground might throw a tantrum initially because he can't manage his anger or frustration, but if he's found that it has worked to delay leaving the park, he's more likely to do it again. "It really depends on how the adults in his life have responded," says Matthew Rouse, PhD, a clinical psychologist. Other kids may not tantrum but instead master the art of whining, distracting, or negotiating with the adults in their life.

While transitions are triggers for lots of kids - what parent hasn't gotten resistance from a child being asked to stop playing a video game and come to dinner? - they are particularly difficult for kids with emotional and developmental issues. And while the behaviors may be the same, experts point out that the reasons behind the behavior are different for kids with different challenges. Here we look at why children with ADHD, anxiety, autism and sensory processing issues, find transitions particularly difficult.

For kids with ADHD, it all comes down to what they perceive as rewarding, says Dr. Rouse. While the disorder is described as an attention deficit, experts say it may be more useful to think about it as difficulty regulating attention - turning your attention to something you are expected to do, rather than something that you find rewarding.

"Kids with ADHD have fewer neurons in their reward centers, or neurons that aren't as active in the reward centers of their brains, so they find things throughout their day less rewarding," he explains. When they do find something rewarding, they tend to hyper-focus on it, which explains why someone with ADHD seems all over the place but then can play video games for hours. Ask them to do something less rewarding (like putting away Legos), and you might hit resistance.

Michael Rosenthal, PhD, a clinical neuropsychologist, adds that children with ADHD have a tougher time managing their emotions than other kids. "There's also research that shows that the wiring in the brain centers that are involved in helping kids exercise control over their emotions are less developed, so you get bigger emotional displays from them compared to kids who don't have ADHD."

Although transitions can be similarly challenging for kids with autism, the reactions tend to be more extreme, and the issue is rooted in a different difficulty. "For kids with autism," says Dr. Rosenthal, "the world is just an incredibly confusing and overwhelming place, so the need for sameness and predictability is adaptive," or practical. It's not simply that changing activities is upsetting, it's that any deviation from the routine can feel like the rug is being pulled out from under them.

Dr. Rosenthal refers to this as cognitive inflexibility, and says that it also explains why those on the autism spectrum have hyper-focused interests and tend to prefer doing the same things in the same order. "Any unexpected changes or transition for a kid with autism disrupts their equilibrium."

Although sensory processing is not a diagnostic term like ADHD or autism, kids with either disorder-or no disorder-can have sensory processing issues, which can lead to problems with transitions. For kids who are easily over stimulated, the world feels confusing and seems to move too fast. They crave order, which helps them feel calm and in control. "When you change things up on them too quickly," says Dr. Rosenthal, "then you see resistance or problem behaviors."

Kids with sensory issues are sometimes prone to dramatic meltdowns-emotional outbursts that they can't control-when they are overwhelmed by unexpected changes.

For kids who suffer from anxiety, trouble with transitions might come from a place of fear. "It could be fear of the unknown, or fear of what's going to happen when they're put in a new situation," notes Dr. Rosenthal. The problem is "usually some stimuli that's connected to the transition, rather than the process of transitioning itself," he adds.

If they've had an upsetting experience in a particular setting, the prospect of a transition to that location itself could also trigger anxiety. If a child is terrified of dogs, being asked to leave for the home of someone with a dog could trigger a tantrum, or even make a child lash out in anger.

Some kids with anxiety, especially those with obsessive-compulsive disorder (OCD), have an intense need to do things perfectly. If they are interrupted before they are able to do something exactly the right way-forming letters perfectly in a writing assignment, or lining things up or doing a series of things in a prescribed order-they can get very upset, leaving an adult not aware of the anxiety mystified.

Understanding the triggers that make kids balk, or get upset, at transitions, is the first step to managing them better for both kids and adults.

# data[].attributes.attachment_link.title
Why Do Kids Have Trouble With Transitions? - Child Mind Institute

# data[].attributes.attachment_link.description
Humans are creatures of habit. Even when we welcome it, change takes more energy. So perhaps it's not surprising that children often find it difficult to make transitions between activities, places and objects of attention. Being asked to stop one thing and start another is a very common trigger for problem behavior, especially for kids who have emotional or developmental challenges.

# data[].attributes.body
This is a big room for older children however this little 3 minute video highlights the need to think about the resources and plans you put in place to support various sensory needs within your class, and the difference it can make for children.

# data[].attributes.attachment_link.title
The Sensory Room: Helping Students With Autism Focus and Learn

# data[].attributes.body
Interoception is vitally important for us to know about what our body is telling us. If we are not tuned into our body signals e.g. for hunger, thirst, pain, toileting etc, there could be consequences for our mental and physical wellbeing. Autistic children and adults may find this tricky and may need support. This article talks about interoception, its importance and some tips to support it.

# data[].attributes.attachment_link.readable_text
Have you ever gone a morning without eating and/or drinking, only to be reminded you're famished by a visual cue such as a clock, rather than noticing a dry mouth or hunger pains?

If the answer is yes, you may, like many Autistic individuals, experience interoception differences.

What is interoception?

Interoception is colloquially known as the eighth sense (Mahler, 2017), and is a lesser-known yet crucial sense that helps individuals perceive and interpret signals originating from within their own bodies - signals such as hunger pains, thirst, fatigue, nausea, tummy flutters, a racing heart, goosebumps, sexual arousal, muscle tension, toileting urges, and even pain.

Our interoceptive awareness is mediated by a network of sensory receptors located in various organs, including the heart, lungs, stomach, bladder, eyes and skin. These receptors send signals to the insula in our brain about the state of our body's internal environment. Our brain then uses the information about how our body feels as clues to our emotional state. Are we anxious, sick, tired or excited?

Interoception is important because we need to be able to sense, process and integrate our bodily cues in order to maintain homeostasis, regulate our emotions and enjoy an overall state of wellbeing and connection to ourselves and others.

Interoception and Autism

Research shows our Autistic community experiences interoception differences more frequently than non-autistic individuals (Zachary et al., 2023). Similar to our sensory processing of external stimuli, Autistic individuals may be hyper- (over) or hypo- (under) aware of our bodies' internal cues.

This means we might have difficulty accurately perceiving our internal body signals, we may over-feel these signals or simply have difficulty differentiating between body signals and emotional signals, for example, struggling to discern if our discomfort is due to hunger or anxiety.

Such challenges can manifest in various ways and significantly impact our daily life, and physical and emotional wellbeing.

Challenges in Identifying Basic Needs

Interoception differences can make it difficult for Autistic individuals to accurately recognise and respond to basic bodily needs. This can lead to irregular eating and drinking habits, dehydration, constipation, or difficulty getting to the bathroom in time.

Emotional Regulation Difficulties

When non-autistic individuals begin to feel frustrated, angry, or upset, they can recognise these emotions and can utilise internal bodily signals to help them understand the reasons for those emotions, to take action to address them. In contrast, some Autistic people might struggle to notice and connect internal physical sensations with emotions. This confusion and disconnect can make it challenging to actively regulate our emotions when we need to do so.

As a result, we might appear fine, until unmet physical and emotional needs pile up and overwhelm us, leading to big emotions and/or survival behaviours like or .

Read more about how Autistic people experience emotions differently .

Difficulty with Introspection and Alexithymia

Interoception is essential for introspection, the ability to reflect on one's thoughts and feelings. Autistic individuals with interoception differences might find it challenging to engage in introspection, as it can prove difficult to interpret internal cues and connect them with our mental and emotional states. This can affect our ability to understand ourselves and integrate our experiences.

Many Autistic individuals are also alexithymic. alexithymia is a condition in which a person has difficulty identifying and describing their emotions and is closely associated with interoception differences. When internal bodily signals are misinterpreted or not recognised, it becomes challenging to associate these signals with specific emotions and identify how you're feeling. This can lead to a confused sense of self. Read an Autistic account of alexithymia.

Heightened or Diminished Experiences of Pain

Some Autistic individuals may experience heightened sensitivity to internal signals of pain. This can make it look like we're being 'overly dramatic' with big reactions, but it is vital to remember that each person's experience of their pain is genuine, individual, and intimately related to their interoceptive sensitivity. Others might have a diminished sensitivity, making it harder to notice when they're in pain.

This can have long-term health implications as Autistic people with low pain interoception may not attend to symptoms of injury, disease, illness or infection in themselves until it is well advanced. Read more about the Autistic experience of pain .

Impact on Social Interactions

Social interactions often rely on the ability to recognise and respond to one's own as well as others' emotional states. Interoception differences can make it harder for Autistic individuals to pick up on social cues and respond appropriately. For instance, we might not notice subtle signs of discomfort or stress in ourselves, which would help us remove ourselves from overwhelming or even dangerous situations.

Health and Wellbeing

Atypical interoception can also affect overall health and wellbeing. Difficulty in recognising and responding to bodily needs can lead to chronic health issues, such as poor nutrition, dehydration, and gastrointestinal problems. Additionally, the stress associated with misinterpreting internal signals can contribute to mental health challenges, such as anxiety and depression.

Strategies to Support Autistic Individuals with Interoception Differences

Autistic-led research shows that our interoception can be improved and there are many activities that can be harnessed to improve your or a loved one's interoception (Goodall, 2021).

Here are some strategies that can help:

1. Engaging in Interoceptive Awareness Training

Interoceptive awareness training involves activities and exercises designed to help individuals recognise and interpret internal signals. Mindfulness practices, body scans, and guided relaxation techniques can be beneficial. These practices can enhance awareness of bodily sensations and improve the ability to connect these sensations with emotions and needs.

2. Involving Visual Supports and Communication Tools

Visual supports, such as emotion charts and body maps, can aid Autistic individuals in identifying and expressing their internal states. These tools provide a visual representation of bodily sensations and emotions, making it easier to communicate needs and feelings. For example, an emotion chart might help an individual identify that a headache is related to stress or that a stomachache signals hunger.

3. Providing Consistent Routines

Establishing consistent routines around eating, drinking, and other selfcare activities can help mitigate the challenges of interoception differences. Regular schedules can serve as external reminders to address internal needs, reducing reliance on internal signals that might be misinterpreted or unnoticed.

4. Modifying our Environment

Creating a supportive and predictable environment can help Autistic individuals manage interoceptive challenges. Reducing sensory overload and embracing technology such as phone alerts to prompt selfcare activities such as drinking water can help individuals feel more in control of their internal states.

5. Making Space for Stimming

In a 2019 study, Autistic researchers found that repetitive, stimming behaviours, such as hand flapping and body rocking, are self-soothing and help to regulate the autonomic nervous system, which in turn generates interoceptive signals (Palser et. al., 2020). The focused attention from such stimming behaviours helped the Autistic children to accurately notice their heartbeats.

Caregivers, educators, family members and healthcare professionals should advocate for accommodations and encourage self-regulatory behaviours such as stimming, to provide a supportive environment for the Autistic individual.

Read more about the study in our summary for non-academics.
6. Offering Understanding and Validation

Supporting Autistic individuals with interoception differences requires a deep understanding and acceptance of our unique experiences. It's important to recognise that our perception of our own bodies may differ significantly from non-autistics, yet this difference is not a deficit. Our responses to internal cues, and physical sensations may be unexpected to some, but these responses are our authentic lived reality.

Validating and respecting our experiences, even when they diverge from neuronormative expectations, fosters an environment of support and empathy. By acknowledging and embracing these differences, loved ones can provide meaningful and compassionate support to us.

7. Upskilling your knowledge of interoception

Informing caregivers, educators, family members and healthcare professionals about interoception and its impact on Autistic individuals is crucial. Interoception differences significantly affect various aspects of life for Autistic individuals, from recognising basic bodily needs to managing emotions and engaging in social interactions. By understanding these impacts and implementing supportive strategies, we can improve Autistic quality of life, and support greater selfcare, emotional wellbeing, and social connection.

References

Goodall, E., (2021). Facilitating Interoceptive Awareness as a Self-Management and Self-Regulation Tool to Increase Engagement in Learning and Education . Master's Thesis, University of Southern Queensland.

Mahler, K., (2017). Interoception: The eighth sensory system. Lexena: AAPC Publishing.

Palser, E.R., Fotopoulou, A., Pellicano, E. et al. (2020). Dissociation in How Core Autism Features Relate to Interoceptive Dimensions: Evidence from Cardiac Awareness in Children. J Autism Dev Disord 50, 572-582. https://doi.org/10.1007/s10803-019-04279-4

Williams, Z.J., Suzman, E., Bordman, S.L. et al. (2023). Characterizing Interoceptive Differences in Autism: A Systematic Review and Meta-analysis of Case-control Studies. J Autism Dev Disord 53, 947-962. https://doi.org/10.1007/s10803-022-05656-2

# data[].attributes.attachment_link.title
Interoception: Knowing Yourself Inside and Out - Reframing Autism

# data[].attributes.attachment_link.description
Have you ever gone a morning without eating and/or drinking, only to be reminded you're famished by a visual cue such as a clock, rather than noticing a dry mouth or hunger pains?If the answer is yes, you may, like many Autistic individuals, experience interoception differences.

# data[].attributes.body
With ADHD some behaviour can seem counter-intuitive. When we understand more we can better explain what is happening. People with ADHD are motivated by interest - not importance. This explains why the activities neurotypical people will do because they are important, are left til the last minute for the person with ADHD. Have a read of Dr Neff's blog that talks about this point.

# data[].attributes.attachment_link.readable_text
ADHD is often associated with difficulties in starting, completing, and initiating tasks. Case in point - I should be working on finishing my manuscript that is due Friday. But the topic of interest-based nervous systems has caught my interest, so instead of completing the important task, I'm side-questing today and writing about interest-based systems (I know this is all so very meta).

Okay; so ADHD is characterized by difficulty with doing things. But here's a question:

"If you could get engaged and stay engaged, has there ever been anything you couldn't do?"

This question, posed by Dr. William Dodson to many of his ADHD clients, highlights a core aspect of ADHD that is frequently misunderstood.

The challenge often lies not in performing the tasks but in getting motivated and engaged. Dr. Dodson notes that the majority of ADHDers respond with: "If I can get engaged, I can do anything." Once we are motivated, we can harness immense power, creativity, out-of-the-box problem-solving, and deep focus. The problem is getting ourselves engaged! This is where the concept of the interest-based nervous system comes in, which we will dive into today. Over the next few weeks in this series, we will discuss the core drivers of ADHD and ideas for how to work with an interest-based nervous system.

