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What is declarative language? - Autism Awareness

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Declarative language is a comment or a statement that shares what one knows, observes, or thinks. It emphasizes shared observations, thoughts, and experiences rather than directives or demands. A lot of communication approaches rely heavily on questions (who, what, where, when, why or how) or instructions; declarative language does the opposite. Instead of telling a person exactly what to do…

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Information on the services available for children and young people up to 25 years with special educational needs and/or disabilities (SEND) and how to access them

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Free Social Work Tools and Resources: SocialWorkersToolbox.com

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Free direct work, assessment and interventions resources for children’s social workers . Offering 400+ free tools for social workers, including guides, worskeets, booklets, children’s stories, and videos for direct work with children. Find resources for domestic abuse, mental health, substance use, adoption and fostering and more.

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Talk to people who share similar experiences to yours by joining a workshop, drop-in session, coffee morning or virtual meeting. Each session is delivered by parents and carers of autistic people who are happy to share their knowledge and experience with others.

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Sheffield Children's NHS Foundation Trust

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What is the Sensory Service?

The Sensory Service is a multi-disciplinary team based at the Ryegate Children's Centre in Sheffield. We aim to help parents, carers, school staff and young people to have a better understanding of sensory processing and how this impacts on every day life. We provide information and advice on how to adapt activities and the environment to support children's sensory needs. The team includes Occupational Therapy, Physiotherapy, Clinical Psychology, Speech and Language Therapy.

What is sensory processing?

Sensory processing is the way that our body takes in and makes sense of information. Our senses include hearing, vision, touch, taste and smell, as well as vestibular processing (which helps with balance and movement), proprioception (which is the awareness of our body in the space around it), and interoception (our awareness of our internal body feelings). We use our senses every day to interact with the world.

What might happen when sensory processing becomes a problem?

Children might find sensory information overwhelming and they might struggle to cope with certain sensory experiences. They may try to avoid certain things, people or places.

Children might find everyday tasks difficult to tolerate, such as showering, wearing certain clothes, eating or teeth-brushing.

Children may seek out sensations to help them to regulate in a way that creates a problem in another way, (for example, needing to move a lot during lessons).

When children are overwhelmed by sensory information it can make it more difficult for them to communicate their needs.

Sensory sensitivities can lead to higher stress and anxiety levels in a child. This in turn can mean they're more tuned into sensory information and can become overwhelmed more easily.

Children may present differently from one day to the next and their sensory needs may be context specific or be influenced by other factors, such as mood, tiredness or stress levels.

Who is the service for?

The service is for any child aged 3-16 years, living in Sheffield, who is having day to day difficulties because of the way that they process sensory information. Children known to the CAMHS Learning Disability service will be re-directed to CAMHS Occupational Therapy, if needing support beyond Universal Provision.

What is the Virtual Therapy Area?

The Virtual Therapy Area is our universal provision, the first level of service for all families. It aims to provide parents and carers with knowledge, ideas and strategies to support your child or young person with sensory needs that may be impacting on their every day life. These resources are primarily aimed at supporting children who are neuro-divergent; for example, your child may have a diagnosis of Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD), Developmental Coordination Disorder (DCD), Developmental Language Disorder (DLD) or a combination of these. However, your child may not have any diagnosis, but may present with sensory needs that are creating challenges in everyday life. Or your child might have a different diagnosis and also have sensory needs that are impacting on their day to day life.

The Royal College of Occupational Therapists states "The term Sensory Processing Disorder is not recognized as an independent diagnosis...and should be avoided" (RCOT Informed View, 2021). Therefore, at the Sheffield Sensory Service, we do not formally assess or provide diagnosis of Sensory Processing Disorder. Our focus is to offer sensory interventions that support a child's sensory needs by adapting tasks or the environment, and by improving a child's capacity for self-regulation.

In addition to the virtual resources, our multi-disciplinary team deliver sensory training to Sheffield schools and educational establishments, and we are aiming to support all schools in Sheffield to be 'sensory accessible'.

If you need these resources in a different language, look at the bottom of the page for a guide to Google Translate.

How to use these resources

Translating information to your home language: Google Translate

1) Click the Google Translate button:

2) Click on your home language. The text will then change

Google Translate may not translate all words correctly. Please contact us on 0114 271 7645 if you have any questions about the text.

Translating information to your home language: subtitles

1) Click the subtitles icon

2) Click the settings icon then ' subtitles/CC'

3) Click Auto-translate

4) Choose your language

You need to turn on the subtitles for all the videos.

The subtitles are translated through YouTube. Some words may not be translated correctly. Please contact us on 0114 271 7617 if you have any questions about the videos. We can arrange a telephone call with an interpreter if needed.

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Sensory processing difficulties - Sheffield Children's NHS Foundation Trust

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What is the Sensory Service? The Sensory Service is a multi-disciplinary team based at the Ryegate Children's Centre in Sheffield. We aim to help parents, carers, school staff and young people to have a better understanding of sensory processing and how this impacts on every day life.

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Parent guide- it is American but useful advice

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Parent guide- it is American but useful advice

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25 Must-Try Techniques for Autism Emotional Regulation

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Struggling with meltdowns? Explore 25 effective autism emotional regulation strategies to help your child feel safe, seen, and in control.

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Speech and Language UK: Changing young lives

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Skip to content

We give families the confidence and skills to help their children. If you're concerned about your child's speech and language development, we can help.

We know that it can be hard to know where to start if you are worried about your child's development. If you think your child is having challenges with talking and understanding words, we are here to help you.

Our free resources and services can help with understanding what to look out for, how to get support and even some simple ways you can help your child at home.

Our progress checker will provide short questions you can answer to see how your baby or child is getting on with their talking and understanding of words.

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Help for families - Speech and Language UK: Changing young lives

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We give families the confidence and skills to help their children. Access our free resources and learn more about ways to encourage children's speech and language development.

