590- Don't Tell Me What to Do: Pathological Demand Avoidance (PDA) in Neurodivergent Kids

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Welcome to the Attention Deficit Disorder Expert Podcast Series by Attitude Magazine. I'm Annie Rogers and on behalf of the Attitude Team I am delighted to welcome you to today's ADHD experts presentation. Titled, don't tell me what to do. Pathological demand avoidance in neurodiversion kids. Leading today's presentation is Diane Gold. Diane is a licensed clinical social worker and the founder and executive director of PDA North America. She co-authored with Ruth Fiddler, the book Navigating PDA in America, which was published in June 2024. In April 2024 Diane was diagnosed as autistic. She has a private practice in the Chicago area where she serves neurodivergent children, adults, and their families. For the last 40 plus years she has worked for both private agencies and school systems. And we're here today to discuss pathological demand avoidance or PDA. Children, teens, and young adults with PDA exhibit a strong desire for autonomy and are extremely sensitive to real or perceived demands. They may refuse to do a homework assignment just because you reminded them that it's due tomorrow or rack up an impressive string of tardies because you set firm expectations for when they should leave the house. PDA differs from other diagnostic categories and it's important for parents, teachers, and other professionals to understand the challenges and supports to help children with PDA and their families. Today's discussion will cover behavioral strategies and support for children with PDA, including how to help them build self-regulation skills and manage stress and strong emotion as well as what not to do as the parent of a child with PDA. Okay, without any further ado, I'm so pleased to welcome Diane Gold. Diane, thank you so much for joining us today and for leading this really important conversation. Oh, I'm so delighted to be here and grateful to have the opportunity to talk about PDA, which is kind of my favorite topic. And when I'm trying to learn something new, I like to kind of start with the history, so hopefully that's the same for some of you. So how PDA really got started was there was a psychologist in the UK, Elizabeth Newsen, who focused on doing assessments on children and mostly it was diagnosed kids as autistic or PDD at that point, pervasive developmental delay. And she noticed this subgroup of children who are different than the majority of kids, but very much like each other. And one of the traits that stood out to her was that these kids just couldn't help avoiding everyday tasks. So she named this group pathological demand avoidant kids or PDA. And she intentionally chose the word pathological because she wanted people to understand that these children just couldn't help it. They weren't trying to be difficult. They weren't during this unpurpose. Now we kind of wish she hadn't chosen the word pathological, but she did for a good reason. So it took kind of years, even in the UK, for awareness to build at their kind of autism society in the UK. It took toll 2008 before it was named the first book on PDA came out in 2011 by Phil Christie and Ruth Fiddler. And the PDA society was formed in 2014 and they're kind of the world leader. And we started in 2020. So we're not so behind. We're behind, but not so behind. So I started PDA North America because a parent, a mom, wouldn't take no for an answer and kept sending me articles about PDA. And I think everything in the world of disability or neurodivergence happened because there was a mom who wouldn't take no for an answer. And I got really interested in PDA and thought all right I'm going to get training from somebody in the UK and put together a conference. So March 2020 was our first conference of that date rings the bell. It's because that's when the pandemic started. So the week before the pandemic, we had 165 parents come from all over America. I brought two speakers from the UK to present. And we got people back in the last flights that were leaving Chicago. It became a parent at the end of that conference that this was a beginning, not an ending. I hadn't really thought past doing the conference. And PDA North America was established. We became a nonprofit in 2023. So we're growing quickly, but we're still tiny. We do webinars almost every Thursday night. We are planning our seventh conference. And hopefully some of you be able to attend its hybrid. We do trainings for parents and professionals. And we've just launched a PDA in education, a connection based learning program for schools. That hopefully some of you will be able to tell your schools about. We have a whole learning lab of webinars and insights which are kind of our blogs on our website. We have a community connection list so people can find each other. And probably what's used the most on our website is we have a PDA affirming professionals list so people can look for therapists and other professionals for their kids. And as was said in my introduction, I wrote a book on PDA a little bit ago. So you all might want to look at that book if you want more information. You know as our real focus of PDA North America over the last years has been awareness, just awareness of PDA. And now because that's worked, we need to mention that not all demand avoidance is PDA. Kids and teenagers and adults avoid demands for all kinds of reasons besides PDA, even neurodivergent people, even autistic people, and executive functioning gets in the way, anxiety gets in the way. There's so many reasons people avoid demands. So not all demand avoidance is PDA. So I wanted to point that out. And people generally want numbers and we don't really know. The only study I know of that really looked at numbers was 10 years ago in the UK and they found that one and four autistic people fits the PDA profile. It's just a guess. And I don't think it's correct because one of the things we have found out in working and focusing on PDA is that PDA individuals are so often undiagnosed or misdiagnosed. Adults and teens are often misdiagnosed as bipolar or having borderline personality disorder. Children are misdiagnosed ODD which is oppositional, defiant disorder, conduct disorder. And what we're really finding out is that black and brown children are so much more likely to be diagnosed as having a behavior problem. ODD conduct disorder instead of having their neurodivergence explored at all. This episode is brought to you by Neuroclinic USA. What clinic level neurofeedback without leaving home? At Neuroclinic