Two years ago, I began to parent my son differently. This was not a philosophical choice, it was in response to the uncomfortable realization that a strict, behavioral approach was not only making things worse, it had ushered our entire family into a severe crisis. As my son hit rock bottom, so did our family, and we spent the next two years leaving jobs, re-conceptualizing our family life, and settling into a small town in Michigan after a cross-country move.
Amidst these changes, I spent my time researching parenting approaches for “challenging” children. As I experimented with different strategies, I wondered how on earth to parent a neurodivergent child outside of a reward-sanction framework. It was only when I began peeling back the layers on my son’s brain-wiring, that I began to understand why even some gentle parenting strategies – ones that work great for neurotypical kids – are not appropriate for PDA children. The primary reason is that regardless of how gentle these approaches are, they are still designed for neurotypical kids and premised on incorrect assumptions about why our children behave the way they do and how their brains naturally respond to stimuli.
Natural Consequences*
When I abandoned the reward-sanction framework, I first turned to the "Natural Consequences" model found in the book Positive Discipline. Here, instead of a parent imposing rewards or sanctions artificially (e.g. giving a treat for complying with a request or a time-out in response to kicking their brother), they let the child experience the natural result of their behavior. The idea is that once the child internalizes that the consequences are pretty unpleasant, they will change the unwanted behavior in the future.
Take a family that has the following rule: mom is only going to make one meal for each mealtime and all the members of the family will eat together at those specified times of the day (wouldn’t that be nice?). If a child doesn’t eat what is served, the natural consequence would be hunger until the next meal.
This seemed like a reasonable approach when I read about it, so I set about letting my son experience the impact of his behaviors. Within the first week of my experiment, my son went hungry, overheated while still refusing to change out of fleece pajamas in 90-degree weather, and continued to hit me despite what I thought were obvious facial expressions and “natural responses” (moving away, telling him I didn’t like it) indicating my displeasure. Instead of his behavior improving, his dysregulation and distress escalated exponentially and his behavior worsened.
It has taken me years to fully internalize why this approach didn’t work, even though now it seems so straight-forward: the assumptions underlying this model are premised on the workings of a neurotypical brain without sensory integration issues and extreme demand avoidance caused by hypersensitive neuroception.
Natural consequences don’t work for PDA children for a few reasons. First, if a child has trouble with sensory integration – say interoception challenges or alexithymia – their brain does not always register an accurate and timely response to the stimuli they experience. As a result, they cannot make the connection between the cause (their behavior) and the effect (the natural consequence). In the case of interoception, a child may not feel hunger after not eating for a day or may misinterpret heat, cold, thirst, or a need to go to the bathroom. Similarly, with alexithymia – a child is not able to consistently and accurately discern what emotion they are feeling, and thus is not able to infer the impact of their actions (say, knocking down another child’s sand castle) on their own emotional state (remorse, sadness, empathy).
Secondly, PDA children have hypersensitive neuroception and thus perceive most things in their environment as a threat. If a seemingly gentle or “natural” consequence is too triggering for them – for example, if their socks get wet after jumping in a puddle and this sets off a panic response – they cannot rationally understand cause and effect in that moment because the “thinking” brain is offline.
In our home, we try to modify the idea of natural consequences. We logically and neutrally explain the consequences of a behavior before my son makes a choice, and in PDA-friendly fashion, allow our son to make his own decision, as long as it isn’t dangerous. We then prepare ourselves to coregulate and mitigate unwanted consequences. Of course, this strategy’s only hope of being mildly effective is if the PDA child is in a regulated state before decision-making time.
Take the following example: even if it is 90 degrees out and sunny, I give my son a real choice as to what he will wear to the park. I explain that he will be hot, uncomfortable, and sweaty if he wears fleece pajamas, however, I still let him decide. At the same time, I'll of course stuff a comfortable t-shirt and shorts in my bag, for the inevitable moment when he overheats and needs to change clothes. The next time we are preparing to leave the house on a hot summer day, I remind him of needing to change at the park the last time we went, which sometimes cues him to make a different choice, and sometimes does not, depending on his regulation levels.
Of course giving a child true autonomy over their decision-making - even when you can clearly see they will make the wrong choice - takes immense patience, a lot of planning ahead, and faith that it will eventually click. But the reality is that by not allowing for true autonomy with a PDA child, you end up with meltdowns and a chronically dysregulated child who won’t leave the house at all.
Firm Boundaries
As a first-time mom, I set out to establish firm boundaries in our household. I had learned that even if I was going to be gentle, child-led, and flexible, once I set a boundary, I needed to follow through. This is premised on the idea that in a chaotic world, children need to feel safe by understanding the limits laid down by their parents.
For the PDA child, safety is absolutely primary, but it is important to remember that the perception of safety is filtered through a different neurobiology than that of neurotypical kids. PDA children who are confronted with strict, never-budging boundaries will not experience safety, but rather fear and panic. When confronted with boundaries that don't budge, these kids experience a complete loss of their control, autonomy, and balance of power (thank you for adding this concept, Kristy Forbes), which results in a nervous system response of fight, flight, freeze, or fawn. This is not something you, or any other PDA parent can change, it is simply part of their brain-wiring and an aspect of their disability.