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The Speech, Language and Communication Framework (SLCF) - SLCF - The Communication Trust

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What is the Speech, Language and Communication Framework? The SLCF is a free professional development tool, accessible to all, which sets out the key skills needed to support the speech, language and communication development of all children and young people. It is a self-assessment tool which enables individuals to map out their skills, knowledge and ...

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Social and Emotional Skills for Preschoolers

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Supporting Big Feelings in Little Ones: A Strength-Based Approach to Social and Emotional Learning

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Potty Training For Autism – The Ultimate Guide

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Struggling to potty train for your autistic child? Our guide provides tips and step-by-step strategies that will help you!

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The Best Autism Fidget Toys to Relieve Stress and Anxiety

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Discover the best autism fidget toys designed to reduce stress and anxiety while promoting focus and relaxation.

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How Can I Calm Myself Down Cut and Stick Activity Sheet

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NHS staff have been given free access to a number of wellbeing apps to support with their mental health and wellbeing. Click each link below for more information, including how to access support and when this free offer expires.

The Stay Alive app is a suicide prevention resource for the UK, packed full of useful information and tools to help you stay safe in crisis.

Bright Sky is a free to download, confidential mobile app providing support and information for anyone who may be in an abusive relationship or those concerned about someone they know.

The WorkLife Central programme consists of a curated collection of expertise, information and inspiration available through video, live event and written format, covering five principal topic areas - Careers, Families, Inclusion, Wellbeing and Workplace.

Headspace is a science-backed app in mindfulness and meditation, providing unique tools and resources to help reduce stress, build resilience, and aid better sleep.

Unmind is a mental health platform that empowers staff to proactively improve their mental wellbeing.

Zero Suicide Alliance provides you with a range of free online learning sessions that provide you with a better understanding of the signs to look out for and the skills required to approach someone who is struggling, whether that be through social isolation or suicidal thoughts.

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NHS staff have been given free access to a number of wellbeing apps to support with their mental health and wellbeing. Click each link below for more information, including how to access support and when this free offer expires.

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Back to School transition visual supports

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Back to School transition visual supports

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Children and Young People's Therapy Service

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Any professional or a parent can refer a child to the Children and Young People's Therapy Service.

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Somerset Graduated Response Tool Early Years Version September 2023

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Interoception is a sensory term you may not have heard of before...but you have certainly felt or been impacted by the processing of our interoceptive sense! Internal feelings of hunger, fatigue, thirst, body temperature, digestion, and other internal systems offer a certain "feeling", right? This is your interoception sensory system at work! Here, we're covering everything you need to know about this complex sense, and taking a detailed look at how interoception impacts function.

Interoception The 8th sense

Did you know that the five senses we were taught in school is not actually a complete list of a human's senses? In fact, there are 7 or 8 senses that humans experience, depending on who you ask.

Understanding our many senses helps us comprehend how we and others experience the world around us. For the sense we are highlighting today, it is how we understand what is going on inside of us. Check out this post on the OT Toolbox regarding Multisensory Learning: Emotion Activities

Definition of the interoception sense

Interoception is the sense of oneself; it is the ability to understand the body's physical signals that tell you when you are hungry or full, thirsty or quenched, hot or cold, scared or calm, etc.

Interoception refers to the body's ability to identify and process internal actions of the organs and systems inside the body. This lesser-known sensory system helps you understand and feel what's going on inside your body. You can then make essential decisions about eating when you are hungry, drinking when you are thirsty, going into the restroom when you need to toilet, and other physical actions.

There are nerves throughout the body that send these signals to the brain to help regulate the body, and promote homeostasis.

Some of these signals require a conscious act, like drinking water when we are thirsty, while others are non-conscious, like sweating when we are hot.

Interoception comes into play when we consciously realize, " Oh, I am sweating because I feel hot, I should take off my jacket to cool down."

How Does Interoception Impact Function?

Interoception can be thought of as a mind-body connection. Having a strong interoceptive sense would mean that you have a strong sense of the physical self, and what you need to promote comfort at any given time.

Being able to confidently act on your body's needs, makes everything a bit easier. You are likely able to make it to the bathroom before an accident, eat food before you feel light-headed, and stop eating before you feel sick.

But what about individuals who are not able to accurately process the bodies internal signals? They may find it more challenging to be potty trained, have a healthy diet, or emotionally regulate.

The ability to understand and respond to our body's needs is a huge factor in our independence. If we don't quite know what our bodies need, it makes everyday activities much more challenging, and focus on school or work tasks may dwindle.

Interoception even has to do with how our body moves, the action of bones in the skeleton, bone growth (growing pains have a lot of "pain" that is felt internally for kiddos who are rapidly growing! Be sure to check out this related blog on bone names to help tach kids about this concept.

Functionally, interoception impacts so many areas of everyday tasks:

Eating

Drinking

Sleep

Toileting

Getting dressed (putting on temperature-appropriate clothing, or taking off clothing before becoming overheated)

So many more considerations!

Interoception and Emotion

Interoception has a strong connection to emotional processing because of the physical way that we experience emotions. Our muscles clench when we are angry, quiver when we are scared, and relax when we are calm.

Likewise, the stomach may feel upset when we are nervous, and one might get a headache from frustration. People with good interoception can relate these physical feelings to emotions.

If a person sensory processing differences, the signals from the body may not be accurately represented or relayed to the brain. They may be muddied or confusing, leading to a misunderstanding of what the body is trying to tell the brain. Because of this, a tickle may feel like pain, or a person may not know why they are experiencing discomfort.

Without interoception, labelling emotions is then a bit more challenging, as well as understanding how to remedy undesired feelings.

Children may act out in aggression, cry or scream uncontrollably, or show other signs of sensory dysregulation, potentially due to a lack of interoception.

If you know a child who has multiple characteristics of reduced interoception, like potty accidents, over/under eating, and emotional dysregulation, they may benefit from therapeutic intervention to improve their body awareness.
The interoception system plays a part in feelings and emotions, too.
When we feel anxious or worried, we might feel a tenseness about us. Our heart rate might speed up, and we feel that anxiety coursing through our systems.