The Interest-Based Nervous System Explained

The term "interest-based nervous system," coined by Dr. Dodson, contrasts with the traditional importance-based system dominant among neurotypical people. An interest-based nervous system is motivated by tasks based on interest, passion, fascination, wonder, and play. The worlds of passion, curiosity, and interest are essential motivators for ADHDers and this explains why we struggle with conventional work and educational structures, typically designed around an importance-based model.

Interest-Based vs. Importance-Based Systems

While the interest-based nervous system drives motivation through personal engagement and curiosity, an importance-based system prioritizes tasks based on responsibility and external pressures.

People with importance-based systems are motivated by the significance of a task that is personally meaningful, important to someone else (like a boss or teacher), or linked to potential rewards or consequences. For instance, a task may be deemed important because it is:

Personally significant (Importance)

Important to someone they care about (Secondhand Importance)

Tied to clear rewards or penalties (Rewards/Consequences)

This system allows individuals to prioritize and arrange tasks in order of importance, helping them engage on demand, access their abilities when needed, and stay focused until the task is completed. The task doesn't need to be immediately important for the person to engage with it effectively.

Conversely, those with an interest-based nervous system may conceptually understand the importance of tasks like cleaning or scheduling medical appointments but find it challenging to initiate them until they become urgent. Our motivation is driven by interest, novelty, play, and challenge-factors that stimulate dopamine production.

Core Motivators for the ADHD Brain

The ADHD brain thrives on several core motivators. Dr. Dodson originally used the acronym ICNU to describe these, but it has since been popularized as PINCH, a more memorable acronym. PINCH stands for:

Passion (And I like to add Play): Engaging in activities that are enjoyable and intrinsically motivating.

Interest: Focusing on tasks that are inherently fascinating and captivating.

Novelty: Seeking out new, shiny, and exciting experiences to maintain engagement.

Competition (Cooperation or Challenge): Adding an element of competition, working cooperatively, or turning tasks into challenges to make them more engaging.

Hurry (Urgency): Completing tasks under time pressure to create a sense of urgency.

Challenges in a Society Designed for Importance-Based Systems

Unfortunately, most societal systems, including schools and workplaces, operate on an importance-based model. This often leads to tension and burnout for ADHDers, as the misalignment between our natural motivators and societal expectations creates significant stress and can lead to shame spirals and negative self-esteem. We often don't understand why things that seem straightforward and simple to others pose so much challenge for us.

Complicating matters, therapeutic interventions designed to support ADHD are often built on the requirements and motivators of an importance/reward nervous system. When we respond poorly to these interventions, it often deepens the shame about not being able to "do the thing."

Conclusion

Navigating environments (and interventions) that conflict with the ADHD brain's motivational systems can lead to shame, exhaustion, burnout, and defeat. Learning how our interest-based nervous system works and how to work with it (rather than against it) is key to breaking these cycles of defeat and burnout. Stay tuned for our next posts where we will dive deeper into the core motivators of the ADHD brain and provide practical strategies for harnessing them effectively.

ADHD is often associated with difficulties in starting, completing, and initiating tasks. Case in point - I should be working on finishing my manuscript that is due Friday. But the topic of interest-based nervous systems has caught my interest, so instead of completing the important task, I'm side-questing today and writing about interest-based systems (I know this is all so very meta).

Okay; so ADHD is characterized by difficulty with doing things. But here's a question:

"If you could get engaged and stay engaged, has there ever been anything you couldn't do?"

This question, posed by Dr. William Dodson to many of his ADHD clients, highlights a core aspect of ADHD that is frequently misunderstood.

The challenge often lies not in performing the tasks but in getting motivated and engaged. Dr. Dodson notes that the majority of ADHDers respond with: "If I can get engaged, I can do anything." Once we are motivated, we can harness immense power, creativity, out-of-the-box problem-solving, and deep focus. The problem is getting ourselves engaged! This is where the concept of the interest-based nervous system comes in, which we will dive into today. Over the next few weeks in this series, we will discuss the core drivers of ADHD and ideas for how to work with an interest-based nervous system.

The Interest-Based Nervous System Explained

The term "interest-based nervous system," coined by Dr. Dodson, contrasts with the traditional importance-based system dominant among neurotypical people. An interest-based nervous system is motivated by tasks based on interest, passion, fascination, wonder, and play. The worlds of passion, curiosity, and interest are essential motivators for ADHDers and this explains why we struggle with conventional work and educational structures, typically designed around an importance-based model.

Interest-Based vs. Importance-Based Systems

While the interest-based nervous system drives motivation through personal engagement and curiosity, an importance-based system prioritizes tasks based on responsibility and external pressures.

People with importance-based systems are motivated by the significance of a task that is personally meaningful, important to someone else (like a boss or teacher), or linked to potential rewards or consequences. For instance, a task may be deemed important because it is:

Personally significant (Importance)

Important to someone they care about (Secondhand Importance)

Tied to clear rewards or penalties (Rewards/Consequences)

This system allows individuals to prioritize and arrange tasks in order of importance, helping them engage on demand, access their abilities when needed, and stay focused until the task is completed. The task doesn't need to be immediately important for the person to engage with it effectively.

Conversely, those with an interest-based nervous system may conceptually understand the importance of tasks like cleaning or scheduling medical appointments but find it challenging to initiate them until they become urgent. Our motivation is driven by interest, novelty, play, and challenge-factors that stimulate dopamine production.

Core Motivators for the ADHD Brain

The ADHD brain thrives on several core motivators. Dr. Dodson originally used the acronym ICNU to describe these, but it has since been popularized as PINCH, a more memorable acronym. PINCH stands for:

Passion (And I like to add Play): Engaging in activities that are enjoyable and intrinsically motivating.

Interest: Focusing on tasks that are inherently fascinating and captivating.

Novelty: Seeking out new, shiny, and exciting experiences to maintain engagement.

Competition (Cooperation or Challenge): Adding an element of competition, working cooperatively, or turning tasks into challenges to make them more engaging.

Hurry (Urgency): Completing tasks under time pressure to create a sense of urgency.

Challenges in a Society Designed for Importance-Based Systems

Unfortunately, most societal systems, including schools and workplaces, operate on an importance-based model. This often leads to tension and burnout for ADHDers, as the misalignment between our natural motivators and societal expectations creates significant stress and can lead to shame spirals and negative self-esteem. We often don't understand why things that seem straightforward and simple to others pose so much challenge for us.

Complicating matters, therapeutic interventions designed to support ADHD are often built on the requirements and motivators of an importance/reward nervous system. When we respond poorly to these interventions, it often deepens the shame about not being able to "do the thing."

Conclusion

Navigating environments (and interventions) that conflict with the ADHD brain's motivational systems can lead to shame, exhaustion, burnout, and defeat. Learning how our interest-based nervous system works and how to work with it (rather than against it) is key to breaking these cycles of defeat and burnout. Stay tuned for our next posts where we will dive deeper into the core motivators of the ADHD brain and provide practical strategies for harnessing them effectively.

# data[].attributes.attachment_link.title
Interest-Based Nervous System: Understanding ADHD and Motivation

# data[].attributes.attachment_link.description
Explore how the Interest-Based Nervous System influences motivation in people with ADHD. Learn about the difference between interest-based nervous systems and importance-based systems.

# data[].attributes.body
This handout has been created around different kinds of boxes that can be tailored to the needs and interests of children to make them meaningful for them and support their love of learning. They might be helpful for children who need or like to focus, thrive in their own space, enjoy small tasks or have a special interest.

# data[].attributes.body
This article talks about having flexible play skills to support children with additional needs

# data[].attributes.attachment_link.title
How to Build Play Skills for Your Child With Special Needs

# data[].attributes.attachment_link.description
Play may come as a challenge for kids with special needs, but we have tips on flexible play skills to grow their creativity and cognitive skills.

# data[].attributes.attachment_link.embed_code
How to Build Play Skills for Your Child With Special Needs

# data[].attributes.body
Have a look at this article which points to the importance of knowing about the development and types of play. "Play should be fun! What really motivates your child? This may not actually be toys but may be non-toy items; parts of items, or repetitive behaviours. Whatever the motivator, it will be key to success in trying to play with your child and developing their play."

# data[].attributes.attachment_link.readable_text
Play is such a fundamental part of child rearing, and one that comes so naturally to most babies, children and parents that we often don't stop to think about the importance of play on so many parts of a child's development.

As parents, most of us are naturally motivated to play and interact with our children. It can come as a surprise therefore if a child isn't responsive to these attempts, and we may not know what to try next. For many children with autism, play may be different and more difficult to achieve. As parents, our attempts to engage may sometimes falter. However, with understanding and support it should be possible to progress their play, including their 'social play', and for this to support other areas of their development too.

Scottish Autism's Autism Support Team has been involved in developing the play of many pre-schoolers with autism and often advises on play to parents. Here are some key strategies to think about if you are trying to develop your child's play.

As a starting point, it's helpful to have an understanding of the different stages play goes through in typical development. The following chart shows the recognised stages of play, in the order that they usually occur in typical development. The second chart shows the stages of social play:

Stages of play

Sensorimotor Play

The baby or child is primarily occupied with the way things taste, look, sound, feel, smell, etc. For example, he or she not only shakes a rattle but sucks it; feels its texture; examines the way it looks; smells it and plays with other items in a similar way.

Organising Play

The baby or child is concerned with organising the play items but hasn't acquired an understanding of their purpose. So, for example, they may line up their toy cars but not actually drive them around.

Functional Play

The child has an understanding of the actual purpose of the toys and uses them accordingly. For example, they may now drive the toy car around the floor.

Pretend Play

Pretend, or imaginative, play incorporates several levels: Initially the child will use items in a very functional way such as pretending to stir and drink from a toy tea cup. This could be called 'functional imaginative' play.

The next stage is using one item to represent another (e.g. they don't have a cup so they pretend something else is a cup).

Imaginary play then develops into increasingly symbolic play such as projecting real life qualities onto a doll or toy animal (e.g. pretending dolly is a person); pretending something or someone is there that isn't (e.g. an imaginary house) and taking on imaginary roles (role play).
(Adapted from Beyer & Gammeltoft, 1999)
Stages of social play

Solitary play

Playing by themselves

Spectator play

Spectating as other children play but without interacting

Parallel play

Playing alongside but with minimal interaction

Associative play

Playing closely together with associated activities but without sharing their play ideas

Co-operative play

Ability to play together in a co-operative way
(Adapted from Sheridan, 1999)
By looking at these charts it can be seen that many children with autism do show some of these types of play, but this is often different to their typically developing peers. There may be many reasons for this. For example:

Play is often predominantly social; uses communication and requires imaginative ability. In children with autism there can be a tendency for play to be solitary and limited to exploring sensory aspects or lining toys up in a rigid manner for much longer than in typical development. Imitation may be difficult. Playing imaginatively may not be achieved to the same extent or in the same types of scenarios seen in typical development. In some older children, ability with memory and imitation can enable them to engage in imaginary scenarios, however, for some children this comes about as a result of rote copying of an activity they have seen other children engaged in; or that they have seen on TV, or in a film or book, rather than being self-generated. Of course, some typically developing youngsters will generate play scenarios based on these sort of experiences but are more likely to be able to deviate and develop them rather than adhering to the original format or content.

Planning to develop your child's play:

First of all, become familiar with your child's developmental level around play. This is key to playing with them and developing their play! Use the brief outlines of levels of play/social play in the previous charts. Which is/are your child predominantly interested in? Knowledge of his or her play level will help you to identify what strategies and playthings to use to engage with your child and try to develop their play.

To help with the previous exercise, watch your child in a range of play settings with a range of play and 'sensory' items, as well as other people/other children. See what your child does; what items/toys/people he or she is drawn to and what he or she does with them. Here are some suggestions for types of playthings, although be guided by your knowledge of your child's preference, any sensory sensitivities and safety issues:

Bubbles; balloons; toys for blowing; strings of beads; fabric or other materials with different textures or patterns; colourful, contrasting, shiny and reflective items; spinning tops; moving toys; vibrating toys; musical toys; balls; books; stacking cups; blocks; empty boxes/containers; large dominoes; cause and effect toys (e.g. Jack in the Box); jigsaws; train set; toy figures/animals/dolls and accessories; tea set; crayons and paper; play dough; pots and pans and toy food; dressing up clothes; hats; toy money, toy phone ...

Please note that many of these items could be used at various levels of play: for instance dolly could be used imaginatively or in a sensori-motor way (such as the feel of its hair) as well as in a functional way.

Try not to worry if your child's play is different to that of other children you know. The important thing is to find out what level your child is at and use this as a starting point. We have found that many children with autism can and do develop in their play if the nature of their differences is understood and suitable play approaches and strategies used.

Play should be fun! What really motivates your child? This may not actually be toys but may be non-toy items; parts of items, or repetitive behaviours. Whatever the motivator, it will be key to success in trying to play with your child and developing their play.

Get down to your child's level - if they want to play on the floor, do this. If they need the structure of playing at a table, this is fine. Do ensure, though, that you are at the right level to catch any eye contact that's going!

Think about the play environment. Are there aspects which might distract or disturb the child, especially if they have sensory sensitivities? What 'messages' is the environment sending out to the child? For example, if you're playing in the kitchen do they think it's time for a meal? Can they smell food cooking that might mislead them or upset them? Is the TV or radio on? Try to make the environment as neutral as possible so the focus is on play only.

'Set the scene' for play. Something like a play mat or blanket on the floor can help the child's expectations by visually showing where to play. He or she may be able to learn that next time when the mat is laid out this means play, helping them to predict events. Having the playthings in a box also helps to signal what is about to happen and adds structure.

How long can your child play for and why might this be? Keep your expectations open and feel confident in your instincts of when to stop. One or two minutes of positive play or tolerance from your child will be far more productive than a painfully drawn out session.

A difficulty often described by parents, actually engaging with their child in a playful manner, is more likely to be achieved if these areas are taken into account. Try to be relaxed about what you are trying to achieve and remember that even a brief or fleeting response from your child is a success and something to learn and develop from. The next section suggests some tactics for engaging:

During play with your child:

Strategies for gaining attention are very individualised, but some of the following may suit your child - the aim of each of these activities would be for you to pause and wait for some acknowledgment from the child before continuing:

Games like 'Peek-a-Boo' using a textured or patterned fabric that they like.

Singing a familiar nursery rhyme, song or jingle.

Playing a repetitive musical instrument/tapping out a rhythm.

Rough and tumble or tickling, again pausing and waiting for a signal to continue.

Blowing bubbles.

Try following your child's play instead of trying to lead it. Later you can look at adding in your own motivating changes!

Once your child's initial interest is captured, use your knowledge of your child and your instincts to try to develop the interaction. To ensure that you are able to keep things flowing, it is helpful to have a range of motivating props (e.g. toys; sensory based items) close to hand so that you can feed in new activities. Remember to stop as soon as you feel your child has had enough.