Through many, many painful experiences with my son – and even before PDA awareness – I learned that Cooper's reactions to boundaries were not a conscious choice, but something that he clearly had no control over. Arbitrarily strict boundaries (e.g. you must be in bed by 7:30pm on the dot), would give way to defiance, meltdown, flight (elopement), destruction, aggression, manipulation, and reduced ability to communicate verbally.
Over time, I have accepted that my PDA child feels safest if I am flexible in moments of dysregulation. Although this sounds simple, I found that this has been one of the hardest things for me and my husband to wrap our heads around. Backing down from boundaries led me to feel that I was rewarding bad behavior and doing something inherently wrong because I was supposed to be "in control." But over time I realized that -- in moments of panic and dysregulation -- ceding or altering a boundary was the only thing to de-escalate panic and preserve trust.
Through this practice, I have had to shift my understanding of what is actually going on in his brain. I have learned that his outward “bad behavior” is not intentional or rational, but rather is an indicator of a panic attack. So rather than thinking, I have to hold firm boundaries tightest when he is “misbehaving”, I have realized that paradoxically, my boundaries have to be most malleable when he is experiencing distress. It totally goes against the conventional wisdom, but it has been a game changer.
Let me give you an example. Cooper often slaps me hard on my backside as he runs to the bathroom. Although I know this is sensory-seeking behavior, it triggers some PTSD for me because of his unexpected physical aggression in the past. Yet, if I set a firm rule that he cannot slap me on the butt, he immediately starts to escalate, although the degree to which he does so depends on his base state of regulation.
I try to override my instinct for doubling down on the boundary and remind myself to compromise and collaborate. I might say, I wonder if I could hold a couch pillow and you can slam against it on your way to the bathroom, Or in a real pinch, I might say, OK go ahead, but give me a minute for a deep breath and please just do it more gently this time. This usually de-escalates enough so that we move through it and he is far more likely to refrain in the future than if I give him a verbal command not to.
Stable Routine
Conventional wisdom also tells us that a stable routine is important for both neurotypical children and Autistic children to feel safe. This was a hard one for me to let go of because after all, my son is Autistic, so I assumed he needed all the laminated charts, visual timers, and schedules to reduce his pervasive anxiety about the unknown. However, for the PDA child, the foundation for feeling safe is premised on their ability to feel that they are autonomous, in control, and in balance. This driving need will always trump a routine, even if the child craves predictability. Furthermore, a strict or never-changing routine ultimately becomes a demand that the PDA child will resist or avoid.
This is complex and paradoxical, like many aspects of the PDA brain-wiring, and my son is no different. While he loves predictability, he also needs there to be a degree of flexibility and spontaneity. A helpful mindset shift for our family has been to replace the notion of routines with the idea of rhythms.
For example, instead of focusing on a particular bedtime, we focus on a range of times that are allowable. Or instead of insisting he sleep in his bed, we focus on him simply staying in his room, but how he sleeps in there, is up to him. Every couple of weeks he rotates sleeping on the top bunk, bottom bunk, and the floor, exerting his own autonomy and novelty within the context of the stable rhythms that we set.
Unattuned Coregulation
This title feels like an oxymoron as I write it, but hear me out. When I first learned about the concept of co-regulation, I applied a neurotypical framework to my PDA son, which (surprise, surprise) did not result in much success. This was due to my incorrect assumption that Cooper would enjoy the same co-regulation strategies that I – and many other neurotypical children – want when they need to be soothed.
But rather than liking his hair stroked or listening to my reassuring words, my son lashed out because of his tactile sensitivities, auditory processing challenges, and the perception that spoken communication was a demand. Now, instead of applying my neurotypical approach to co-regulation, I have learned to tune in to what he actually needs, which often includes no words at all, proximity rather than physical touch, gentle facial expressions, or rough-housing.
Mirroring
Mirroring is a concept that I tried a few times when my son was younger, however, I don’t know if I would truly put it into the “gentle” category. The idea is that the parent mirrors a toddler or child’s distressing or unwanted behavior so that the child sees how it looks and realizes it isn’t appropriate. As a result, they stop the unwanted behavior. The assumption underlying this strategy is that the child exhibiting “unwanted” or “inappropriate” behavior is not aware of how their behavior looks or the ways in which it might be distressing for others.
This strategy is not appropriate for the PDA child because it assumes that they don’t cognitively understand or are not aware of their “incorrect” behavior. This assumption is not accurate, as PDA children do understand how they should behave, they simply can’t access the "correct" behavior due to their heightened threat response in the moment.
For example, if my son is constantly interrupting me while I try to talk to his father, it is not because he doesn't understand how it feels to be interrupted or the fact that this behavior is socially inappropriate. Rather, it is a reflection of his high anxiety levels and perhaps the beginning of a panic response. In this case, the approach we use is to signal safety and co-regulate, so as not to trigger him further or cause more distress.
Hopefully this review is helpful for understanding why your PDA child might not be responding to conventional parenting approaches. We would love to hear your perspective or tips/ tricks/strategies that have been helpful for your family!
*This is distinct from the “natural positive consequences”, which Laura Kerbey describes as an effective strategy for working with PDA children.
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