But for the child with difficulty expressing these feelings, they can't tell us what they are feeling on the inside. They don't have the words to identify specific interoceptive feelings they are having.

Others might not recognize a racing heart. They might not realize that physical implication of anxiety or worry because they can't actually feel their racing heart (when it is very much racing).

When one feels anxious about a situation or an idea, we can help them to focus on their heart beat. We can help them take deep breaths to calm down. This focus on how their body is responding can help their internal state match the environment.

Other ways to help with interoceptive identification include habit and routines to help us feel organized. When we know what to expect, we feel a lot more organized. The body is able to modulate better.

As we increase the challenge, we have to also increase our supports. We can use some external organizational strategies (deep breaths, awareness, mindfulness, heavy work, routines) to help compensate for the lack of internal ability to organize ourselves.

When we are disorganized, this is where we can fall apart. We have to be mindful ahead of time, and be accommodating and accepting of immature nervous systems, whether this is with our children, our spouse, or ourselves.

Tips for Improving Interoception

There are all sorts of activities you can do with children to help increase their interoception skills. Below you will find tips for improving interoception, including mindfulness, and children's books on topics like emotions, potty training, and problem solving.

Modelling how you understand your bodies signals may also help - be sure to emphasize how you are feeling, and what you will do about it!

Mindfulness - the act of intentionally connecting to oneself and/or the world around them. This can help an individual get "out of their head" and feel more grounded in the present moment. By doing so, it may improve self-awareness and a positive mood. Mindfulness is not just great for improving interoception - see this article for more information

This video guides a progressive muscle relaxation. Intentionally contracting and releasing muscles brings more awareness to the physical body, and deepens the connection that we feel to it.

Here we have another video that guides mindfulness, in the form of a "body scan". It also adds a great piece of education for children on what it means to understand their bodies signals, and why it is important.

The OT Toolbox has this great list of more active ways to explore mindfulness through gross motor play.

Focus on awareness- So often, parents, children, clients, educators, and even professionals are not aware of ALL of the ways that the interoceptive sense impacts everyday functioning, learning, and daily participation in everything one does throughout the day. Educate, educate, educate! Then, bring that awareness to a full circle with activities that take the concept of interoception in daily tasks home. For example, you can cover how sleep is impacted by interoception and incorporate a few of our hibernation activities. Without interoception, animals that hibernate would not instinctively know to fill up on foods before winter and to keep eating even when they may feel full. Then that sleep that allows them to slumber through the winter is in effect. It's all related!

Books to Improve Interoception

Below are Amazon affiliate links to resources and books on interoception and internal states.

We Listen to Our Bodies is a book that follows a young girl as she feels emotions through her day. The physical representations of emotions are highlighted in ways that are familiar to young children.

For a similar read pick up this book, that follows a boy and his day full of feelings at the zoo!

Time to Pee by Mo Williams is a great book that helps kids understand how to respond when they have that 'funny feeling' in their tummies.

I Feel... activity books have been praised by therapists for their ability to make learning mindfulness fun! The activity book linked here focuses on sickness in the body and what it feels like to be sick in different ways.

The OT Toolbox has a great resource called the Sensory Lifestyle Handbook to tie sensory processing together

For more children's books on mindfulness to elicit peace and calm, check out this resource:

While interoception is new and lesser known, it is an important sense to have.

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What you Need to Know about Interoception - The OT Toolbox

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Interoception- Use these interoception strategies to Impact the 8th sense, needed for self awareness, regulation, homeostasis, mindfulness.

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Your child’s journey to school starts at home. We understand that all children develop at their own pace, and that we’re all learning from birth. When it’s time to start school, some children will need more help than others.

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Benefits and Uses of a Visual Schedule for Children with Autism

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Discover how social stories, visual schedules, and reminder strips can help alleviate the stress and anxiety associated with everyday tasks for autistic children.

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Benefits and Uses of a Visual Schedule for Children with Autism

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Listening is Cool I Can Use My Words Eye Contact or Staring (from Watson Institute) Being a good friend Noticing Friends How to Talk to My Friends (from Watson Institute) Playing with Friends (from headstartinclusion.org) Airports Bowling MiniatureGolf Movies Farm Airplane Trip Museum Disney Going to the Dentist (from iroqsea.org) Going to Wendy's (from speakingofspeech.com) Picking My Fingers (from speakingofspeech.com) What Can I Lick?

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Explore how executive functioning deficits affect children with autism and strategies to support them.

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Autism and Clumsiness: Understanding Motor Skills Challenges

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Learn about autism and clumsiness, understanding how motor skills challenges affect daily life and ways to provide effective support.

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Pathological Demand Avoidance (PDA) is a term often used to describe a specific profile within the autism spectrum. PDA autism is characterized by an intense need to resist everyday demands and a preference for feeling in control. While not officially recognized in diagnostic manuals, it is gaining attention among parents, caregivers, and professionals.

Understanding PDA can help create supportive environments for individuals who experience this profile. Exploring its traits, challenges, and strategies sheds light on how PDA intersects with autism and reveals ways to provide effective support.

What is Pathological Demand Avoidance (PDA)?

Pathological Demand Avoidance (PDA) is a profile of autism characterized by an overwhelming need to avoid everyday demands and expectations.

Unlike typical avoidance behaviors, individuals with PDA often use social strategies, such as distraction, negotiation, or withdrawal, to manage these demands.

The underlying cause for this avoidance is said to be a high level of anxiety, usually from expectations of demands being placed on them. This often leads to a feeling of not being in control of a situation.

For those with PDA, even routine tasks can feel overwhelming, leading to heightened stress and a strong drive to resist. Understanding this unique profile can pave the way for more effective approaches to support and care.

Developmental psychologist Elizabeth Newson introduced the term pathological demand avoidance in the 1980s. She observed children with autism-like traits who displayed stronger social skills and significant demand avoidance.

