We generally lead an extremely low demand lifestyle, however there are times when things come up that pose a huge demand, are a high priority, and are as close to non-negotiables as we get.
For our family these might be things like taking daily medication, having to pick up some essentials from the shops, or getting in the car for the afternoon pick up to collect his sister. They can also be less frequent things like moving house, catching a flight, 6-monthly dentist appointments or scheduled vaccinations.
Something that we have often have great success with, is leaning into explaining why things need to be done.
PDAers have a high need for autonomy and are innately driven by intrinsic motivation. Telling them they have to do something is likely going to activate their threat response, however if we can explain to them why something is important, often it helps them to come to the decision of their own accord.
Often, we don’t tell our PDAer things too far in advance, however for some of these less frequent events we often do start having conversations ahead of time when he is calm and regulated.
There are generally 3 ways that we give information to our PDAer:
- Matter-of-fact discussions.
- Homemade stories.
- Drawing out the plan.
I thought the best way to explain these might be to share an example of each in action. As with everything I share, this is what works for us. You know your child best, it might validate something you are already doing or if you think it would work at your house, you might like to give it a try.
Matter-of-fact discussions:
Having a simple, matter-of-fact discussion is always a good place to start. Recently our almost 5-year-old PDAer started on daily medication to assist in managing his anxiety levels. Before he started on this medication we talked it through with him. We always pick our times for discussions that we know might be a bit anxiety provoking. Before saying a word, we have some lovely time to connect through one-on-one play and make sure he is nice and calm. The conversation went something like this…
- Me: Hey buddy, I’ve noticed that there are times when you get pretty scared. And sometimes it’s even about things you want to do, like that day we went to visit the waterfall.
- PDAer: Yeah
- Me: Everyone gets scared sometimes and when we feel scared lots of extra chemicals get released in our brain. If we are getting scared lots, and it is stopping us from doing things that we enjoy, we can help stop those chemicals by taking some medicine every day.
- PDAer: OK
- Me: The doctor said that for it to work we have to try and stick with it for a month and then you can decide if you want to keep taking it or not.
- PDAer: OK we can do that.
Once we had his buy-in we then talked through and involved him in all the steps in the process. He tested out the tablet cutter, we brainstormed the best way to crush the tablets, we showed him the special cup he would use, he picked what drink he wanted to mix the medicine in with, and we tested out the blood pressure machine that we would use each morning to check that his body stays nice and healthy.
We are yet to encounter any battles over taking his daily medication.
Homemade stories:
When I was a new graduate OT, my mentor introduced me to a book called Homemade Books to Help Kids Cope by Robert G. Ziegler. It teaches you how to create individualised stories for your child about a whole range of different scenarios. It has been one of the best resources that I have used over and over again both in my work and now with my own kids. One of the techniques in this book is how to create a story about a big life change. The general outline is pretty simple: highlight what is happening now, discuss the change/what is going to happen next, and validate emotions that might come up. This is a summary of a little book I wrote as part of the process to prepare our PDAer about moving house. Each statement was on its own page with a photo…
- Title: Our New House
- Page 1: Since I was a baby, I have lived in our house with Mummy and Daddy. I really like our house.
- Pages 2-11: (Each page described a different part of the house and what he liked to do there) e.g. This is outside where I do lots of things like painting, play “the car is stuck”, walk on my stepping stones, do experiments and water the garden.
- Page 12: Soon our new house will be finished, and we will be moving in to our new house.
- Page 13: My room will be upstairs. Downstairs we will have a playroom for all our toys. Outside we will have a pool and room for a swing set.
- Page 14: We will take all of our things to the new house. Doggy will come. My bed will come. My bike will come. All my toys will come too.
- Page 15: When our new house is ready, Mummy and Daddy will pack things into boxes, so they stay safe. Then they will get put into a big truck which will take everything to our new house.
- Page 16: It is ok to feel sad. It can be hard to say goodbye to our house. We can read this story to help remember our house and what we liked doing there.
Obviously, we had loads of discussions in addition to this too. The day after we first read this book, my PDAer said to me in alarm “Mummy what about my bed! It won’t fit into a box!”
Drawing out the plan:
We tend not to use visual schedules or rigid routines with our PDAer, however when there are situations where we are doing something that is unfamiliar with lots of transitions, we find that drawing out the plan can assist in decreasing the unknowns and reduce our PDAer’s anxiety levels.
Last year we took a short flight to Sydney and on the morning of the flight I could tell that our PDAer was really struggling and becoming increasingly anxious. I said I could tell he was feeling a bit worried and asked if he would like me to draw out the steps for what was going to happen, to which he nodded. I quickly hand drew a numbered list that looked like this, as you can see you don’t need to be an artist to get the point across….
After we had talked through the plan our PDAer became visibly calmer and was then ready to get in the car.
Giving information and explaining the ‘why’ is obviously just part of it.
We have a foundation of trust and invest lots of time in maintaining a strong relationship.
Letting most of the day-to-day demands slide means that our son has more tolerance when these high priority demands come around.
We problem solve the parts that he can collaborate on. Even if the ‘what’ is non-negotiable there are often other aspects that he can weigh in on.
We control the things we can, to gear ourselves for success.
And then of course, you have to tune into where our child is at. Our son is currently in a place of stability. When he was in burnout, there would have been no way we were leaving the house. There will be times when your child is going through a rough patch and things need to get postponed until they have the capacity to face those demands.
How do you explain the ‘why’ at your house?