Another technique that has been found successful is using matching sets of toys for the child and the adult (Beyer & Gammeltoft, 1999). The reasons for having matching items include the interest this may create in the child; the ability to copy the child, letting him or her experience taking the initiative; and the ability to guide the child using a matching toy.

Marwick (2005) developed the use of appealingly decorated 'paired boxes' of toys with slight differences. The rationale for this is that the child will be drawn to the boxes decoration and then you can imitate any initiatives the child makes to explore the boxes or toys, using your own version. Because the toys are broadly the same, you can then pick up on what interests the child, using your own matching toy. Furthermore, the child may pick up on, and be further interested by, your items having slight differences. In addition, you can 'scaffold' the child's exploration/play by demonstrating new ways of using whatever item they have picked up, using your matching item.

To help your child understand the difference between these play sessions with you and other play times, try keeping the toys and playthings you use in these sessions separate to the ones your child uses at other times.

Try videoing your play session - often a child's interaction may be so fleeting that it is easily missed. However, if you can see it on video, and what you did to achieve this, then you have something to focus on next time.

After the play session:

A structured end to the play session is often beneficial. For example, you could develop a routine for 'winding down' and putting away the toys, involving the child as much or as little as they're willing.

You might want to make up a song along the lines of 'play is finished...we're putting the toys away' - your child may enjoy the musical aspect to this and singing it can become a routine to help herald the end of the play session.

If the child has a visual schedule, use this to show clearly that play is finished, it is time to tidy up, and what will happen next. This information can also be communicated by showing the toy box/singing the song and by giving them an item for what is happening next (e.g. coat for going outside)

When possible, spend some time reflecting on the play session (and watching the video if you were able to take one). Think about what felt good for you, and what seemed enjoyed by your child; what wasn't so successful; what the child responded to; how long this lasted, etc. What can you learn from this session to take to the next one?

Visual supports such as a 'story board', photos, video clips or a 'Social Story'TM could also be useful to reflect later with your child on what has happened during the play session. This may encourage their recall skills and also help them to understand what happened and what fun it was.

Other Suggestions

Just as the child with autism requires structure in many aspects of their life, so their play too may gain from being structured. The following strategies may help your child:

A visual schedule showing what is going to happen during (and after) the play session, and who will be involved.

Visual supports for any turn-taking. This will give predictability and understanding.

A 'Social Story'TM to set the scene for what will happen in the play session; the other adult or child's perceptions and expectations, and what to do.

Scripts to support a play scenario. These could be made using photos or even video clips.

Remember that you are also providing structure by the way in which you 'set the scene' for play and finish the session, and this may be all that your child needs.

Make sure that any such visual supports used are easily understood by your child, and not a challenge in themselves.

Bear in mind that toys designed for typical children of your child's age may not interest or motivate your child. This could be because they are pitched at a specific play level. Or it could be that the sensory aspects of the toy are off putting. If the toy is designed to be used socially (e.g. a game) or imaginatively, this again may not be appropriately pitched for your child.

Develop your child's social play - this could be starting at the level of simply being able to tolerate you sharing in their activity, or developing two way 'joint play', playing together with another person. Perhaps your child has reached these stages and you can look at ways to develop peer play with other children? (see the reading list, below)

Help your child to become more flexible in the way they use their toys and other items. Do this in a positive way by drawing on their motivators. Remember that if you are doing things differently this might be challenging for them as it requires skills of flexible thinking and 'seeing the bigger picture'. Using your own matching plaything rather than the child's own item may help.

It can help to let relatives and friends know the type of toys, items and experiences your child is interested in so that they are more likely to get it right when buying him or her presents. So much more enriching for both the giver and the child!

Play involving more than one other child/adult is so complex for the child with autism. Focus initially on developing their play with one adult only, and then gradually extend it to one additional person. Introducing another child/ren will bring a whole different dynamic. Try to structure this as carefully as possible so that the child with autism still has some control and predictability. It will of course help if the other child is empathic and supportive.

Remember!

Is your child motivated by the play activity?

Is the toy or play item motivating?

Is the 'scene' (environment) set for play?

Does the child know its play time?

The play needs of each child and the way they respond to their play routine being developed will vary considerably. If you would like to discuss your child's play in more details with an Autism Advisor please contact our Autism Advice Line on 01259 222022 or email advice@scottishautism.org. Our Advisors have been involved in delivering play interventions to children with autism and have received training specific to play and autism.
Download Autism and Play as a PDF

# data[].attributes.attachment_link.description
Play is such a fundamental part of child rearing, and one that comes so naturally to most babies, children and parents that we often don't stop to think about the importance of play on so many parts of a child's development.

# data[].attributes.body
Play Is Not Linear

'Stages' imply a linear pathway. Children do not move through play stages in a fixed order. They may engage in solitary, parallel, or cooperative play depending on:

Their mood

The environment

Their developmental profile

Their neurotype

For example, autistic children may prefer parallel play or solitary play, and this is not a deficit—it is a valid and meaningful way to engage with the world.

# data[].attributes.body
Respecting Neurodiversity

it is important to know that the developmental milestones we look to including within this infographic are based on a 'typical' developmental model

Trying to push children into social play before they are ready—or interested—can be counterproductive and even harmful. It may:

Increase anxiety

Undermine autonomy

Reinforce the idea that their natural preferences are “wrong”

Instead, we should observe, listen, and respond to how each child chooses to play, and support that authentically.

Rather than measuring children against a fixed developmental benchmark, we ask:

What does this child value?

What does this child enjoy?

What freedoms and supports does this child need to flourish?

Play should be about agency, joy, and expression, not compliance with a developmental model.

# data[].attributes.body
This is great, and honest, blog from Megan Neff about her personal experience of demand avoidance within her family with support around how to manage some the difficulties using low-demand parenting strategies.

# data[].attributes.attachment_link.readable_text
Parenting can be a wild ride full of constant adjustments and tweaks. My husband and I used to joke that it was a "co-evolutionary arms race" as we tried to keep up with our daughter's changing needs. We have two doctorates (mine in clinical psychology, his in education). With my background in clinical psychology and my husband's in education, we thought we had all the tools and strategies to handle any challenge that came our way. But sometimes, nothing seemed to work, and we found ourselves at a loss for how to parent our daughter. We would often ask ourselves, "If we can't figure this out with our backgrounds, who can?!"

We quickly realized that our bright, intelligent daughter could sense when we were trying to influence her into a specific response. Rewards and threats of consequences only made things worse. As the stay-at-home parent, I found myself getting caught up in her meltdowns and feeling like a terrible mother. My nervous system was constantly on edge, and I struggled to understand why parenting felt so incredibly hard.

When she was first diagnosed as Autistic, it helped explain some of our struggles, but we still felt like there was something missing. That's when we learned about PDA, which became the missing piece of the puzzle in understanding our child. Through our exploration of PDA, we discovered the concept of low-demand parenting, which is often associated with PDA advocacy and parenting groups. But before we dive into low-demand parenting, let's first unpack what PDA is and what it isn't.

There is a lot of information in this article (my Autistic brain just kept going with it, feel free to save it for later in taking in the pieces of information that feel useful).

What is Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA) is a term that has historically been used to describe a profile of autism. However, an increasing number of individuals identifying with this profile are beginning to use "Pervasive Drive for Autonomy" instead (coined by Tomlin Wilding), better capturing the underlying core need. Demands are only a problem insofar as they threaten autonomy, and for people with PDA, autonomy equals safety. Any threat to that autonomy is perceived as dangerous, triggering a fight, flight, or freeze response.

The neurodivergent nervous system tends to be more rigid, meaning it more easily flips into a stressed state. In the case of PDA, there is almost no window of tolerance, so simple, everyday demands like "put on your shoes" can lead to big emotional reactions.

People with PDA can vacillate in their mood. On the one hand, they can be absolutely charming and light up the room (particularly when they have control and autonomy). On the other hand, when they feel threatened, they can appear excessively controlling and dominating, engaging in ways that may feel manipulative to others. Understanding the neurobiology behind PDA can help parents and caregivers respond with more attunement and empathy rather than frustration and confusion (and for PDAers it can lead to greater self-compassion).

Characteristics of Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA) is not yet an official medical diagnosis, but there are several core characteristics associated with it. While demand avoidance is the most widely discussed characteristic of PDA, other traits cluster with the PDA profile, which can lead to confusion for parents and healthcare professionals. The PDA Society in the UK has outlined the following core characteristics of PDA:

Resists and avoids the ordinary demands of life

Uses Social Strategies as part of their avoidance

Appears sociable on the surface

Experiences excessive mood swings and impulsivity

'Obsessive' behavior, often focused on other people

Appears comfortable in role play and pretend, sometimes to an extreme extent

Play can appear imaginative

When they involve others in their role-play, children with PDA are usually very controlling of the themes, roles, and dialogue

Other features of PDA include masking and strengths such as a strong sense of justice and fairness, independence, charisma, creativity, compassion, humor, imagination, and tenacity. Individuals with PDA face a great deal of misunderstanding and are frequently misdiagnosed with behavioral disorders. This can lead to blaming being placed on them and the parents for their explosive meltdowns and responses to autonomy threats, leaving parents feeling helpless and confused after trying a variety of therapies, medications, and parenting tactics.

In order to support individuals with PDA effectively, it is crucial to recognize and understand the characteristics of this condition. However, PDA can perplex many clinicians as it often goes unrecognized and can complicate the identification of autism due to its masking or influencing the presentation of Autistic traits.

Why Does PDA Cause Diagnostic Confusion

Dr. Donna Henderson, an expert on non-stereotypical presentations of autism, has identified several clinical characteristics of PDA that contribute to its diagnostic confusion. She explains in her blog post, "PDA: Not what you think it is!" :

"These individuals tend to have better eye contact and better social reciprocity than most with autism, and they can often appear to be socially typical. Their relatively good superficial social skills often make people wonder whether or not they are really on the autism spectrum (but in my experience, they are)."

Additionally, PDAers tend to be more socially savvy than most people with autism, and they can use sophisticated strategies (often perceived as manipulative) to regain a sense of autonomy. Furthermore, the presentation of PDA can vary depending on the context, making it difficult to diagnose. As Dr. Henderson notes,

"Individuals with PDA can do really well for short periods of time and then (seemingly) all of a sudden stop doing well (Jekyll and Hyde), which makes it look like their behavior is entirely volitional (it isn't)."

This inconsistency can lead to misdiagnosis, particularly when the child is able to mask well in certain settings. For example, "Some PDAers only struggle in one setting. So, they might do well at school (camouflage) and then completely fall apart at home. Conversely, they might do well at home (if there are low demands) but fall apart with the demands of school."

Finally, PDAers may not exhibit the same need for a routine that is characteristic of autism. Dr. Henderson explains, "PDAers may not do as well with routine and seem to need more novelty than most autistic individuals." These differences in presentation make PDA a perplexing case for many clinicians, leading to misdiagnosis and misunderstanding of the condition.

Parenting PDA

Parenting a child with PDA can be a challenging experience, as demands and requests can trigger a threat response in the child. With hundreds of demands placed on children each day, parents may inadvertently contribute to their child's stress and anxiety. Everyday tasks like brushing their teeth, getting dressed, and answering questions can become a source of conflict and emotional distress for children with PDA. And when they go to school, they may face even more demands that exacerbate their difficulties. Interestingly, a significant percentage of children with PDA do not thrive in traditional school environments, further complicating the situation for parents.

Given the unique challenges associated with this condition parenting a child with Pathological Demand Avoidance (PDA) can be a daunting task. PDA is characterized by an overwhelming sense of anxiety and avoidance when faced with demands or expectations. Traditional parenting techniques that rely on firm boundaries and consequences may not be effective for PDA children. This is where Low Demand Parenting comes in.

What is Low Demand Parenting?

Low Demand Parenting is a low-arousal approach that prioritizes reducing stress and anxiety levels in children with PDA. It is based on trust, flexibility, collaboration, and a balanced approach to demands. It involves adapting the environment and activities to the child's unique needs and preferences and allowing the child to take the lead in their play and activities. As Amanda Diekman, author of Low Demand Parenting explains it: "Low-demand parenting allows you to drop the demands and expectations that are making family life impossible and embrace the joyful freedom of living life with low demands."

When working with PDA children, the goal is to help them stay out of fight-and-flight mode. If we try to do interventions to try to get the kids to change, it's not going to end well. We need to build an environment that feels safe for the child. Gaining a lens for understanding demands and autonomy threats while becoming flexible in our demands is critical for fostering a safe environment.

Parenting a child with PDA can be challenging, but by adopting a low-demand parenting approach, parents can create a safe environment for their child to grow and thrive. Here are a few basic practices you can implement to support your PDA child:

Supporting your PDA Child (Credit: Adapted from PDA Society )

✦ Prioritizing flexible and collaborative approaches that foster a sense of autonomy, rather than making the child feel controlled by others, while still maintaining appropriate boundaries.

✦ Using indirect communication styles and depersonalizing requests to minimize the perception of demands and reduce stress.

✦ Employing low-arousal strategies that help keep anxiety levels to a minimum and provide a sense of control while also allowing for some flexibility and choice.

✦ Allowing plenty of time to process questions and information, and avoiding rushing communication, to reduce stress and overwhelm.

✦ Being mindful of sensory overload and taking steps to minimize it, such as creating a calm and quiet environment and providing sensory supports as needed.

Low-arousal approaches are essential when it comes to parenting a child with PDA. Traditional parenting techniques that rely on firm boundaries and consequences, such as those used with other children or even those recommended for autism, may prove to be ineffective or even counter-productive for PDA children. Instead, a low-arousal approach can be more successful, keeping anxiety levels to a minimum and providing a sense of control.

This type of approach is based on trust, flexibility, collaboration, careful use of language, and a balanced approach to demands. It aims to reduce the demands placed on the child and provide an environment that minimizes stress and anxiety. This approach recognizes that the child's needs are unique and require tailored solutions that take into account their individual differences.

Is Low-Demand Parenting Permissive Parenting?

When first learning about low-demand parenting, there may be some confusion as to whether it is a form of permissive parenting where there are no boundaries or expectations for the child's behavior. However, this is not the case. Low-demand parenting is a unique approach to parenting that prioritizes reducing stress and anxiety for the child while still maintaining appropriate boundaries and expectations.

Rather than imposing demands or punishments, low-demand parenting involves adapting the environment and activities to the child's unique needs and preferences and allowing the child to take the lead in their play and activities. Strategies such as redirection and reframing demands are used to provide structure and guidance while still respecting the child's autonomy.