Sometimes referred to as Extreme Demand Avoidance, the PDA profile continues to evolve, though no universally accepted definition exists.

What causes Pathological Demand Avoidance?

While the exact causes of PDA are still being researched, here are some key factors:

Neurological differences: Like other autism profiles, PDA is linked to differences in how the brain processes information and social cues. This can lead to heightened anxiety and difficulty understanding or responding to demands.

Sensory sensitivities: Many individuals with PDA also experience sensory sensitivities. Everyday sights, sounds, or textures can be overwhelming, making it harder to cope with demands.

Anxiety and control: PDA is often linked to high levels of anxiety. Avoiding demands can be a way to feel in control and reduce anxiety.

Symptoms of PDA autism

PDA is thought to be relatively uncommon, and according to Professor Newson's findings, it is not gender-specific (although there are no prevalent studies).

PDA is often characterized by some of the following:

A resistance or avoidance of the typical demands of life

When a waiter asks, "Would you like something to eat?" most people respond with their choice of meal. For people with PDA, however, this could produce anxiety caused by needing to make a quick decision.

Praise can create pressure to meet higher expectations in the future. External factors like time constraints, uncertainty, social events, or playing a game can contribute to this pressure. Even internal needs, such as eating or sleeping, can trigger these feelings.

This can have the same effect as not wanting to do a chore. The need for control in situations often accompanies these feelings.

It is important to note that someone with PDA might react to a demand in an oppositional way, but they are not defiant, as in the case of Oppositional Defiant Disorder.

For example, not wanting to wear a shirt with a tag could be because of a sensory issue, not deliberate defiance.

Use of social strategies to avoid those demands

To avoid the typical demands of life, these individuals will use some type of social distraction. This can range from making excuses, changing the subject, and procrastinating to running away or aggression.

The reaction can quickly escalate if the person is pushed rather than being allowed to avoid the demand.

Appearance of social ability without social understanding

They may appear to have better conversational skills and social awareness or use more eye contact than others with autism. However, their sense of social identity is often lacking. They struggle to understand how communication works or how to process certain social situations.

This could mean not being able to understand someone's tone of voice or having trouble processing verbal communication quickly to keep up with a conversation.

Heightened emotions or excessive mood swings

Anxiety often manifests as anger, crying, or other intense emotions. When an individual is unable to label or understand these feelings, it can lead to further confusion and frustration.

The inability to process or cope with these overwhelming emotions can increase distress and make it harder to manage everyday situations.

Comfortability using role or pretend play

Children with PDA often have great imaginations, and many enjoy role-playing or participating in " dress-up " activities. For some, though, this can extend to extremes, such as adopting different personas for everyday life to avoid demands.

Obsessive behavior that often focuses on people

Often, a person with PDA has an interest in a particular subject, wanting to know everything they can about that topic. Many times, this interest is in another person, focusing on them to try and know and understand all they can about the person.

This can be difficult in a social setting if a child with a PDA is showing more attention to one child over the others. It can also feel "smothering" to the person receiving all the focus.

PDA vs. autism

It's easy to get confused between PDA vs. autism in general, as PDA is actually considered a profile within the autism spectrum.

Here's a simple breakdown of the key differences.

Autism:

Core features: Difficulties with social communication, repetitive behaviors, and restricted interests.

Cause of demand avoidance: Although some people may show some resistance to demands, it's usually linked to sensory overload, difficulty understanding expectations, or a desire for routine.

Social interaction: Can vary greatly, with some autistic individuals enjoying social interaction and others preferring solitude.

PDA:

Core feature: Extreme and persistent need to avoid everyday demands, even those they enjoy. This is driven by anxiety and a need to maintain control.

Demand avoidance: Goes to great lengths to avoid demands, using strategies like meltdowns, distractions, or even manipulation.

Social interaction: Often appears sociable and engaging, but struggles with the demands that come with social situations.

PDA autism diagnosis

The DSM5 and other diagnostic manuals do not currently include PDA as part of the autism spectrum. However, an initial autism evaluation can be done by a pediatrician or any doctor who provides neurodevelopmental assessments.

Once this is determined, a PDA profile can then be identified. According to the National Autistic Society, UK, this is usually done with assessments from:

Having a specific profile that includes the child's strengths and specific needs helps ensure the proper support for home, school, and/or work. These can be tailored as the individual's needs change.

Managing PDA parenting

First, education is key. Parents need to learn as much as they can about PDAs while also considering their child's personality. There is no "one size fits all" approach.

Because the panda bear is sensitive and needs specific accommodations to survive, the PDA Society has chosen the acronym PANDA to explain how to tailor an approach to this disorder.

The letters stand for the following:

P - Pick Battles
A - Anxiety Management
N - Negotiation and Collaboration
D - Disguise and Manage Demands
A - Adaptation

Pick battles

Many parents have heard this term, and it is important in dealing with a child who feels anxiety when they are not in control of their situation. Understanding that your child is not being willful but is responding to their level of anxiety can help immensely.

Try to focus on your child's positive qualities rather than on the unwanted behavior. Explaining why something is happening gives the child some perspective and, if possible, allows the child to make choices or control the situation.

Anxiety management

While anxiety is the underlying cause of avoidance and resistance, trying to manage it is important. If a child has social or sensory challenges, be aware of the anxiety that presents with these challenges and plan for it.

Preparing for an early departure from a crowded or loud event or giving a child seamless socks to wear with comfortable shoes might lessen the stress.

Reducing uncertainty can help alleviate that "fear of the unknown." However, even with the best plan, emotional outbursts may still occur. Handle these like a panic attack, staying calm in the moment and supporting the child throughout the episode.

Negotiation and collaboration

Trust is important in any relationship, but it is essential for children with anxiety about the unknown to trust their caregiver.

It is important for a parent to remain calm while working together with their child to overcome challenges, negotiating an agreement in a fair way.