USA, we bring high-end clinic grade equipment straight to your door and for a fraction of the price. With expert guidance and exceptional customer support every step of the way, whether you're working on focus, anxiety, emotional regulation, or helping your child thrive, neurofeedback can make a real difference and now you can access it from the comfort of your own home. Feel calmer, clearer, and more in control. Use promo code ADD50 to receive $50 off your first assessment. Start today at neuroclinicusa.com or call 1646-982-0560. When I first started this kind of PDA effort in 2019, 2020, I was pretty blown away that I heard the same stories from parents who contacted me and it didn't matter if it was a parent of a five-year-old on a farm in Iowa or a parent of a 15-year-old in an apartment in Manhattan and parents talked about the light bulb moment that they had when they heard about PDA and I'm hoping some of you watching today might have that light bulb moment. Parents talked about that their child had received many diagnoses but the parent thought they never really fit and some parents had thought their child was autistic based on their own research but would take their child to a neuropsychological evaluation and would be told oh no no no he's way too talkative to be autistic or she's so social she can't be autistic or they make eye contact so they're not autistic and probably the hardest thing for parents to talk about was how hard they tried to follow all the advice that they were given from therapists, psychiatrists, pediatricians, teachers and even in the parenting books and those strategies didn't work and often made things worse and hearing those stories really motivated me that we needed to do something so I had mentioned that we're not so thrilled with the word pathological even though some people do like it based on the same original reason it was called pathological that it's not under someone's control but adults mostly in the UK started renaming it pervasive dry for autonomy or some people even persistent dry for autonomy and they did that not only to get rid of the word pathological but to highlight that the more important thing to focus on is this dry for autonomy and demand avoidance is part of having this drive for autonomy so that's something that that most people now prefer that term in America but we kept the initials pda but they're not great initials either so we're struggling with that so when I first approached Ruth Fiddler to write a book with me I had a whole notebook of questions about pda because she had written many books about pda and knew how to write books but she was a real expert and before I had even my first question out of my mouth she interrupted me but in a very polite British way of course and today and we can't possibly talk about pda until we talk about autism and then went on to say that the U.S. is so behind in our thinking of autism and we still talk about it in a very outdated stereotypical way. She didn't mention ADHD in that conversation but that's the same and that the understanding has evolved and I'll talk about that later too. So I was so grateful even though I was a bit taken back by this conversation and thought oh now I have to learn everything new about autism but it's been so helpful professionally and personally to me and now I'm happy that there's multiple voices in America talking about the need to understand autism differently than how I was taught. Dr. Devon Price is one of those people who's written a couple books on masking autism and on masking for life and what I like that he says and he's an autistic adult is that autistic people tend to be hyper reactive to even small stimuli in the environment and of trouble distinguishing between information and sensory data that should be ignored versus data that should be carefully considered and I think that is so important in understanding autism. He also talks about the processing of situation takes more time and energy than it does in their typical person and again I think that is so important to understand and any of us who are neurodivergent or supporting someone who is knows how exhausting it can be to be neurodivergent and process information and operate in a world that's not designed for your neurotype. Also one of the people whose work I admire is Donna Henderson and I love her definition of autism too because I think it's like so pure and simple but right on and she just talks about being autistic and its core means having a different kind of neurotype and people have this kind of nervous system experience process and respond to the world differently than non-autistics. That is all about the nervous system and that is what we have found in understand PDA is that it's about recognizing nervous system differences in neurotypes and her books are amazing if people are looking for resources and I think I have found that whenever there's a TV or movie character who's autistic that character portrays the stereotypical presentation and you know it's kind of the presentation that a lot of medical professionals still hold on to and what many of us were trained in. It's that person loves routine and is concrete and pragmatic. You notice their sensory differences and their social differences but you don't really notice their empathy. It's a very externalized presentation with high anxiety and under stress they go into fight flight or freeze but the majority of autistic people including PDA individuals and you know people who have ADHD and autism you know have this like non-stereotypical much more nuanced presentation with high camouflaging and masking and the special interests can blend in socially and culturally. People who fit this majority profile are hyper empathetic and it can be very internalized so what you see on the outside might not be their inner experience. People also share high anxiety but under threat they might use fight flight, fun or freeze. So we have to kind of move away from this traditional approach of autism. It's a way of experiencing the world. It's not a checklist of behaviors in Illinois where I am to qualify a student under autism for special ed. Everyone at the table has to agree to this checklist of stereotypical behavior. It's really triggering and I feel like the PDA folks in the UK they were so ahead of you know everyone in that they were always broad and nuanced and inclusive and they from the start said there's no gender difference in autism. There's also a psychologist I admire in Belgium, Peter Vermulin and one of the things he talks about in his books is that autistic people have prediction differences in the brain so if you're less able to predict what it will feel like or be like if you say yes to a request you're less likely to acquiesce you're more likely to refuse and I think that has implications for PDA. This episode is brought to you by No CD. 