Permissive parenting, on the other hand, may appear to involve reducing demands and allowing the child to do as they please, but it does not involve setting clear boundaries or expectations. This can create confusion and anxiety for the child due to a lack of structure and predictability.

Low-demand parenting involves finding a balance between meeting the child's needs and providing structure and guidance without imposing unnecessary stress and anxiety. The goal is to create a supportive and nurturing environment that fosters the child's growth and development while minimizing stress and frustration. By setting clear expectations and boundaries while prioritizing the child's emotional and psychological well-being, low-demand parenting helps children to feel more supported, connected, and secure while also learning important life skills and behaviors.

Incorporating Low-Demand Parenting in Practice

Low-demand parenting involves a variety of practices, but three core strategies stand out as particularly important:

Parents need to be aware of the demands placed on their children and drop non-critical demands to reduce stress levels. They can also use strategies such as redirection and reframing demands rather than imposing demands or punishments. By reducing the perception of demands, parents can help create a supportive and nurturing environment that fosters the child's growth and development while minimizing stress and frustration.

Becoming Demand-Aware

The first step in implementing low-demand parenting is to become aware of the many demands that our children experience on a daily basis. By putting ourselves in our child's shoes and considering life from their perspective, we can gain a deeper understanding of the challenges they face. One way to do this is to take an inventory of the demands our children experience throughout the day.

To get started, take a walk through your child's day and make a note of every demand they encounter. You may be surprised at just how many there are! This exercise can help us to recognize the sheer volume of demands our children face and can help us to better understand their struggles.

Dropping Demands

Once we become aware of the demands our children face, the next step is to consider which demands are truly critical and which can be dropped. This can be particularly important during times of burnout or overwhelm when reducing demands can help our children to feel more in control and less stressed.

It's important to remember that what constitutes a critical demand may vary from family to family and even from day-to-day. For example, going to a therapy appointment may be a critical demand for one family but not for another. By prioritizing critical demands and dropping non-critical demands, we can help our children to better manage their daily load and reduce stress.

As a parent of an Autistic PDAer, it's important to discern between critical and non-critical demands, especially during burnout periods. For instance, while eating dinner together as a family wasn't critical for us, we recognized that our child needed space during high sensory days and allowed them to eat in their room. On the other hand, attending the long-awaited occupational therapy appointment was a critical demand for us, while going to Tae-Kwon-Do was a demand we could drop.

One of the biggest challenges for our family, and many others, was that most interventions aimed at supporting Autistic children felt like demands, including therapy, medication, and occupational therapy. To balance expectations and autonomy, we took an option approach where we provided a buffet of options for our child to choose from.

We communicated the overarching need and let our child decide, creating a framework with clear expectations while also honoring their autonomy. I call this the "bucket approach" (because the bucket is non-negotiable, but within the bucket, our child has several options to choose from). This "bucket approach" is a frequently used strategy in our family.

Reducing the Perception of Demands

Finally, we can work to reduce the perception of demands by using language, tone, and other strategies that help to frame requests in a more positive, choice-oriented way. This can include using declarative language, rephrasing requests to talk about objects rather than people, and incorporating elements of choice into requests. The PDA society has an in-depth list of how to do reduce the perception of demands , and several of the following recommendations are adapted from their recommendations.

Consider Your Language: Use declarative language , rephrase requests to talk about objects rather than people, and start requests with "please" to reduce the perception of demands. Phrases like "I wonder whether..." and "Let's see if..." also incorporate an element of choice.

Phrasing and Tone: Be mindful of using a low-arousal and non-demanding tone of voice, as tone and sound can signal safety or threat for the nervous system.

Take a Collaborative Approach: Engage in collaborative problem-solving to approach challenges together.

Monitor Your Energy: PDAers are sensitive to the energy of others, so be aware of your own energy and how it may impact your child.

Outsource Demands and Depersonalize: Explain that requirements are made by some higher authority or incorporate them into daily routines, post-its, or to-do lists to depersonalize demands and reduce uncertainty.

Support Sensory Safety and Regulation: Many PDAers have sensory integration and sensory disabilities, so create a sensory-safe environment and support their sensory regulation.

Limit Demands: Use declarative statements and be mindful of your language to reduce implicit demands.

Activate and Accommodate: Distract from demands by turning them into a game or incorporating interests to tap into intrinsic motivation.

Use Humor and Novelty: Use humor to make everyone feel more relaxed and incorporate novelty to keep things interesting.

Slow Down Communication: Give ample time to process questions and information to reduce overwhelm and prevent rushing communication.

Ask for Help: Say that you don't know or can't remember how to do something to perceive the child's autonomy while requesting support.

Offer Choices: Give the child some control by offering limited or free choices within certain parameters to maintain autonomy

By implementing these core practices of low-demand parenting, we can create a more supportive and understanding home environment that helps our children to manage their daily demands more effectively.

Lower Demand Lifestyle

Before concluding the discussion on low-demand parenting, it's important to also highlight the value of supporting a low-demand lifestyle for the entire family. If we only focus on low-demand parenting within the home, we miss an essential component of creating a supportive environment for children with PDA. In today's fast-paced and high-demand culture, it's challenging to slow down and establish a lifestyle grounded in simplicity and connection. However, a low-demand lifestyle can be beneficial for the entire family by supporting natural rhythms and routines.

Prioritizing a lower-demand lifestyle involves creating a home culture that resists the culture of busyness and reduces the demands placed on both parents and children. This includes creating space for rest, reflection, and connection, simplifying schedules, and prioritizing self-care. By supporting a low-demand lifestyle for the whole family by reducing demands placed on both parents and children, families can create space for rest, reflection, and connection.

Adopting a low-demand lifestyle can help families align with their innate human nature and foster a more sustainable, connected, and fulfilling life. It's not just about reducing individual demands but creating a culture of simplicity and ease that benefits everyone. It's about embracing a more intentional and mindful way of living, where the focus is on what truly matters: connection, well-being, and a sense of meaning.

Where to Go From Here?

If you're looking for further resources and guidance on PDA, there are several great options available.

✦ The Low Demand Parenting Summit ( you can purchase tickets here)

✦ Dr. Donna Henderson and I partnered up to host Neurodivergent Insights' first Master Class, where you get a deep dive into understanding what PDA is and what it is not. The 90-minute master class is currently on sale for 19.99 (the normal price 29.99).

Other PDA Resources

✦ The PDA Society also offers a variety of free resources and guides, including a comprehensive booklet on what PDA is , as well as their PANDA approach to implementing low-arousal strategies in parenting. Their guide for parents of PDAers is particularly helpful.

✦Another excellent resource is Amanda Diekman's book, Low-Demand Parenting: Dropping Demands, Restoring Calm, and Finding Connection with Your Uniquely Wired Child. This book offers practical advice and guidance for implementing low-demand parenting strategies in your home.

References

Identifying and Assessing PDA: https://www.pdasociety.org.uk/what-is-pda-menu/identifying-assessing-pda/

What is PDA? booklet www.pdasociety.org.uk/resources/what-is-pda-booklet and information sheet www.pdasociety.org.uk/resources/what-is-pda-information-sheet

Henderson, Donna, Ph.D. PDA: Not what you think it is! www.drdonnahenderson.com/post/grow-your-blog-community

Diekman, Amanda. Low-Demand Parenting: Dropping Demands, Restoring Calm, and Finding Connection with Your Uniquely Wired Child

Parenting can be a wild ride full of constant adjustments and tweaks. My husband and I used to joke that it was a "co-evolutionary arms race" as we tried to keep up with our daughter's changing needs. We have two doctorates (mine in clinical psychology, his in education). With my background in clinical psychology and my husband's in education, we thought we had all the tools and strategies to handle any challenge that came our way. But sometimes, nothing seemed to work, and we found ourselves at a loss for how to parent our daughter. We would often ask ourselves, "If we can't figure this out with our backgrounds, who can?!"

We quickly realized that our bright, intelligent daughter could sense when we were trying to influence her into a specific response. Rewards and threats of consequences only made things worse. As the stay-at-home parent, I found myself getting caught up in her meltdowns and feeling like a terrible mother. My nervous system was constantly on edge, and I struggled to understand why parenting felt so incredibly hard.

When she was first diagnosed as Autistic, it helped explain some of our struggles, but we still felt like there was something missing. That's when we learned about PDA, which became the missing piece of the puzzle in understanding our child. Through our exploration of PDA, we discovered the concept of low-demand parenting, which is often associated with PDA advocacy and parenting groups. But before we dive into low-demand parenting, let's first unpack what PDA is and what it isn't.

There is a lot of information in this article (my Autistic brain just kept going with it, feel free to save it for later in taking in the pieces of information that feel useful).

What is Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA) is a term that has historically been used to describe a profile of autism. However, an increasing number of individuals identifying with this profile are beginning to use "Pervasive Drive for Autonomy" instead (coined by Tomlin Wilding), better capturing the underlying core need. Demands are only a problem insofar as they threaten autonomy, and for people with PDA, autonomy equals safety. Any threat to that autonomy is perceived as dangerous, triggering a fight, flight, or freeze response.

The neurodivergent nervous system tends to be more rigid, meaning it more easily flips into a stressed state. In the case of PDA, there is almost no window of tolerance, so simple, everyday demands like "put on your shoes" can lead to big emotional reactions.

People with PDA can vacillate in their mood. On the one hand, they can be absolutely charming and light up the room (particularly when they have control and autonomy). On the other hand, when they feel threatened, they can appear excessively controlling and dominating, engaging in ways that may feel manipulative to others. Understanding the neurobiology behind PDA can help parents and caregivers respond with more attunement and empathy rather than frustration and confusion (and for PDAers it can lead to greater self-compassion).

Characteristics of Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA) is not yet an official medical diagnosis, but there are several core characteristics associated with it. While demand avoidance is the most widely discussed characteristic of PDA, other traits cluster with the PDA profile, which can lead to confusion for parents and healthcare professionals. The PDA Society in the UK has outlined the following core characteristics of PDA:

Resists and avoids the ordinary demands of life

Uses Social Strategies as part of their avoidance

Appears sociable on the surface

Experiences excessive mood swings and impulsivity

'Obsessive' behavior, often focused on other people

Appears comfortable in role play and pretend, sometimes to an extreme extent

Play can appear imaginative

When they involve others in their role-play, children with PDA are usually very controlling of the themes, roles, and dialogue

Other features of PDA include masking and strengths such as a strong sense of justice and fairness, independence, charisma, creativity, compassion, humor, imagination, and tenacity. Individuals with PDA face a great deal of misunderstanding and are frequently misdiagnosed with behavioral disorders. This can lead to blaming being placed on them and the parents for their explosive meltdowns and responses to autonomy threats, leaving parents feeling helpless and confused after trying a variety of therapies, medications, and parenting tactics.

In order to support individuals with PDA effectively, it is crucial to recognize and understand the characteristics of this condition. However, PDA can perplex many clinicians as it often goes unrecognized and can complicate the identification of autism due to its masking or influencing the presentation of Autistic traits.

Why Does PDA Cause Diagnostic Confusion

Dr. Donna Henderson, an expert on non-stereotypical presentations of autism, has identified several clinical characteristics of PDA that contribute to its diagnostic confusion. She explains in her blog post, "PDA: Not what you think it is!" :

"These individuals tend to have better eye contact and better social reciprocity than most with autism, and they can often appear to be socially typical. Their relatively good superficial social skills often make people wonder whether or not they are really on the autism spectrum (but in my experience, they are)."

Additionally, PDAers tend to be more socially savvy than most people with autism, and they can use sophisticated strategies (often perceived as manipulative) to regain a sense of autonomy. Furthermore, the presentation of PDA can vary depending on the context, making it difficult to diagnose. As Dr. Henderson notes,

"Individuals with PDA can do really well for short periods of time and then (seemingly) all of a sudden stop doing well (Jekyll and Hyde), which makes it look like their behavior is entirely volitional (it isn't)."

This inconsistency can lead to misdiagnosis, particularly when the child is able to mask well in certain settings. For example, "Some PDAers only struggle in one setting. So, they might do well at school (camouflage) and then completely fall apart at home. Conversely, they might do well at home (if there are low demands) but fall apart with the demands of school."

Finally, PDAers may not exhibit the same need for a routine that is characteristic of autism. Dr. Henderson explains, "PDAers may not do as well with routine and seem to need more novelty than most autistic individuals." These differences in presentation make PDA a perplexing case for many clinicians, leading to misdiagnosis and misunderstanding of the condition.

Parenting PDA

Parenting a child with PDA can be a challenging experience, as demands and requests can trigger a threat response in the child. With hundreds of demands placed on children each day, parents may inadvertently contribute to their child's stress and anxiety. Everyday tasks like brushing their teeth, getting dressed, and answering questions can become a source of conflict and emotional distress for children with PDA. And when they go to school, they may face even more demands that exacerbate their difficulties. Interestingly, a significant percentage of children with PDA do not thrive in traditional school environments, further complicating the situation for parents.

Given the unique challenges associated with this condition parenting a child with Pathological Demand Avoidance (PDA) can be a daunting task. PDA is characterized by an overwhelming sense of anxiety and avoidance when faced with demands or expectations. Traditional parenting techniques that rely on firm boundaries and consequences may not be effective for PDA children. This is where Low Demand Parenting comes in.

What is Low Demand Parenting?

Low Demand Parenting is a low-arousal approach that prioritizes reducing stress and anxiety levels in children with PDA. It is based on trust, flexibility, collaboration, and a balanced approach to demands. It involves adapting the environment and activities to the child's unique needs and preferences and allowing the child to take the lead in their play and activities. As Amanda Diekman, author of Low Demand Parenting explains it: "Low-demand parenting allows you to drop the demands and expectations that are making family life impossible and embrace the joyful freedom of living life with low demands."

When working with PDA children, the goal is to help them stay out of fight-and-flight mode. If we try to do interventions to try to get the kids to change, it's not going to end well. We need to build an environment that feels safe for the child. Gaining a lens for understanding demands and autonomy threats while becoming flexible in our demands is critical for fostering a safe environment.

Parenting a child with PDA can be challenging, but by adopting a low-demand parenting approach, parents can create a safe environment for their child to grow and thrive. Here are a few basic practices you can implement to support your PDA child:

Supporting your PDA Child (Credit: Adapted from PDA Society )

✦ Prioritizing flexible and collaborative approaches that foster a sense of autonomy, rather than making the child feel controlled by others, while still maintaining appropriate boundaries.

✦ Using indirect communication styles and depersonalizing requests to minimize the perception of demands and reduce stress.