Disguise and manage demands

This might be as simple as making a game out of an everyday event or working alongside your child to complete a task. It can also be helpful to monitor your child's capacity for certain demands and keep the demands within that level of tolerance.

Adaptation

Adaptation and flexibility in a variety of situations are key. Allow for extra time and have an alternate plan or a "way out," such as finding a quiet area in a noisy space.

Finally, distraction, role-play, and even humor can help alleviate tension in a situation. Being silly or asking the child, "How do I do this?" can make the demand seem less daunting.

Supporting children with PDA autism

If a child has autism with a PDA profile, it is important to focus on their positive attributes instead of their challenging behavior. Looking for long-term coping skills rather than a "quick fix" can lead to a more positive outcome over time.

Finally, whatever behaviors the child exhibits, try not to "take it personally." They are responding to their own anxiety, not responding personally to their caregiver. Parents should find resources for themselves, either in the way of a support group or some self-help.

A parent who is equipped with knowledge and tools can better handle a difficult situation, giving them a better perspective on their child.

FAQs

Q: What are the symptoms of PDA autism?

A: PDA is characterized by extreme avoidance of everyday demands and a high level of anxiety in response to perceived pressure. Individuals with PDA may also display controlling behaviors, meltdowns, and social difficulties.

Q: Can kids with PDA live a normal life?

A: With appropriate support and accommodations, children with PDA can lead fulfilling lives, although they may face challenges in areas such as social interaction and school performance. Early intervention, understanding, and a personalized approach can help manage symptoms and improve outcomes.

Q: How do you discipline a child with a PDA at home?

A: Disciplining a child with a PDA requires a flexible, non-confrontational approach that reduces demands and anxiety. Using positive reinforcement, offering choices, and minimizing direct control can help encourage desirable behaviors.

Q: Can a child have PDA but not autism?

A: While PDA is often associated with autism, it can also occur in children without an autism diagnosis. However, PDA is primarily recognized as a behavior profile within the autism spectrum.

References

O'Nions E, Gould J, Christie P, Gillberg C, Viding E, Happé F. "Identifying features of 'pathological demand avoidance' using the Diagnostic Interview for Social and Communication Disorders (DISCO)." Eur Child Adolesc Psychiatry. 2016;25(4):407-419. doi:10.1007/s00787-015-0740-2. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26224583

Pathological Demand Avoidance - Part of the Autism Spectrum. Retrieved from: https://www.pdasociety.org.uk/life-with-pda-menu/family-life-intro/helpful-approaches-children

Garnett, M. S., & Attwood, T. (2023). PDA: Why it is important and where we are now. Attwood and Garnett Events. https://attwoodandgarnettevents.com/pda-why-it-is-important-and-where-we-are-now/

Nawaz, S., & Speer, S. (2025). What are the experiences and support needs of families of autistic children with Extreme (or 'Pathological') Demand Avoidance (E/PDA) behaviours?. Research in Autism Spectrum Disorders, 119, 102515. https://www.sciencedirect.com/science/article/pii/S1750946724001909

Woods, R. (2020, August). PDA-a new type of disorder?. The British Psychological Society. https://openresearch.lsbu.ac.uk/item/8v10v

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Autism PDA: Understanding Pathological Demand Avoidance

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Explore what PDA means in the context of autism, its characteristics, and practical approaches for fostering understanding and support.

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Autism Parents Together Tees Valley is a charity that provides support for families of children on the autism spectrum

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Dyslexia Friendly Schools - Louise Selby Dyslexia Specialist

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Special thanks go to schools who offered to share their good practice in the form of images and case studies for the books All About Dyslexia and this website:

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After-school restraint collapse: what it is, and how to help your child | Hazel

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How to help your kid cope with after-school restraint collapse.

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Picture the scene: your child comes out of school and the teacher says they've behaved like the perfect child all day, but the moment you get home they have a complete meltdown. Your child screams, shouts, lashes out, sulks or generally acts in an unruly manner.
If that scene is familiar to you, you're not alone. This type of behaviour is what some psychologists refer to as 'after-school restraint collapse' and it's not unusual. It happens because your child has been busy managing their emotions all day as they navigate the complexities of school life.

When they get home, that's their safe space to let it all out!

So, now you know what it is, what can you actually do about it? Parents' Toolkit has been speaking to educational and child psychologist Dr Anisa-Ree Moses, for some tips on how to handle these outburst of emotions after-school.

1. Understand how hard school can be for some children

Dr Anisa-Ree Moses says that children can feel emotional, physical and mental exhaustion at the end of the school day. They have been trying to manage a mix of things like learning, social expectations, their own growing social awareness and all the feedback they're getting from teachers and peers.

"When they come out of that environment a pressure valve is released. If kids feel safe to express themselves, they will do so!"

The transition from school to home can also be challenging for some children: "Some kids may have difficulty separating from their parents. It's a relief when they see them, because their parent or carer represents a level of safety, but they're frustrated at the same time - the child wants them but is finding connection difficult at that moment. It's a positive reunion but it's also really emotional and can be hard for some children to channel."

Dr Moses adds that it can be particularly difficult for neurodiverse children who are coping with sensory sensitivities and the effort of containing a lot of emotions. When they come out of school they often can't hold it all in any longer.

For older children, she also says the transition home can be tricky too. They need space and time after school - they might not want to talk to you about it or will go to their room for a bit first.

Dr Moses suggests having a think about what your child needs when they come out of school.
"Do they need to go and run around the school playground a few times and let go for a bit before they walk home? Do they need movement or do they need a healthy snack? Or quiet time alone with no music or no chatting on the way home in the car or bus?"
It will be different for different kids, but Dr Moses suggests trying to be quiet on the walk or ride home.
"Connect with your child. Not by asking 'how was your day?' but through genuine emotional connection. You could say 'I'm so happy to see you, I'm glad we get to go home together, it made me happy coming out of school this way'. Being calm and using supportive words is important for your children."

