Rule out the Biological

You will need to rule out if there are any biological issues that may be contributing to the violent behaviour, including:

• Gut issues

• Celiac

• Hay Fever

• Eyesight

• Hearing

• Full bloods, Glucose, Vitamin D, Iron

• Sleep Studies

• Chromosome Testing

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Look at School

Many children - whether violent at school or home - are affected by issues at school. Kids may hold themselves tightly at school, and then get to the car and lose it. 

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Many children struggle to be successful successful at school and this impacts their stress and anxiety, so look at:

• Timetable

• Learning - adaptation (adapt the task), modification (modify that task - helps teacher, but shames the child and pushes them back into a corner and they come out fighting), differentiation (appropriate to their developmental level and age)

• Relationship with the school - find your person

• Levels of success

• Demands

• Peer issues

• Bullying

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Look at Home

• Family relationships

• Siblings

• Step Parents and Step-Siblings

• Family Violence

• Exhaustion

• Covid Whiplash

• Mental Health Issues

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Theory of Mind

Theory of Mind - imagining what someone else might be feeling and moderating your behaviour in response. Ability to predict and interpret the behaviours of others. Many of our children, don't have a well developed theory of mind. People with impaired theory of mind can learn the steps (it's not necessary intuitive like it is with neuroticaly children). Please download the slides below to see more on this.

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Capacity vs Ability

Children don't always have the capacity for things that they have the ability for. One day they might be able to dress themselves, on another day they don't have the emotional capacity to dress themselves. There are things you can do to build their emotional capacity.

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Extreme Anxiety

In ADHD, extreme anxiety is expressed as Oppositional Defiance Disorder.

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In Autism, extreme anxiety is expressed as Pathological Demand Avoidance. More energy is put into avoiding the task than actually doing it that is well beyond the age appropriate resistance you might see in young children.

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Anxiety creates maladaptive behaviours to deal with their anxiety.

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The Violence  Continuum

Normal Age Appropriate Development Stage

• Normal adult to child request

• Child not wanting to do what they are asked to do

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Extremes

• Task refusal using violent and aggressive behaviours

• Seen in ODD, ADHD, PDA, anxiety disorders, ASD, Down Syndrome, Chromosome Disorders

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Violent Behaviour

• Parents feel overwhelmed

• They feel scared of their child and violence

• No one likes to get hurt

• We react from fear

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Extreme Anxiety

ASD

• Firm boundaries

• Praise

• Structure and routine

• Rewards

• Consequences

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PDA

• Person-centred approach​

• Negotiation

• Collaboration

• Flexibility

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PANDA Tool

The PDA PANDA symbolises the need to tailor the environment to meet the needs and the PANDA mnemonic is a simple reminder of helpful approaches.
 

• Pick Battles

• Anxiety Management

• Negotiation and Collaboration

• Disguise and Manage Demands

• Adaptation

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Pick Your Battles

• Minimise Rules

• Explain reasons

• Enable some choice and control

• Accept that some things can't be done

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Anxiety Management

• Reduce uncertainty

• Recognise underlying anxiety and social/sensory challenges

• Think ahead

• Treat meltdowns as panic attacks and move on

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Negotiation and Collaboration

• Keep calm

• Proactively collaborate and negotiate to solve challenges

• Fairness and trust are essential

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Disguise and Manage Demands

• Word and position requests indirectly

• Constantly monitor tolerance for demands and match demands accordingly

• Doing things together helps

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Adaptation

• Be flexible

• Try humour, distraction, novelty and role play

• Have a Plan B

• Allow for plenty of time

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Praise as an Implied Demand

​Praise is actually an implied demand for many children and especially those with PDA. See the webinar for further details. It sounds counter-intuitive, but don't praise.

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Resources

• GP

• Pediatrician

• Psychiatrist

• Orange Door (Family Violence)

• Police

• Carer Gateway (they will link you to a local provider)

• NDIS

• Step Up program

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Links

UK PDA Society
https://www.pdasociety.org.uk/

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Diagnosing Pathological Demand Avoidance

https://www.pdasociety.org.uk/what-is-pda-menu/diagnosing-pda/

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Pathological Demand Webinar

https://www.bcbm.com.au/pathalogical-demand-avoidance

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School Avoidance Webinar

https://www.bcbm.com.au/schoolrefusal

 

Webinar Slides

Download the slides from the webinar.

Download PDF of Slides

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Audio Only

Listen to the audio recording of the webinar.

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Download Audio Now

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Watch Webinar Replay

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