✦ Employing low-arousal strategies that help keep anxiety levels to a minimum and provide a sense of control while also allowing for some flexibility and choice.

✦ Allowing plenty of time to process questions and information, and avoiding rushing communication, to reduce stress and overwhelm.

✦ Being mindful of sensory overload and taking steps to minimize it, such as creating a calm and quiet environment and providing sensory supports as needed.

Low-arousal approaches are essential when it comes to parenting a child with PDA. Traditional parenting techniques that rely on firm boundaries and consequences, such as those used with other children or even those recommended for autism, may prove to be ineffective or even counter-productive for PDA children. Instead, a low-arousal approach can be more successful, keeping anxiety levels to a minimum and providing a sense of control.

This type of approach is based on trust, flexibility, collaboration, careful use of language, and a balanced approach to demands. It aims to reduce the demands placed on the child and provide an environment that minimizes stress and anxiety. This approach recognizes that the child's needs are unique and require tailored solutions that take into account their individual differences.

Is Low-Demand Parenting Permissive Parenting?

When first learning about low-demand parenting, there may be some confusion as to whether it is a form of permissive parenting where there are no boundaries or expectations for the child's behavior. However, this is not the case. Low-demand parenting is a unique approach to parenting that prioritizes reducing stress and anxiety for the child while still maintaining appropriate boundaries and expectations.

Rather than imposing demands or punishments, low-demand parenting involves adapting the environment and activities to the child's unique needs and preferences and allowing the child to take the lead in their play and activities. Strategies such as redirection and reframing demands are used to provide structure and guidance while still respecting the child's autonomy.

Permissive parenting, on the other hand, may appear to involve reducing demands and allowing the child to do as they please, but it does not involve setting clear boundaries or expectations. This can create confusion and anxiety for the child due to a lack of structure and predictability.

Low-demand parenting involves finding a balance between meeting the child's needs and providing structure and guidance without imposing unnecessary stress and anxiety. The goal is to create a supportive and nurturing environment that fosters the child's growth and development while minimizing stress and frustration. By setting clear expectations and boundaries while prioritizing the child's emotional and psychological well-being, low-demand parenting helps children to feel more supported, connected, and secure while also learning important life skills and behaviors.

Incorporating Low-Demand Parenting in Practice

Low-demand parenting involves a variety of practices, but three core strategies stand out as particularly important:

Parents need to be aware of the demands placed on their children and drop non-critical demands to reduce stress levels. They can also use strategies such as redirection and reframing demands rather than imposing demands or punishments. By reducing the perception of demands, parents can help create a supportive and nurturing environment that fosters the child's growth and development while minimizing stress and frustration.

Becoming Demand-Aware

The first step in implementing low-demand parenting is to become aware of the many demands that our children experience on a daily basis. By putting ourselves in our child's shoes and considering life from their perspective, we can gain a deeper understanding of the challenges they face. One way to do this is to take an inventory of the demands our children experience throughout the day.

To get started, take a walk through your child's day and make a note of every demand they encounter. You may be surprised at just how many there are! This exercise can help us to recognize the sheer volume of demands our children face and can help us to better understand their struggles.

Dropping Demands

Once we become aware of the demands our children face, the next step is to consider which demands are truly critical and which can be dropped. This can be particularly important during times of burnout or overwhelm when reducing demands can help our children to feel more in control and less stressed.

It's important to remember that what constitutes a critical demand may vary from family to family and even from day-to-day. For example, going to a therapy appointment may be a critical demand for one family but not for another. By prioritizing critical demands and dropping non-critical demands, we can help our children to better manage their daily load and reduce stress.

As a parent of an Autistic PDAer, it's important to discern between critical and non-critical demands, especially during burnout periods. For instance, while eating dinner together as a family wasn't critical for us, we recognized that our child needed space during high sensory days and allowed them to eat in their room. On the other hand, attending the long-awaited occupational therapy appointment was a critical demand for us, while going to Tae-Kwon-Do was a demand we could drop.

One of the biggest challenges for our family, and many others, was that most interventions aimed at supporting Autistic children felt like demands, including therapy, medication, and occupational therapy. To balance expectations and autonomy, we took an option approach where we provided a buffet of options for our child to choose from.

We communicated the overarching need and let our child decide, creating a framework with clear expectations while also honoring their autonomy. I call this the "bucket approach" (because the bucket is non-negotiable, but within the bucket, our child has several options to choose from). This "bucket approach" is a frequently used strategy in our family.

Reducing the Perception of Demands

Finally, we can work to reduce the perception of demands by using language, tone, and other strategies that help to frame requests in a more positive, choice-oriented way. This can include using declarative language, rephrasing requests to talk about objects rather than people, and incorporating elements of choice into requests. The PDA society has an in-depth list of how to do reduce the perception of demands , and several of the following recommendations are adapted from their recommendations.

Consider Your Language: Use declarative language , rephrase requests to talk about objects rather than people, and start requests with "please" to reduce the perception of demands. Phrases like "I wonder whether..." and "Let's see if..." also incorporate an element of choice.

Phrasing and Tone: Be mindful of using a low-arousal and non-demanding tone of voice, as tone and sound can signal safety or threat for the nervous system.

Take a Collaborative Approach: Engage in collaborative problem-solving to approach challenges together.

Monitor Your Energy: PDAers are sensitive to the energy of others, so be aware of your own energy and how it may impact your child.

Outsource Demands and Depersonalize: Explain that requirements are made by some higher authority or incorporate them into daily routines, post-its, or to-do lists to depersonalize demands and reduce uncertainty.

Support Sensory Safety and Regulation: Many PDAers have sensory integration and sensory disabilities, so create a sensory-safe environment and support their sensory regulation.

Limit Demands: Use declarative statements and be mindful of your language to reduce implicit demands.

Activate and Accommodate: Distract from demands by turning them into a game or incorporating interests to tap into intrinsic motivation.

Use Humor and Novelty: Use humor to make everyone feel more relaxed and incorporate novelty to keep things interesting.

Slow Down Communication: Give ample time to process questions and information to reduce overwhelm and prevent rushing communication.

Ask for Help: Say that you don't know or can't remember how to do something to perceive the child's autonomy while requesting support.

Offer Choices: Give the child some control by offering limited or free choices within certain parameters to maintain autonomy

By implementing these core practices of low-demand parenting, we can create a more supportive and understanding home environment that helps our children to manage their daily demands more effectively.

Lower Demand Lifestyle

Before concluding the discussion on low-demand parenting, it's important to also highlight the value of supporting a low-demand lifestyle for the entire family. If we only focus on low-demand parenting within the home, we miss an essential component of creating a supportive environment for children with PDA. In today's fast-paced and high-demand culture, it's challenging to slow down and establish a lifestyle grounded in simplicity and connection. However, a low-demand lifestyle can be beneficial for the entire family by supporting natural rhythms and routines.

Prioritizing a lower-demand lifestyle involves creating a home culture that resists the culture of busyness and reduces the demands placed on both parents and children. This includes creating space for rest, reflection, and connection, simplifying schedules, and prioritizing self-care. By supporting a low-demand lifestyle for the whole family by reducing demands placed on both parents and children, families can create space for rest, reflection, and connection.

Adopting a low-demand lifestyle can help families align with their innate human nature and foster a more sustainable, connected, and fulfilling life. It's not just about reducing individual demands but creating a culture of simplicity and ease that benefits everyone. It's about embracing a more intentional and mindful way of living, where the focus is on what truly matters: connection, well-being, and a sense of meaning.

Where to Go From Here?

If you're looking for further resources and guidance on PDA, there are several great options available.

✦ The Low Demand Parenting Summit ( you can purchase tickets here)

✦ Dr. Donna Henderson and I partnered up to host Neurodivergent Insights' first Master Class, where you get a deep dive into understanding what PDA is and what it is not. The 90-minute master class is currently on sale for 19.99 (the normal price 29.99).

Other PDA Resources

✦ The PDA Society also offers a variety of free resources and guides, including a comprehensive booklet on what PDA is , as well as their PANDA approach to implementing low-arousal strategies in parenting. Their guide for parents of PDAers is particularly helpful.

✦Another excellent resource is Amanda Diekman's book, Low-Demand Parenting: Dropping Demands, Restoring Calm, and Finding Connection with Your Uniquely Wired Child. This book offers practical advice and guidance for implementing low-demand parenting strategies in your home.

References

Identifying and Assessing PDA: https://www.pdasociety.org.uk/what-is-pda-menu/identifying-assessing-pda/

What is PDA? booklet www.pdasociety.org.uk/resources/what-is-pda-booklet and information sheet www.pdasociety.org.uk/resources/what-is-pda-information-sheet

Henderson, Donna, Ph.D. PDA: Not what you think it is! www.drdonnahenderson.com/post/grow-your-blog-community

Diekman, Amanda. Low-Demand Parenting: Dropping Demands, Restoring Calm, and Finding Connection with Your Uniquely Wired Child

# data[].attributes.attachment_link.description
Having a child with PDA can be challenging, but low-demand parenting can help. Learn about it here.

# data[].attributes.body
This short booklet talks about Sensory Processing Responses and also offers resources and references.

# data[].attributes.body
Identiplay is an activity you can do with children who may require support with social communication skills. It offers shared focus opportunities and helps develop imitation skills. This explanation from the Solihull Early Years Team offers examples of how to use this approach and some scripted play models.

# data[].attributes.body
This article is a good summary and explains the stages of T.O.M and how it develops in infants and toddlers to young children. New evidence is suggesting that children do not develop a fully theory of mind and understand false belief until 6 or 7 although we do talk about mentalisation from an early age.

# data[].attributes.body
The Neurodiversity Education Academy has lots of resources and information that support neurodivergence.

# data[].attributes.attachment_link.title
Resources | Neurodiversity Education Academy

# data[].attributes.attachment_link.description
Here you can find relevant resources from videos, books, and articles around neurodiversity.

# data[].attributes.body
This table may help to look at hyper and hypo sensitivities as well as sensory seeking behaviours, to help you consider what you may need to provide as part of your reasonable adjustments.

# data[].attributes.body
This is a PDF document that you can download for ideas.

# data[].attributes.body
There are 4 stages to Attention Autism. Stage 1 will start your session. This link has all the stages modelled by Gina Davies - the creator of AA. If children are not at this stage yet, look at the curiosity stage that comes beforehand. Look at the 'bucket full of ideas' post under this for inspiration which you can print.

# data[].attributes.attachment_link.description
Here at Just One Norfolk, we are dedicated to providing children and young people's health services to the community. Find out more about our services

# data[].attributes.body
If you are interested in Gestalt language processing and echolalia then this website is for you. There is a free masterclass where you can learn what GLP is, how it differs from analytical language processing and how to approach a child's language learning which differs from the more traditional approach of vocabulary building, expanding, prompting and questioning. It also talks about taking a play based, child led approach and explains how supporting GLP's supports their play.

# data[].attributes.attachment_link.readable_text
S.D., Parent

This experience has opened my eyes that there is not just one way to learn language. Language development is not a "one-size-fits-all" approach. Finding the right therapist that understands how your child learns is key. I would encourage all parents and professionals to educate themselves about NLA and the benefits it can bring to children who need language support.

# data[].attributes.attachment_link.title
Meaningful Speech - Echolalia Education - Gestalt Language Processing

# data[].attributes.attachment_link.description
Courses, handbooks, and resources to teach you how to confidently identify, evaluate, and help guide children who script (communicate with echolalia) to original language. Learn about the Natural Language Acquisition framework, gestalt language processing, AAC, and more with Meaningful Speech.

# data[].attributes.body
This little online tool may help to find out what sensory needs a child may have to help you to create provision for them. This does not replace advice or a formal assessment from a health professional

# data[].attributes.attachment_link.description
This tool has been designed to support education staff and parents take a fresh look at behaviours that may have a sensory function.

# data[].attributes.body
This infographic reminds us that that we listen and learn in different ways. Whole body listening can be a discriminatory practice if we are stopping children being able to learn in a way that they can understand and feel comfortable.

# data[].attributes.body
The webinar above talks, after Kerry Murphy in the second half about this programme that supports all children's play. The webinar explains the research. There are free resources on this website and it is a really interesting study.

# data[].attributes.attachment_link.provider_name
The Brick-by-Brick programme | Play Included

# data[].attributes.attachment_link.readable_text
We all love to play! That's the ethos behind the Brick-by-Brick® programme. Young people collaborate together to build LEGO® models - making friends and developing skills all whilst having fun. It's the most up to date thinking in LEGO brick based therapy, supported by the LEGO Foundation.

Run by Play Included certified facilitators, the Brick-by-Brick® programme offers children positive, meaningful social experiences in an understanding, playful and accepting environment. Brick Club (as it's known to children) supports its members to collaborate, communicate, problem-solve and share fun experiences all through collaborative LEGO® play. Watch the video below to find out more.

"It's great having a group or club that your child feels no stress about attending. This is a first." - Brick Club Parent

About the programme

Brick Clubs take a child-led approach which means they can be extremely flexible and tailored to the person's strengths, interests and needs. They include team-based activities where you work together to build a LEGO® model, taking turns to play different roles (called the Engineer, Supplier and Builder) until the model is built. Brick Club members play a leading role in the activities that happen in the session, deciding on who does which job, what model is made and when to take turns. Another option is freestyle building, where pairs or small teams can design and create their own models together. For more advanced LEGO builders, there's also the opportunity to create stop-motion animations and work on coding and programming LEGO activities. In fact, as the children are in charge, there are so many different LEGO building activities that can happen in Brick Club that it's impossible to describe them all!

To find out more head to our YouTube channel where you will find more videos including a free introductory webinar.

The benefits of LEGO brick based therapy

Play has a fundamental role in young people's development. Some of the benefits we see for members of Brick Club are:

Social opportunities - by having the chance to build, play and interact with others in an environment that accepts and understands your needs, young people develop confidence and start to develop meaningful friendships, all whilst using their skills in collaborating, turn taking, communicating and problem-solving.

A sense of belonging - being a member of Brick Club and meeting others who share your interests and have similar challenges to you, means that young people feel less anxiety, have improved self-esteem and start to build confidence and friendships in a safe environment.

Pride - Young people leave a session with a huge sense of pride for what they've created. And they often share this pride outside of Brick Club, talking about their creations and sharing pictures with others.

LEGO® brick based therapy

Play Included's Brick-by-Brick® programme is gold standard LEGO brick based therapy, designed by our expert team using the latest research on the importance of learning through play and acceptance of neurodiversity.

Who is the Brick-by-Brick® programme (LEGO brick based therapy) for?