She adds: "Include some downtime rather than moving straight on to homework or out to a club, so that your child can decompress. They might enjoy their clubs but still feel anxious, so build in downtime first and make their routine clear, visual and written down if they need that. You can also ask them what will help, for example drawing, reading a book or even just relaxing for a bit. Do it with them and help them to see they can do things to support themselves."

"Be understanding of their emotions - help them feel listened to if they want to talk about what's gone on, or be angry."
"You could say 'I can see you're shouting. I can see you want to be really loud, maybe let's go to the park on the way home'. Validate how they feel rather than try and control it. If they are impolite in the moment, come back to that later - talking at that moment won't help."

"Help them feel listened to and respected and make a genuine connection."
Dr Moses says the after-school 'meltdown' is an expression of emotion that often comes out physically. As parents you can recognise and label it so your child can see if for what it is.
"For example, 'I can see you are kicking the bin, I can see you're clenched and red, I can hear you're shouting and that's making me think you're angry, so I want to help you. However, here's not the safest place to do that, let's go to the park, etc.'"

"Build their emotional vocabulary and link it to the emotion - then they can tell you what they're feeling. You can say things like 'I want to help you. I can't do that when you're screaming. Let's take a deep breath, both of us.' Acknowledging it helps children to not feel alone."
With older children, Dr Moses says it's often more about them not wanting to talk or engage in any discussion about school.
"Especially for those who see school and home as two completely separate things. Just encourage them to build their emotional vocabulary, and be interested in what's happening in general in their life."

She adds: "Questions like 'how was your day?' will get a grunt or 'it's fine'. Think about what you are trying to find out. Can you remember an assignment they had or what they were going to be talking about with their friends? And connect by saying 'I'm happy to see you and hope you've had a good day' until they feel ready to come and have a conversation. Then offer yourself as being there, offer yourself as someone who wants to help and is interested in what's going on.

"Help them feel listened to and respected and make a genuine connection."

Dr Moses says your child might also be upset when they come out of school if there were any difficulties that day that weren't addressed, or there's something unresolved that's happened.

If your child's behaviour after school changes or is different to what's usual for them, try and find out if there are things happening during the school day that are affecting them.

"Think about whether you need a home-school communication book, so that you know whether what's been happening in school could trigger what happens at home. Information from school can help parents know how to approach a situation and whether there's something that needs resolving."

Connection is a great way for your child to know they're loved and that you're there for them, no matter what.
It could be snuggling up in bed, reading a book together, playing a quick game, or just having a chat.

Dr Moses suggests thinking about what your morning routine is like: "Is there anything you can build in there that can help them feel connected to you? I know this can be hard, I know how frustrating and annoying school runs can be! Let them know you're looking forward to seeing them later, just for who they are, not for what they've achieved."

She adds: "If your child is finding separation difficult, can you give them a note or something of yours to have in school? For some children, knowing that Mum or Dad is a phone call away and it won't be withheld from them helps them more.

"Also think about whether you have conversations about emotion at home. It's about helping your children with emotional literacy, building resilience and problem-solving skills, as well as building in transitioning - learning how to make things more predictable so that transitions are not as big and scary. Children are better able to manage their emotions if they know what's going to happen."

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Five tips on how to handle the after-school 'meltdown' or 'restraint collapse'

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'After-school restraint collapse' isn't unusual. Your child has been busy managing their emotions all day and when they get home, it's time to let it all out! Here are some expert tips on how to cope as a parent.

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Echoes of Echolalia: Looking at Autistic Language Development Through a New Lens (Oct. 27, 2021)

Marge Blanc, MA, CCC-SLP, is joined by Dr. Ann Peters, qualitative researcher and author of The Units of Language Acquisition, as they examine natural language acquisition in all children (both analytic language processors and gestalt language processors).

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Research and Resources for Gestalt Language Processing

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Meaningful Speech has compiled a list of research and resources on gestalt language processing.

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Kids & Youth Nappies | ConfidenceClub

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Shop our range of cruelty-free, dermatologically tested, and co2-neutral magics youth pants designed for big kids and teens aged from 4 to 15 years of age. Risk Free & Free Returns.

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Adaptive clothing and resources eg toothpaste

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Adaptive clothing and resources eg toothpaste

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Adaptive Clothes Incontinence Swim Sensory SEN | Fledglings

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Fledglings is a non-profit shop offering products for SEN children with disabilities, inc. sensory toys, incontinence swimwear and adaptive clothing.

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Generate sight words & colourful semantics 

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Generate sight words & colourful semantics 

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Home | SEN Tools | Colourful Semantics | Sightwords | Worksheet Generator |

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Discover specialized, evidence-based intervention tools for students with special education needs at SEN Tools. The platform empowers special needs educators to quickly and efficiently create tailored worksheets using key intervention strategies like Sight Words and Colorful Semantics. Designed for simplicity and effectiveness, SEN Tools is your go-to resource for enhancing learning experiences and achieving remarkable educational outcomes."

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Children and Young People's Therapy Service

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Any professional or a parent can refer a child to the Children and Young People's Therapy Service.

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Children and Young People's Therapy Service

# data[].attributes.attachment_link.description
Any professional or a parent can refer a child to the Children and Young People's Therapy Service.

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Affordable, customisable, chewy jewellery (chewelry) & fidget toys! Fun, funky and customisable...

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From how to apply to a new school to how to be more involved in school life to how to share your voice on education, this section is for everybody in a…

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Triple Bristle™ Original Sonic Electric Toothbrush is developed by a dentist with three brush heads to clean all surfaces and around the gumline.

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Featuring patented angled brush heads that clean along the gum margin and extra soft bristles that do not harm teeth, roots or gums, the inside and outside heads are positioned at a 45° angle so they automatically brush perfectly every time. The three sides of the brush naturally adapting to the teeth so that it works on teeth of all shapes, sizes and positions.

Incorporating a built-in bristle indicator to let you know it's time to change.

Triple Headed Toothbrushes are recommended for children 8 years old and above. They are safe for use with implants and other restorations.

What's in the Box?

2 Triple Bristle brush heads (one pink, one blue)

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2 Snap-on brush head covers

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Instruction manual

Features & Benefits

Unique brush head design - cleans all surfaces of your teeth at the same time

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This brush is great if you need a little extra help reaching all surfaces of every tooth. Carers will find this easy to use when cleaning someone else's teeth and gum. Use with a pea sized blob of fluoride toothpaste. spit out after brushing but don't rinse all the toothpaste away. Let the toothpaste work for longer. Brush last thing at night and one other time every day. Clean in between teeth with floss or interdental brushes BEFORE brushing or at a different time each day - or as advised by your dental team or Growing Smiles coach.

Learn more about toothbrushing here.

Delivery Information

Free UK delivery on orders over £40.00

UK P&P under £40.00 cost 1st Class - £4.65 & 2nd Class - £3.65

Free P&P on EU orders over £100.00

EU P&P under £100.00 cost £14.99 per order unless otherwise stated, using Royal Mail International Tracked & Signed.

Rest of world please email: [email protected]

Only logged in customers who have purchased this product may leave a review.

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Triple bristle sonic electric toothbrush makes brushing easier for anyone who struggles to move a toothbrush around the gum margins.

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ora N urse® Unflavoured Toothpaste was initially developed in a response to the need of autistic children who have a problem with taste, even to the extent of not liking the taste of water. This has resulted in the development of a toothpaste with no sodium lauryl sulphate (foaming agent) or flavourings that is available in a range of fluoride strengths and an RDA (relative dentin abrasion) value of 29.68 .

Other possible indications for the need of an unflavoured toothpaste include;

People who simply don't like the taste of mint.
Adults and children who perceive mint to have a 'hot' or 'burning' sensation.

Adults and children with learning disabilities.

Lichen Planus sufferers.
Head and neck cancer patients after radiotherapy.
Burning mouth syndrome.
Asperger syndrome.
Autism.
Sjögrens syndrome
Behcets disease
Kawasaki disease
Parkinson's diseases.
People that have an intolerance to Limonene.

Active Ingredient;
Sodium Monofluorophosphate

Other Ingredients;
Water, Hydrated Silica, Glycerine, Sorbitol, Xylitol, Cellulose Gum, Sodium Benzoate, Titanium

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ora N urse® Unflavoured Toothpaste was initially developed in a response to the need of autistic children who have a problem with taste, even to the extent of not liking the taste of water.

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Speech Delay Support for Parents - Pippin

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Boost your child’s language with tools and activities approved by speech therapists. Pippin is an app that helps parents easily track new words, provides speech strategies and has lots of fun games and activities you can try with your child.

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Somerset Community and inclusion ActivityTeam

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Community Inclusion and Activity Team

The Community Inclusion and Activity Team (formerly the Short Breaks Team) helps and supports children and young people 0 to 18 years with a disability or additional need and their families, to try out new things, have fun and access their local community. They support grant-funded activities that run across Somerset, this includes holiday activities and regular clubs.

Emma introduces the support information and guidance available from the Community Inclusion and Activity Team during Local Offer Live week.

You can view the Community Inclusion and Activity Team Club Activities Booklet here

There are also exciting free activity day passes for a variety of locations and the Somerset MAX Card for families to use. Free Activity Day Passes are available all year round for all families in Somerset with a child or young person with a disability or additional need.

Our activity calendar for the holidays is available here.
Activity Calendar
You can keep up to date following @LocalOfferSomerset Facebook page.

Our office phone line, 01823 358117 is open, or you can email ciateam@somerset.gov.uk, so families can contact us.

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Things to do, try out new things, have fun and access your local community

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Within this section you can find details of our Chill and Chat meet ups, training offer and events. If there is something you would be interested in but can not see it please contact us and we will try to help you find what you need.

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Within this section you can find details of our Chill and Chat meet ups, training offer and events.

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First Steps Nutrition Trust is an independent public health nutrition charity. We endeavour to fill practical and policy-relevant information gaps and provide resources for health workers supporting eating well from pre-conception to five years.

Our Mission

To influence policies which enable the safe, appropriate and optimal feeding of infants and young children in the UK, and to protect them from commercial interest.

To ensure that the importance of good nutrition from pre-conception to age five remains on everyone's agenda.

To provide conflict of interest-free information on infant milks marketed in the UK, and to promote better regulation and marketing of breastmilk substitutes.

To provide resources for health workers to support them in their work with pregnant women and young families.

Our Resources:

Are put together by nutrition experts and are regularly updated.

Can be used in Unicef UK Baby Friendly Initiative accredited settings.

Are available as free pdf downloads for use by anyone promoting better public health on a not-for profit basis.

Everyone who works at First Steps Nutrition Trust feels passionately about the need for better information and support for good nutrition - and good food - from pre-conception to five years.

First Steps Nutrition Trust is supported by generous individual donations and conflict of interest free grants. First Steps Nutrition Trust does not work with organisations or individuals that work with, or take funding from, the breastmilk substitute industry and we reserve the right not to sell them our subsidised resources.

First Steps works with and supports a number of organisations including Unicef UK Baby Friendly Initiative, the Baby Feeding Law Group, the Obesity Health Alliance, the Children's Food Campaign and the APPG on Infant Feeding and Inequalities.

First Steps Nutrition Trust host and regularly update their partner site infantmilkinfo.org which contains comprehensive information about infant milks (for 0-12 month olds) available on the UK market.

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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Supporting Speech Language and Communication Needs During Times of Change

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Alex Marris, Advisory Teacher for Interaction and Communication looks at how to spot and support SLCN during change and uncertainty. 2020 has been an unprecedented year for everyone. Those working in education have not only had to deal with personal challenges but also the numerous changes to the way schools operate.