The Brick-by-Brick® programme supports social and emotional wellbeing and communication for young people, aged from preschool to adulthood who enjoy building LEGO models.

It was originally developed with autistic children in mind, but over the years, we've seen indications that any young person who enjoys LEGO play can benefit from the Brick-by-Brick programme. LEGO play is gender neutral. LEGO brick based therapy is very flexible and can be adapted to a wide range of ages, strengths and needs.

Researching Brick-by-Brick®

At Play Included, we're passionate about research and practice and we encourage rigorous research and evaluation of the Brick-by-Brick programme and LEGO brick based therapy.

We know that play is fundamental for children's positive development and studies have shown that LEGO brick based therapy has a positive impact on social and emotional wellbeing in autistic young people. Research shows the importance of accepting a difference in autistic sociality, and providing opportunities for autistic children to socialise with other autistic children may be especially beneficial.

Our team have been involved in the first large scale randomised controlled trial (called the I-SOCIALISE trial). This study has shown LEGO brick based therapy to be cost effective with a high level of acceptability and with a small positive outcome for autistic children's social skills.

Find out more on our Research page.

Definitions

Play Included C.I.C.: Our company name (formerly called Bricks for Autism C.I.C.)

The Brick-by-Brick®programme: Play Included's trademarked name for our updated version of LEGO brick based therapy, in partnership with the LEGO Foundation

Brick Club: The name young people give to their sessions

"Building together is fun because you're not alone. It's not just about me building it's about everyone building. I like being in a team." - Brick Club member

# data[].attributes.attachment_link.title
The Brick-by-Brick programme | Play Included

# data[].attributes.attachment_link.description
Supporting young people with social communication through collaborative LEGO® play. LEGO-based therapy or LEGO therapy and autism

# data[].attributes.headline
SUPPORTING PLAY FOR NEURODIVERGENT CHILDREN.

# data[].attributes.subject
SUPPORTING PLAY FOR NEURODIVERGENT CHILDREN.

# data[].attributes.body
This webinar starts with Kerry Murphy and her work on supporting play for neurodivergent children. Her messages are around rejecting the deficit model embracing what play means for every child and supporting that play rather than seeing it as 'autistic' play or placing a value on the play of children. The second part is around the work of the Brick by Brick programme and we have put the website on this Padlet too.

# data[].attributes.attachment_link.authors[].name
Play in Education, Development and Learning

# data[].attributes.attachment_link.title
Supporting play for neurodivergent children

# data[].attributes.body
This article from The Independent tells us perhaps what we in EY already know. Not only does it support empathy and other areas of social emotional development, the research here also talks about the benefits for our neurodivergent children as well.

# data[].attributes.attachment_link.title
Playing with dolls could help a child’s social development

# data[].attributes.attachment_link.description
The new findings suggested that broader social engagement with others while engaging in doll play was a unique pathway to social development for these children

# data[].attributes.body
This is a great blog and one of many from the Brain Gut institute. It talks about the importance of sensory integration and what happens when children do not have it - and how it shows up in their behaviour and cognitive abilities.

# data[].attributes.attachment_link.title
Why is sensory processing and sensory integration essential?

# data[].attributes.attachment_link.description
From birth, a baby can see, hear, and sense their body but initially struggles to organize these senses effectively, making the information less meaningful. As they experience different sensory inputs, their brain learns…

# data[].attributes.body
This has been written by Prof. Amanda Kirby. It is a good reminder of our uniqueness, how it should be celebrated, and also how trauma can effect us and "By understanding how stress impacts each of us and recognising individual differences, we can better support children's emotional well-being and resilience".

# data[].attributes.headline
NEURODIVERSITY IS AN IDENTITY NOT A DISORDER

# data[].attributes.subject
NEURODIVERSITY IS AN IDENTITY NOT A DISORDER

# data[].attributes.body
"The one-track public school teaching plans and the bestowing of psychiatric diagnoses to so many are not leading to the outcomes any of us hope for. It’s time to support how we learn best and celebrate our best selves instead of focusing on wrongness while forcing conformity."

# data[].attributes.attachment_link.readable_text
Key points

Neurodiversity and being Neurodivergent are identities, not medical labels.

Living as a Neurodivergent person is more than living with disability. There is exceptionality and community.

Neurodiversity is, to many of us, what Black, Jewish, or Latin are to people who embrace those identities.

Identity springs from how we internalize what we are, starting with our parents and continuing with what we learn from friends and teachers in school. Being Cajun ties us to a culture. Blackness comes from race, and Jewishness is an expression of our faith. All are widely recognized, though they mean different things to different people.

If those identities define who we are, other identities define what we are. Humans have long been recognized for their skills, be they hunters, blacksmiths, or engineers. Kids often find paths to adult vocations in childhood, giving them life goals to feel good about. They have a thing they want to be and an identity they wish to embrace.

Unfortunately, our schools have evolved in such a way that some kids learn what's wrong before they have a chance to see what's right. Feeling broken or defective can overshadow all other identities and leave us in a very difficult space where it's impossible to build a good self-image. We have reached a point in America where brokenness is the largest identity community of all, though hardly anyone wishes to embrace that. Millions are proud to be Mexican, or Catholic, or just American. Who wants to grow up Broken and Deficient? Especially when written in capital letters, because that's how we write identities? Yet that is the designation school functionaries and medical professionals assign to one in seven of us.

It's tricky the way this happens. Teachers say, "Johnny is a little slow," and "Mary needs special help." Even at four years of age, we are wise enough to know there is nothing good for us in those words. Of course, teachers and parents see it differently when they later recall how we learned to read, or even to speak. They don't see the psychic costs for us, being singled out in front of all the other kids.

School psychologists used a divide-and-conquer strategy, calling some of us dyslexic. Others were said to have ADHD. Some have autism, and others, PDD-NOS. Just saying we "have" these things makes it clear how undesirable they are. Those names put us in a dozen individual silos and prevent our coming together. Psychologists unwittingly added to the harm when they told parents, "We don't know how this happens," and parents assumed the worst, which was that their child's difficulties were a result of their bad genes or their bad parenting.

Over the past 30 years, all that has led to the formation of two unhealthy identities: a generation of Broken Kids and the Warrior Moms who raised us. It has taken our growing of age to figure out what's happened, and " Neurodiversity" is the result. Neurodiversity, and Neurodivergent people, are this community's response to the one-sided medical models of autism, ADHD, and other inborn neurological differences that evolved in the 1990s with . According to the latest CDC statistics, one or more of these diagnoses is bestowed on almost one in seven children in America. Make no mistake: these labels are meant to define what's wrong. But can so many people possibly be wrong? Might we simply be different? Might it be that it's easier to marginalize us today, and let us fail, than help us be productive members of society, as we have been for thousands of years of human history?

I believe we will look back on this moment-the emergence of neurodiversity-and see this as the moment we began to correct a wrong that was perpetrated on millions with the best of intent and the worst of results.

Today, our voices are too loud to ignore, and the educational and medical communities are grudgingly acknowledging the errors they made. They were correct when they identified problems many of us had in engaging other people or progressing through school. Where they failed was in seeing the exceptionalities that are also part of so many of us. They were quick to call us out as "too sensitive" when it came to the flickering lights in class or the hard sounds reflected by concrete walls. They failed to see how those same sensitivities made us stars as adults, from conducting music to engineering lasers. We've been called out for failing to progress in school, not because we are not capable, but because we have different learning styles. Rather than support us, schools have taken a "conform or else" approach, which has failed us badly.

Seeing our failures, critics double down, saying, "Not every neurodivergent kid will grow up to be a star." That's true. Nor will every Jewish kid be a star, but that need not take away their identity and their pride in what they feel they stand for. We are all deserving of respect and human dignity. Jewish kids have their own schools, and schools for Neurodivergent kids are now appearing. We can all thrive where we are supported. It's not necessary or desirable to jam us all into one box.

As an adult Neurodivergent person, I recognize that some of my peers have greater skills, just as I have skills others lack. That observation is true for all of us, wherever our abilities may lie. We all deal with disability as we progress through life. Neurodivergent people, by virtue of our different brains, face disability from the beginning, as we struggle to communicate and interact with others whose brains work differently from ours. By recognizing our neurodiversity, we can grow up secure in the knowledge that we are more than just our disabilities. That does not mean we should not face our disabilities-we must do that-but we should do so while also building our strengths, for it is those that will make us stars.

The medical and educational communities thought they were helping us by identifying what was wrong. I believe they meant well, but it's time to move on. The one-track public school teaching plans and the bestowing of psychiatric diagnoses to so many are not leading to the outcomes any of us hope for. It's time to support how we learn best and celebrate our best selves instead of focusing on wrongness while forcing conformity.

One way to accomplish that will be to put more Neurodivergent people in roles that shape public policy, and that is happening slowly. It's a long road, but I believe we will get there.

# data[].attributes.attachment_link.title
Neurodiversity Is an Identity, Not a Disorder

# data[].attributes.attachment_link.description
Personal Perspective: We must reckon with how we see ourselves.

# data[].attributes.body
These are the slides from part 2 which you can use for your own CPD

# data[].attributes.body
These are the slides from part one of the training which you can use for your own CPD

# data[].attributes.body
It is important that we are advocating for children who find social interaction and change difficult. Instead of expecting children to act in a way that is neurotypical we can explain to others that they may not behaviour in ways that other might deem 'social acceptable' but that is ok because they are merely neurotypical constructs which all others should not be judged by.

# data[].attributes.body
This short video explains Alexithymia. It talks about it in relation to Autism but it is not restricted to autists. The important points are about being in tune with a person to understand needs, that emotions are complex with many words to describe them so finding those words may be hard. Figuring out what you feel, why you feel like that and confusing our emotions and feelings, means we need to give others time, space, and support

# data[].attributes.attachment_link.title
What is Alexithymia? (describing emotion)

# data[].attributes.body
This book is a follow on. It is suggested that parents read the 'strengths' and difficulties' one first. It is a longer booklet but has ideas about how to support children around executive functioning

# data[].attributes.headline
UNDERSTANDING THE STRENGTHS AND DIFFICULTIES FOR NEURODIVERGENT CHILDREN

# data[].attributes.subject
UNDERSTANDING THE STRENGTHS AND DIFFICULTIES FOR NEURODIVERGENT CHILDREN

# data[].attributes.body
This is a really nice booklet which give clear concise information using simple diagrams to show what children may find difficult but equally what they might be great at - and how to support this.

# data[].attributes.body
This website is a easy read to explain what Autism is as sometimes it can be difficult to explain what it is!

# data[].attributes.attachment_link.description
A website about autism, for autistic young people - so that everyone can gain a better understanding of what autism actually is.

# data[].attributes.body
A video made by the team at Norfolk County Council discussing the use of visuals.

# data[].attributes.attachment_link.description
Using Visuals https://justonenorfolk.nhs.uk
Pyramid Educational Consultants - PECS https://pecs-unitedkingdom.com
Speech, Language and Communication: Supporting the early years in Norfolk https://padlet.com/account/setup

# data[].attributes.body
Donald Winnicott argues that there is always going to be rupture in our relationships because we are only human! Repairing them is important because it demonstrates respect, love/care, support, responsibility and wanting to go forward. Modelling these things alongside empathy helps to restore balance and trust and gives us the ability to move forward.

# data[].attributes.body
Look at the article on listening from everydayregulation.com This poster is free to download from their website and it explains how to use it and how bodies and brains listening and learn differently. Knowing how your little ones listen and learn will help you with your planning and pedagogy. it also explains why behaviour management that tries to keep children still, may not be helping our children who struggle to keep still - for lots of reasons.

# data[].attributes.body
We can be judgemental about lying, but there are lots of situations, past experiences and feelings that could be influencing the reasons - including developmental age and stage.

# data[].attributes.body
This blog is from Everydayregulation.com and it talks about how we listen and what listening means to different people. Most importantly it reflects on why listening NOT just hearing, or an observable behaviour or a practice in compliance.

# data[].attributes.attachment_link.readable_text
If you surveyed a hundred people on how they define "listening," you would probably get close to a hundred different responses, ranging from "doing as you're told," "making eye contact," or "taking in information."

That is because "listening" is a process highly dependent on individual styles and experiences.

What one person identifies as a need to listen might be distracting for another. An environment that is good for one listener might be over- or underwhelming to another. How one person might move while listening could be how another person moves when they are off-task.

Listening looks, feels, and even sounds different for each person, because each brain takes in, holds, and processes information differently. Listening involves our whole body interacting with our surroundings in a variety of ways based on how we experience, perceive, and exist in the world.

Listening is everything we do-and don't do-to effectively take in information from a communication partner.

What Listening Is Not

Listening is not just hearing. Hearing is a passive function of our ears, which receive sounds and sends them to our brain to be sorted and processed. Hearing is a mechanical process of converting sound waves into information. Hearing is only one part of listening for (most) people.

Listening is not an observable behavior. Listening happens within our brains, and therefore can't be seen or pointed out to children. So often, we (adults) teach children that listening means following a specific pattern of observable behaviors: eye contact, voice off, body still, etc. This approach only teaches children a set of behaviors that help make (many) speakers feel heard, and fails to recognize what each individual learner needs to be an engaged listener.

Listening is not a practice in compliance. Listening is not doing as you're told, conforming to arbitrary standards, or complying with demands. Listening is not reliant on extrinsic conditions, nor does it improve at the behest of authority figures.

Listening is not performative. When children learn to perform adult-defined listening behaviors-rather than learn the listening process-it in fact prevents them from developing true listening skills. Listening does not rely on the outward interpretations of others; yet when we define it as depending on the performance of specific behaviors, we teach students to focus their energy on appearing to listen, rather than the act of listening itself.

Listening is not for the speaker's benefit. People often categorize someone as a "good listener" based on how much the listener's behaviors make the speaker feel heard-which often mimic the behaviors they themselves show when they are listening. But what makes a speaker feel heard does not always align with what allows a learner to listen.

So...what is listening?

To listen is to hear and understand. It is taking in, processing, and applying information. It is active. It is a process. It relies on the skills of interoception, reflection, and advocacy. It involves creatively adapting our personal listening process to honor the needs of our community. It is the foundation of learning and communicating and connecting. And it begins with regulation.

What is the listening process?

The listening process (as defined by author Joseph DeVito, 2000) has five stages: receiving, understanding, remembering, evaluating, and responding.

When someone communicates with us, the information gathered through our senses (typically hearing and/or vision) is received by the brain.

Our brain then works to understand that information by assigning meaning to individual stimuli.