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Why Autism is a Difference, not a Deficit

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Masking

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Autistic Masking is not a simple social fake. Prolonged masking has serious mental health implications for autistics; level up your knowledge so can learn to embrace your autistic loved one as thei...

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This is from America but there are some great ideas.

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"Be understanding of their emotions - help them feel listened to if they want to talk about what's gone on, or be angry."
"You could say 'I can see you're shouting. I can see you want to be really loud, maybe let's go to the park on the way home'. Validate how they feel rather than try and control it. If they are impolite in the moment, come back to that later - talking at that moment won't help."

"Help them feel listened to and respected and make a genuine connection."
Dr Moses says the after-school 'meltdown' is an expression of emotion that often comes out physically. As parents you can recognise and label it so your child can see if for what it is.
"For example, 'I can see you are kicking the bin, I can see you're clenched and red, I can hear you're shouting and that's making me think you're angry, so I want to help you. However, here's not the safest place to do that, let's go to the park, etc.'"

"Build their emotional vocabulary and link it to the emotion - then they can tell you what they're feeling. You can say things like 'I want to help you. I can't do that when you're screaming. Let's take a deep breath, both of us.' Acknowledging it helps children to not feel alone."
With older children, Dr Moses says it's often more about them not wanting to talk or engage in any discussion about school.
"Especially for those who see school and home as two completely separate things. Just encourage them to build their emotional vocabulary, and be interested in what's happening in general in their life."

She adds: "Questions like 'how was your day?' will get a grunt or 'it's fine'. Think about what you are trying to find out. Can you remember an assignment they had or what they were going to be talking about with their friends? And connect by saying 'I'm happy to see you and hope you've had a good day' until they feel ready to come and have a conversation. Then offer yourself as being there, offer yourself as someone who wants to help and is interested in what's going on.

"Help them feel listened to and respected and make a genuine connection."

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Five tips to handle the after-school 'meltdown'

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"Be understanding of their emotions - help them feel listened to if they want to talk about what's gone on, or be angry." "You could say 'I can see you're shouting. I can see you want to be really loud, maybe let's go to the park on the way home'.

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Our Speech and Language Therapy Toolkit contains advice, activities, and general resources to help with the development of children and young people's speech, language and communication skills. Our toolkit has been refreshed to fulfil accessibility regulations. The sections below contain revised and updated information about how to support children and young people with speech, language and communication needs.

The Top 10 Tips for Talking animations are in the Early Communication Section.

If you have any questions, comments or suggestions about the Toolkit, please email Andrea Arnold andrea.arnold@nhs.net - we would love to hear from you.

For general enquires please email lcht.cslt@nhs.net

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Leeds Community Healthcare NHS Trust - Speech and Language Therapy Toolkit

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Our Speech and Language Therapy Toolkit contains advice, activities, and general resources to help with the development of children and young people's speech, language and communication skills. Our toolkit has been refreshed to fulfil accessibility regulations. The sections below contain revised and updated information about how to support children and young people with speech, language and communication needs.

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Help yourself to help others

If a fear of maths has you hiding from homework, we can help!

With a little help from us you can build your number confidence and skills, and begin to feel more prepared for when children come to you for help, and help pass your confidence onto them.

The free National Numeracy Challenge is designed to help you! It's a free, quick and easy way to check your skills and confidence with numbers, where you can go at your own pace, with learning resources tailored to you and your level. It helps with the maths we come across at work and in daily life - not algebra, or trigonometry. You can get started in just 10 minutes, and join the 390,000 others that have already started their journey to number confidence. Give it a go!

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With a little help from us you can build your number confidence and skills, and begin to feel more prepared for when children come to you for help, and help pass your confidence onto them. The free National Numeracy Challenge is designed to help you!

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Several two-sided versions of the SDQ are available with the 25 items on
strengths and difficulties on the front of the page and an impact supplement
on the back. These extended versions of the SDQ ask whether the respondent
thinks the young person has a problem, and if so, enquire further about
ch…

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These pages provide information for teachers and other professionals interested in using the
Socio-Emotional Profile Questionnaires.

What are the Socio-Emotional Profile Questionnaires?
How do I register a class or pupil group to use the questionnaires?

How do I administer the questionnaires?

How do I view the results from the questionnaires?

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These pages provide information for teachers and other professionals interested in using the Socio-Emotional Profile Questionnaires

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SEMH.co.uk - Behaviour Indicator Tool

Go Back

Very Often Often Occasionally Infrequently Never

Please read in full. This tool is for indicating individual needs, not a classroom management tool. The first version of this tool is for Primary aged children. Further versions will be developed. Each version is being continually improved - if you want to help find the feedback form on the last page - the more ideas the better!
Upon loading the results, do not reload the page as you may lose your data. All clickable links will load in new tabs/windows.
This tool is for informational purposes only. This tool is not used as a replacement for professional advice or diagnosis. By continuining to use these tools you agree to not hold SEMH.co.uk or it's owners responsible for any actions you take based on this information and/or guidance. You also agree to any cookies used by third party websites on this site. This website records the results you input anonymously (only recording Primary or Secondary and numbers selected, not initials). This data may be used for large scale analysis of the anonymous data sets and conclusions/results published online.

Please click the button below to continue.

Using this data

The data baseline for this indicator is 20%. A score close to 20% indicates a very low level of confidence in this function. Where there is no evidence of a function in your answers, the bars will show as Red above.

Statements relating to Control

Statements relating to Attention

Statements relating to Escape

Statements relating to Sensory

Initials =

Attention Total

Control Total

Sensory Total

Escape Total

Self Esteem Total

Click to Download To Excel (CSV)

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SEMH.co.uk - Behaviour Indicator Tool Go Back Very Often Often Occasionally Infrequently Never Please read in full. This tool is for indicating individual needs, not a classroom management tool. The first version of this tool is for Primary aged children. Further versions will be developed.

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If you are on Mobile or have Outlook or other email software installed on your laptop/PC, click to Send below checking the email address given. If not, you will need to download (Step 1) and send the attachment via your email account.