It then has to hold multiple pieces of information ( remember) long enough for us to see how all the pieces come together (individual words forming phrases, tone impacting meaning, etc.).

Our brain then works to evaluate the importance and value of the message, which is influenced by our personal experiences, biases, neurotypes, and communication styles.

Finally, our brain decides how to respond to the information it has received: nodding in agreement, ignoring and walking away, adding commentary, asking a question, etc.

Throughout this entire listening process, our brain is also working to manage the body's needs through our nervous system: breathing in and out, coordinating motor movements, activating appropriate muscles, continuing basic organ functions, sorting incoming sensory information, and other important functions.

What does the nervous system have to do with listening?

If your nervous system becomes overwhelmed while you are trying to listen, the brain will shift its attention to self-preservation through the sympathetic nervous system. This interrupts the listening process and prevents our brain from processing the information it is receiving.

However, people can learn tools to recognize when it's important to enter into a state of self-preservation (sympathetic response) and when to calm their sympathetic nervous system (parasympathetic response) when it is activated unnecessarily. This is called regulation.

Different brains respond to stimuli differently, so what triggers a sympathetic response in one person may not trigger the same response for someone else. Learners need practice developing regulation skills in order to become stronger listeners so that they can successfully support their body's nervous system throughout the listening process.

What does regulation look like for my learners?

Put simply, regulation is the process of navigating our emotions, energy levels, attention, physiological needs, psychological needs, and sensory needs. It involvesresponding to the information our brain receives from our body.

Regulation includes going to the bathroom when you need to, taking a deep breath when you feel stressed, getting a sip of water or a cup of coffee when you feel drowsy, standing up when your back is sore, twirling your pen when you need to focus, or connecting with a loved one when you feel lonely.

People learn regulation skills through exploration of their sensory experiences, observation of their peers, modeled strategies by trusted adults, and direct instruction.

Regulation begins with co-regulation, where a trusted person provides grounding support to a dysregulated person. It can sometimes include self-regulation, where a person develops the skills necessary to meet their own regulatory needs.

Why is regulation the first step in the listening process?

In order to listen, we must be in a mental space of safety; have met our body's needs in order to limit distractions and roadblocks; understand what our brain needs to process incoming information; and have the cognitive capacity to hold, sort, and apply that information.

Regulation is a multifaceted concept that involves and relies on many underlying and prerequisite skills, such as sensory processing, situational awareness, motivation management, and emotional awareness.

Regulation as it relates to listening has four primary components:

Interoception: interpreting and understanding the sensations your body is sending your brain about its needs, wants, and responses

Reflection: determining what you can do with the information your brain gains from sensations

Action: doing something to meet the needs of your body and brain, based on the information from your sensations

Advocacy: telling others what you need from them in order to take action to meet your needs

In order to help cultivate active and involved listeners, we must begin with building strong regulators. When we teach learners to listen, it is imperative to focus on the role of regulation within and throughout the listening process. Regulation is a skill that people learn and develop throughout their lives. By practicing and modeling these skills on a regular, daily basis, learners can determine what works for them. Those who practice regulation regularly become listeners who regulate more naturally. When regulation becomes an everyday practice, listening becomes an everyday skill.

If you surveyed a hundred people on how they define "listening," you would probably get close to a hundred different responses, ranging from "doing as you're told," "making eye contact," or "taking in information."

That is because "listening" is a process highly dependent on individual styles and experiences.

What one person identifies as a need to listen might be distracting for another. An environment that is good for one listener might be over- or underwhelming to another. How one person might move while listening could be how another person moves when they are off-task.

Listening looks, feels, and even sounds different for each person, because each brain takes in, holds, and processes information differently. Listening involves our whole body interacting with our surroundings in a variety of ways based on how we experience, perceive, and exist in the world.

Listening is everything we do-and don't do-to effectively take in information from a communication partner.

What Listening Is Not

Listening is not just hearing. Hearing is a passive function of our ears, which receive sounds and sends them to our brain to be sorted and processed. Hearing is a mechanical process of converting sound waves into information. Hearing is only one part of listening for (most) people.

Listening is not an observable behavior. Listening happens within our brains, and therefore can't be seen or pointed out to children. So often, we (adults) teach children that listening means following a specific pattern of observable behaviors: eye contact, voice off, body still, etc. This approach only teaches children a set of behaviors that help make (many) speakers feel heard, and fails to recognize what each individual learner needs to be an engaged listener.

Listening is not a practice in compliance. Listening is not doing as you're told, conforming to arbitrary standards, or complying with demands. Listening is not reliant on extrinsic conditions, nor does it improve at the behest of authority figures.

Listening is not performative. When children learn to perform adult-defined listening behaviors-rather than learn the listening process-it in fact prevents them from developing true listening skills. Listening does not rely on the outward interpretations of others; yet when we define it as depending on the performance of specific behaviors, we teach students to focus their energy on appearing to listen, rather than the act of listening itself.

Listening is not for the speaker's benefit. People often categorize someone as a "good listener" based on how much the listener's behaviors make the speaker feel heard-which often mimic the behaviors they themselves show when they are listening. But what makes a speaker feel heard does not always align with what allows a learner to listen.

So...what is listening?

To listen is to hear and understand. It is taking in, processing, and applying information. It is active. It is a process. It relies on the skills of interoception, reflection, and advocacy. It involves creatively adapting our personal listening process to honor the needs of our community. It is the foundation of learning and communicating and connecting. And it begins with regulation.

What is the listening process?

The listening process (as defined by author Joseph DeVito, 2000) has five stages: receiving, understanding, remembering, evaluating, and responding.

When someone communicates with us, the information gathered through our senses (typically hearing and/or vision) is received by the brain.

Our brain then works to understand that information by assigning meaning to individual stimuli.

It then has to hold multiple pieces of information ( remember) long enough for us to see how all the pieces come together (individual words forming phrases, tone impacting meaning, etc.).

Our brain then works to evaluate the importance and value of the message, which is influenced by our personal experiences, biases, neurotypes, and communication styles.

Finally, our brain decides how to respond to the information it has received: nodding in agreement, ignoring and walking away, adding commentary, asking a question, etc.

Throughout this entire listening process, our brain is also working to manage the body's needs through our nervous system: breathing in and out, coordinating motor movements, activating appropriate muscles, continuing basic organ functions, sorting incoming sensory information, and other important functions.

What does the nervous system have to do with listening?

If your nervous system becomes overwhelmed while you are trying to listen, the brain will shift its attention to self-preservation through the sympathetic nervous system. This interrupts the listening process and prevents our brain from processing the information it is receiving.

However, people can learn tools to recognize when it's important to enter into a state of self-preservation (sympathetic response) and when to calm their sympathetic nervous system (parasympathetic response) when it is activated unnecessarily. This is called regulation.

Different brains respond to stimuli differently, so what triggers a sympathetic response in one person may not trigger the same response for someone else. Learners need practice developing regulation skills in order to become stronger listeners so that they can successfully support their body's nervous system throughout the listening process.

What does regulation look like for my learners?

Put simply, regulation is the process of navigating our emotions, energy levels, attention, physiological needs, psychological needs, and sensory needs. It involvesresponding to the information our brain receives from our body.

Regulation includes going to the bathroom when you need to, taking a deep breath when you feel stressed, getting a sip of water or a cup of coffee when you feel drowsy, standing up when your back is sore, twirling your pen when you need to focus, or connecting with a loved one when you feel lonely.

People learn regulation skills through exploration of their sensory experiences, observation of their peers, modeled strategies by trusted adults, and direct instruction.

Regulation begins with co-regulation, where a trusted person provides grounding support to a dysregulated person. It can sometimes include self-regulation, where a person develops the skills necessary to meet their own regulatory needs.

Why is regulation the first step in the listening process?

In order to listen, we must be in a mental space of safety; have met our body's needs in order to limit distractions and roadblocks; understand what our brain needs to process incoming information; and have the cognitive capacity to hold, sort, and apply that information.

Regulation is a multifaceted concept that involves and relies on many underlying and prerequisite skills, such as sensory processing, situational awareness, motivation management, and emotional awareness.

Regulation as it relates to listening has four primary components:

Interoception: interpreting and understanding the sensations your body is sending your brain about its needs, wants, and responses

Reflection: determining what you can do with the information your brain gains from sensations

Action: doing something to meet the needs of your body and brain, based on the information from your sensations

Advocacy: telling others what you need from them in order to take action to meet your needs

In order to help cultivate active and involved listeners, we must begin with building strong regulators. When we teach learners to listen, it is imperative to focus on the role of regulation within and throughout the listening process. Regulation is a skill that people learn and develop throughout their lives. By practicing and modeling these skills on a regular, daily basis, learners can determine what works for them. Those who practice regulation regularly become listeners who regulate more naturally. When regulation becomes an everyday practice, listening becomes an everyday skill.

# data[].attributes.attachment_link.title
What Does it Mean to Listen? - Everyday Regulation

# data[].attributes.attachment_link.description
"Listening" is a process highly dependent on individual styles and experiences. What one person identifies as a need to listen might be distracting for another. An environment that is good for one listener might be over- or underwhelming to another.

# data[].attributes.body
This is a comprehensive guide to trauma for children coming into setting having witnessed or been exposed to traumatic experiences.

# data[].attributes.body
This link to the Anna Freud website offers information, guidance and advice around trauma, how it might present in babies and young children, and how you can address it.

# data[].attributes.attachment_link.description
Trauma is an emotional response to an event that is deeply frightening or distressing and can affect babies, infants and young children in ways they might not be able to communicate. Find out more.

# data[].attributes.body
Emily is an Autistic speech and language therapist who is passionate about ensuring the SALT practices used with Autistic people are empathetic, empowering and appropriate. Emily challenges many ideas, language and practices used on the Autistic community and her website offers a new lens and reframing of Autism and SALT.

# data[].attributes.attachment_link.readable_text
Hello! My name is Emily Price (she/her)

I don't provide interventions based on behaviourism and the social-deficit theory of Autism; these practices are rooted in flawed theories and outdated research. As a Neurodivergent-Affirming SLT I do not provide Social Skills Training. We know that these interventions are designed to teach Autistic children to mask and perform a set of socially expected behaviours built upon neuronormative norms of attention and communication. As a Neurodivergent-Affirming SLT I focus on helping the Autistic person to advocate for themselves through their chosen method(s) of communication. I support them to express their choices, views, boundaries, emotions, and decisions. I give the person full autonomy to select their own goals. I help them to identify their communication strengths & needs using non-pathologising language. I use a trauma-informed approach which takes into context the historic marginalisation and exclusion of Autistic people, I consider the accumulation of sensory, interpersonal, and emotional trauma, and the intersections between other struggles e.g., gender dysphoria, eating disorders, ethnicity.

To empower Autistic children / adults through:​

# data[].attributes.attachment_link.title
Autistic SLT | Emily Lees | Empowering autistic children

# data[].attributes.attachment_link.description
I'm Emily, AutisticSLT. I am an autistic Speech and Language Therapist in the UK . My goal is to empower Autistic children and adults through - accessible information, lived experience of being autistic, expertise of Speech, Language and Communication, promoting neurodivergent-affirming practice

# data[].attributes.body
This article explains what these terms mean. Echolalia is part of how some children learn language through imitation however a large percentage (some researchers quote 75-90%) of Autistic children will use this as a part of Gestalt language processing to support their language development in the first instance and we can help support this rather than stop it. This way of looking at language is relatively new although in America there is much more work being done around it. If you are interested in this topic please look at the work of Marge Blanc.

# data[].attributes.attachment_link.readable_text
In recent years, myself and David have regularly connected over our shared interest in neurodivergent and disability-informed practice in early childhood. Both disillusioned by the fact that most of our early childhood documents describe typically developing children, we have become increasingly fascinated by ideas, concepts and theories that offer us a renewed way of understanding developmental diversity. We first became aware of Gestalt Language Processing (GLP) via the social media accounts of several American Speech Pathologists, in particular that echolalia was a valid and meaningful form of communication.

We both exchanged experiences where we had been advised that echolalia had little meaning, and should be ignored. We considered the implications of this on the echolalic children we had both cared for and educated, and felt frustrated that we did not have access to this knowledge.

Speech and Language Therapy (SaLT), even more so than early childhood education, has been dominated by a medical and deficit model of neurodevelopmental and linguistic difference. This means that much of the support given to children is focused on "fixing" their perceived delays to get them back on track so they develop and learn like their typically developing peers.

It seems, however that in both fields, this approach is changing. And so, we want to provide an insight into GLP outside of a clinical setting, and to raise awareness that echolalia counts in child development.

Echolalia is an unexpected treasure hunt... it is full of echoing, referencing, scripting, riffing and rifting, storing and combining and recombining, patterning, quoting, punning, swinging from hyperlexic memory to synesthetic connection, words are my tangible playground.

Just Stimming, 2023

What is echolalia?

You could pretty much guarantee that most early years educators have heard at least one child communicating via echolalia. Echolalia is defined as "the repetition of words, phrases, songs or other more elaborate dialogues uttered by another person which may be immediate or delayed." (International Classification of Diseases, 11th Revision; Diagnostic and Statistics Manual of Mental Disorders, 5th Ed).

Perhaps the most obvious example of echolalia might include a child at pick-up time responding to their parent's prompt: "Say goodbye Cleo!" with a "Say goodbye Cleo!" of their own. They also might interject bits from their favourite TV shows, songs or phrases they have heard from adults; often in a way that does not seem to make sense in the context of the moment. Others might seem to babble in a sing-songy way, or you might notice they adopt a particular accent.

We often feel a range of responses when hearing children communicate in "unusual" ways. Some might be puzzled yet endeared by the familiar sounds of a phrase within their settings. Others might feel frustrated by the lack of conversational turn-taking that often emerges in a child's earliest years.

Whilst we might not always know why a child is, say, repeating a favourite phrase from Peppa Pig when they are putting on their jackets to go outside, we can often pick up on the distinct inflection or tone of voice that comes with echolalia. Educators can find themselves feeling equal parts uncertain and charmed when they think about echolalic children in their settings and the usual inclination is to think, " How do I fix this? They are so lovely but why do they speak this way? How can I best connect with and support them?" ‍

If we are being honest, we might often wonder, " How do I get them to communicate normally?"

‍

‍

What is Gestalt Language Processing?

Based on prior research and study, there is a growing movement within speech therapy that is helping us to unpick why children communicate in this way and how we can best support them. The research behind Gestalt Language Processing (GLP) shines a light on what is actually going on with our echolalic children, although it is important to note that this is an emerging area of research that has been somewhat neglected by mainstream Speech and Language Therapy.

It turns out that most autistic children - and some non-autistic children as well - pick up language in a different way that includes a number of stages. Most commonly what we see are "gestalts", meaning "whole."

Children who are gestalt language processors (GLPs) pick up and use language in "whole" chunks or scripts. It is their repeated use of these gestalts that then gets labelled as echolalia. They may use this in immediate ways - for example, repeating straight away - or delayed echolalia, in which their gestalts are used across space and time. Marge Blanc, a speech therapist in the US is widely credited with implementing this research, often to great success.

‍

Analytic language development

Almost all of us are taught that children pick up language on a word-by-word basis. It can be tempting to see this as not only the "normal" way of learning to speak but maybe even the only way.

Spoiler alert: it is not!

If most children (what these speech therapists describe as analytic language processors) have a language journey that looks something like this:

‍Dog -> Dog barking -> I hear a dog barking

Young gestalt language processors might start their language journey by saying "What a nice dog! " every time they see a dog, as they heard a family member exclaim this one day.

There is a growing field of research that shows that gestalt language processors are really able to "get to the same place" as "typical" or analytic language processors, they just have a different path to follow.

‍

‍

Updating our support for Gestalt Language Processors

Unfortunately, most of us are still taught or advised to try to force these children onto the path we are more used to. It is not uncommon for early years educators to be told to ignore echolalia, to add a word to a child's phrase, or dull down our own communication with them as if they had the receptive understanding of a younger child.

Often this looks like us educators focusing on "functional speech" or using the visual communication system PECS (Picture Exchange Communication System) in a needlessly controlling and cumbersome way. For example, only meeting a child's request upon exchange of a visual (imagine if adults placed such conditions on each other during exchanges!).
"Lunch now, then play." "Thirsty?" asking a child if they want a drink. "If you want to play with the car, show me the car visual. Where is the car? Can you give me the car visual?"
In short - much of our current strategy advice for GLPs is like trying to fit a round peg into a square hole. Both of us have experienced the disappointment when a child has not made progress as a result of our mismatched approaches. And we are increasingly having conversations with other early educators who want and need access to approaches that are more attuned to linguistic diversity.

In fact, it is typically older GLP children who get most "stuck" in their speech as they have racked up more time with our "traditional," well-meaning but greatly mismatched approaches. They might have a toolbox of functional phrases but in the words of Marge Blanc, "We have failed to consider that the functional phrases we have taught might actually interfere with [their] potential to develop language competence."
(Natural Language Acquisition on the Autism Spectrum, Marge Blanc. Page 8 published in 2012)

Gestalt language processing is not a disorder, nor is it a diagnosis. It does not need to be fixed or cured - it simply needs to be understood.

Again, gestalt language processors can and do absolutely "get to the same place" as analytic language processors but only if speech therapists, educators and other adults are willing to un-learn many things we have been taught or assumed about all children's language development. It is simply a different way of acquiring language and should not become another term that is used to pathologise those who communicate differently.

We are hoping through these articles, that we can draw upon the expertise of others to shine the light on GLP much brighter.

‍

‍

Kerry and David's top tops for echolalia and Gestalt Language Processing in the Early Years

Echolalia is often meant to communicate!
Even if we don't understand a certain gestalt we should make an effort to acknowledge them with a friendly "yeah!" or repeat their phrase back to them.‍

Don't take children's gestalts/scripts literally.
Some gestalts might be quite confusing. It is often worth asking their family if they know where a certain gestalt came from and what they think it is meant to communicate.‍

Gestalts don't need to be corrected, ignored or stopped. In fact, young children need more gestalts!
This is how young GLPs communicate! They actually need us to model more scripts they can pick up and use for their own purposes and eventually start to "mix and match" together. Short one- and two-word phrases can't be mixed and matched together and if that's all they hear from the adults in their lives, it is likely their communication will not move any further.

Intonation really matters.
GLP children are much more likely to pick up a gestalt if it has an intonation they find pleasing or interesting. Feel free to try different intonations as you like and see what individually clicks with the child in question.

Perhaps most importantly, don't worry and don't over think things!
We know how powerful it can be to informally model language in our everyday interactions with our "typical," ALP children, the same is absolutely true for our GLP children. Model gestalts in certain contexts you would like them to pick up but also feel free to speak how you would with any other child.

Give yourself (or your staff) grace.
Early years educators are already spinning dozens of plates day in and day out. For us to pick up and make use of new knowledge, it needs to be done over time, with support and proper training. We should always be reflective and open to changing the way we do things but change in our practice or provision is best achieved at a sustainable pace. Don't feel like you need to be an instant expert or change your ways immediately.

Check out Meaningful Speech. Run by US-based speech pathologist Alexandria Zachos, they have the main driving force behind this increased interest in embracing gestalt language processing. They share countless free resources on their website and are an excellent starting point for all. David is currently taking their course for parents and other professionals and is learning a great deal. ‍

Some accounts on Instagram to follow to learn more:‍

@montessoriandsensory

@where_idris_leads

@blancmarge

@bohospeechie

@bemespeech

This article was co-written by David Cahn and Kerry Murphy. We have backgrounds in early childhood education and identify as neurodivergent. We are keen to broaden understanding of GLP across different contexts, and we also recognise that this must be done through an intersectional lens that recognises speech, language and communication development as influenced by a range of environmental factors and experiences.

# data[].attributes.attachment_link.title
What are Gestalt Language Processing and echolalia? | Famly

# data[].attributes.attachment_link.description
Meaningful communication in the Early Years: Kerry Murphy and David Cahn on understanding echolalia and Gestalt Language Processing

# data[].attributes.body
I like the messages in this tool about how we can support neurodiversity and the ways we can look at what we do and reflect upon that practice to make our goals for the children strength based.

# data[].attributes.body
A short article about what Gestalt language learning is and how important it is for us to support it with those children who are using it for language acquisition.

# data[].attributes.attachment_link.readable_text
Gestalt Language Acquisition - Another Way of Processing Language

Analytic language is the type of language acquisition often thought of and learned about. This is language learning that starts at the single word level which builds to phrases and eventually sentences.

Gestalt language acquisition is language learned in in larger units of words first, rather than single words. The process of gestalt language development is described through Natural Language Acquisition stages (see stages below).

A gestalt language processor learns language in chunks of words rather than one single word at a time. For example, rather than analytic language learning of "car", to "red car", then eventually "It's a red car!". Gestalt language processors may hear a caregiver say, "Wow, that's a fast red car!" and perhaps that is what they say every time they see a car (despite its color).

There is nothing 'wrong' with gestalt language learning, it is just a of developmental language learning. Embracing how a child learns language can help them continue to acquire new language/skills through their own learning type to make more efficient gains toward their ability to self-generate language. Children who are autistic* are often gestalt language learners. Children who are not autistic can also be gestalt language learners.

What is Echolalia?

Echolalia is the repeating of an utterance that has been produced by others.

Immediate Echolalia: utterances that are repeated immediately or after a brief delay.

Delayed Echolalia: refers to utterances that are repeated after a significant delay (Prezant & Rydell, 1984).

Echolalia COMMUNICATES! The immediate logical reaction may be that we should not encourage echolalia, but in fact we SHOULD encourage it and build from it to acknowledge the communication and boost progress toward self-generated language.

What is Scripting?

Scripting is the use of delayed echolalia that a child may use to attempt communication or just something that they enjoy saying. It could be language they overheard others say, from a game they played, a show they watch, etc.
Example 1:
Child goes down a slide at the park and hears the parent say "wow that's fast!" and now each time the child goes down a slide they say "wow that's fast!". The caregiver would then model additional language phrases other times they or the child go down a slide (i.e. "Wow that's fun!").
Example 2:
A teacher says: "Okay time for gym!" and the child says: "Let's go to the spaceship!". This indicates delayed echolalia/scripting from a show the child enjoys. When the child says "Let's go to the spaceship!", their intended meaning is "Let's go to the gym" but they are not yet able to self-generate 'gym'. The caregiver may then acknowledge the child's attempt at communication by saying "Yes, let's go!".

Natural Language Acquisition Stages
Stage 1 - Echolalia:
"Let's go outside", "Time to play"
Stage 2 - Mitigated Gestalts -
"Let's" + "play" = "Let's play"
"Time to" + "go outside" = "Time to go outside"
Stage 3 - Single Words
"Let's go" + "go outside" have turned to using "go!"
Stage 4/5/6 - Beginning Grammar & More Complex Sentences - Use of original sentences - Using single words that have isolated words from partial gestalts Use of partial gestalts

1. Respond! Smile, nod, or even just repeat it back to acknowledge that you know it is a communication attempt.

2. Don't take the echolalia or scripted comment seriously (i.e. "it's on fire!" may have a different meaning to the child than something actually being on fire/hot/etc.).

3. Don't respond with "replacement language". Language development is a process. It's better to embrace a child's attempts to communicate and clearly model your OWN language during good teaching moments.

4. Be a detective - Ask yourself, "What are they communicating to me when they say this script?". Once you discover the true meaning, you will be able to target ways to increase self-generated language through modeling your own language.

Speech Therapy for Gestalt Language Learners
https://www.meaningfulspeech.com/
The ultimate goal in speech therapy for children who are gestalt language learners is to eventually use self-generated language. Speech therapy intervention for gestalt language is the most effective when language is targeted in the most natural and engaging contexts as possible. A speech therapist will likely embrace child-led play and the child's interests to target language. For gestalt language, acquiring skills takes time, detective work from caregivers, and consistency. This will be best accomplished by doing activities or playing with items that the child enjoys.

4 Tips for Responding to Echolalia and Gestalt Language:
References:
For more information about Gestalt Language, check out these websites/resources:

* While many people may be more familiar with Person First Language (i.e. Person With Autism or ASD), the autistic community has voiced a preference for Identity First Language (i.e. 'autistic'), which is why Identity First Language was chosen to be used in this post.

- Ashley Cubberly, M.A. CCC-SLP

Peters, A. 1983, 2002. The Units of Language Acquisition. Cambridge: Cambridge University Press. http://www.ling.hawaii.edu/faculty/ann

Prizant, B. 1983. "Language Acquisition and Communicative Behavior in Autism: Toward an Understanding of the 'Whole' of It." Journal of Speech and Hearing Disorders 48:296-307.

Prizant, B., and P. Rydell. 1984. "An Analysis of the Functions of Delayed Echolalia in Autistic Children." Journal of Speech and Hearing Research 27:183-92.

Wetherby A. 1986. "Ontogeny of Communicative Functions in Autism." Journal of Autism and Developmental Disorders 16 (3): 295-316.

Rydell, P., and B. Prizant. 1995. "Assessment and Intervention Strategies for Children Who Use Echolalia." In Teaching Children with Autism: Methods to Increase Communication and Socialization, edited by K. Quill: 105-129. Albany, NY: Delmar Publishers.

Stiegler, L. 2015. "Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand?," American Journal of Speech Language Pathology: 1-13.

Zachos, A. (n.d.). Meaningful speech- echolalia education. Meaningful Speech- Echolalia Education. Retrieved May 1, 2022, from https://www.meaningfulspeech.com/

# data[].attributes.attachment_link.title
What is Gestalt Language Learning? - Associates in Pediatric Therapy

# data[].attributes.attachment_link.description
What is Gestalt Language Learning? A gestalt language processor learns language in chunks of words rather than one single word at a time. There is nothing 'wrong' with gestalt language learning, it is just a type of developmental language learning.

# data[].attributes.body
Our language progression tends to be linear but children use imitation and echolalia as part of their acquisition too. Children who may be Gestalt processors of language may use whole chunks of language and memorised phrases. This video shows how we can help support a different way of language acquisition.

# data[].attributes.attachment_link.title
gestalt language processing early years provision - Bing video

# data[].attributes.body
This infographic gives us ideas about what children who have sensory needs might be looking for us to provide in terms of experiences that they might enjoy or what to avoid or approach differently when they are uncomfortable and where the child may not be able to express their preference or feelings verbally. Whether intentionally or unintentionally it appears quite sexist where these behaviours are not gender specific.

# data[].attributes.body
These 10 simple strategies start us on the path to look for sensory stimulation or what to avoid that might be overstimulation.

# data[].attributes.attachment_link.readable_text
Corinna Laurie, Clinical Lead Occupational Therapist at the National Autistic Society and Director of Evolve Children's Therapy Services Ltd, gives some simple strategies to target sensory processing differences.
1. For the child who is overwhelmed by excessive noise, try offering them ear defenders, calming ear buds or allow then to use an MP3 player whilst concentrating.

2. For the child who becomes agitated by touch, allow them to stand at the front or back of the queue to avoid being bumped. Allow them to transition to the next lesson three minutes before others, to avoid corridor collisions.

3. For the child who finds it difficult to sit still, include regular movement breaks, try alternative seating, for example wobble cushions/stools to allow fidgety movement. Always have a variety of fiddle toys available to aid focus.

4. For the child who seeks hugs, try Lycra undergarments, rash vests and rugby base layers that are cheaply available from many sports outlets. Weighted lap pads and blow up canoe chairs are also useful.

5. For the child who finds black print on a white background difficult to read, change the paper to a buff colour and consider the font. This is less stressful on the eyes. Consider your presentation layout for PowerPoints too.

6. If a child is overwhelmed by smell, use a sweatband with a drop of oil, shampoo, or perfume/aftershave that they like. Allow the student to take this with them to mask the smell they find uncomfortable.

7. Food play should be encouraged for those children with a limited diet. There should be no pressure on the child and this should not be done at mealtimes. The aim is purely to reduce the fear of food.

8. The use of a quiet, calming room/space within the classrooms and at home are essential for calming. Use a pop-up tent, blanket over a table or under a cabin bed. Add bean-bags and other sensory equipment/toys.

9. For children who want to chew, offer alternatives like commercially available chew toys, crunchy bread sticks or carrot sticks. Drinks in a sport bottle also help those seeking oral input.

10. For children who dislike having their teeth brushed, try a vibrating toothbrush, Collis Curve toothbrush (this cleans all surfaces in one movement) and use unflavoured toothpaste such as Oranurse.

Further information
Laurie, C. (2022) Why is occupational therapy important for autistic children? Laurie, C. (2022) Sensory and Motor Strategies (3rd edition)

# data[].attributes.attachment_link.title
Ten simple sensory strategies for autistic children

# data[].attributes.attachment_link.description
Corinna Laurie sets out some strategies to support sensory processing

# data[].attributes.body
This is a 5 minute video which talks about and shows what intensive interaction looks like. It explains the benefits and it also has parent feedback talking about their story and the difference it has made. The infographic section of this Padlet has information about intensive interaction too.