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We're happy that the neurodiversity movement seems to be making some ground but we have a far far way to go just looking at that there's not one way of thinking learning and behaving. There's differences are not deficits and there's so many ways to interact with the world. I know that the relationship between ADHD and autism is so complex and what we do know is that at least 50 to 70% of autistic people also have ADHD but what we think even though we don't have the data is that it's higher for PDAers and that symptoms may overlap or camouflage each other and it's all really skewed because until 2013 a provider couldn't diagnose both ADHD and autism in a person so we don't have the full understanding that we need to really support people. This Venn diagram was influenced by the work of Megan and Anna Nath who does all kinds of fabulous Venn diagrams and more and more we're seeing the overlap between ADHD and autism as the understanding for both of all. When I was taught about ADHD no one ever mentioned sensory differences. No one talked about rejection sensitivity for either diagnoses. There's a lot of overlap and we all have so much to learn and and one of the areas I think we've really fallen short in is understanding co-occurring conditions. We know that autistic people and it seems like PDAers even more have so many co-occurring conditions but often in the diagnostic process once someone is diagnosed with autism and ADHD and maybe PDA, often people kind of stop being curious and exploring but we know from the people we serve, there's so much more. There can be learning differences that owe immune differences. GI disorders and chronic fatigue. We know lots of PDAers who are struggling with pans and pandas and pots and MCAS and Ellers-Danlos and these co-occurring conditions impact daily life and quality of life and we need to really dig deeper and explore. So in a talk a couple minutes just the features of the PDA profile and what's important to understand is that PDAers generally have better social understanding and communication skills and other autistic people and they kind of use that to their advantage and it can mask difficulties they're having in communication and social situations. So it can be really a hidden disability so so many PDAers don't get the support they need because of that. So we know kind of by definition right that PDAers avoid everyday demands but PDAers use social strategies to avoid so it could be distraction giving excuses instead of just saying no. So it might take some while for people to realize that they are having a pattern of demand avoidance. PDAers are so social and crave social interaction but they still have problems in social understanding and relationships. PDAers can have very fast mood changes and that can cause those misdiagnoses. PDAers can be impulsive and there's so many reasons for these kind of behaviors sensitivity and intensity of emotions and just being hypervigilant. One thing that that's striking about PDAers is they often act very differently in different settings and probably the most common is that a PDAer might fall apart as soon as they get home from school and when the parents report this to the school the school may say something like she's an angel at school. He's so compliant and we don't see any of this and then might say to the parent oh wow is something going on at home? Is there a lot of stress? Are you disciplining consistently and of course that drives you know distance and a problem in the relationship between home and school but it is very common for PDA children to hold it together and mask and camouflage in certain environments and then when they get home fall apart. Also PDAers like other neurodivergent people but sometimes even more extremely have kind of a fluctuating capacity is a good way to look at it so they might be able to do a specific task or handle a specific situation one day but not the next and this can be confusing again especially at school when people say why don't know you could handle the assembly last month why is he refusing to go today or she did fine on the math quiz yesterday why is she falling apart or saying she is the stomach aching can't take the math quiz now capacity fluctuates stresses cumulative. PDAers we know have difficulty complying with their request of others and are unable to follow the rules and routines set by others but what's also really important to understand is sometimes PDAers can't make themselves do things they want to do. I can be a child looking forward to a birthday party or vacation for a long time but when the day comes they just can't do it. We talk about PDAers having a need for control and I have found in my practice that taking control decreases anxiety probably faster than anything else and I think that's part of it. Something else that's unique about PDAers and PDA children and even very young children is they don't really appreciate hierarchy or age difference. A little kid might think why would the principal deserve more respect than a second grader. Respect should be earned it shouldn't just be based on title and this of course can cause problems when there's adults who feel they should be treated with respect just because they are adults. PDAers can be very comfortable in role play and pretend and can use that to avoid demands but also to comply with demands like other autistic people. PDAers can be very obsessive but they're usually obsessed on people not on objects. It's not so much a problem if your PDAer is obsessed with Taylor Swift. It's more of a problem if your PDAer is obsessed with the girl who sits next to her in her reading group and because of that she might not want that girl to play with any other kids that recess only her. So in play which is stressful anyhow a PDH child might be very demanding and controlling and dominate the situation but PDAers in the right situation are often really engaging and charismatic so that's something to think about. PDAers like many autistic people don't really get credit for being empathetic and emotional but PDAers are so sensitive that they're like sponges they absorb the emotions around them so they might get dysregulated if a classmate is dysregulated or if an adult is frustrated or angry at them even if they're pretending that they're not they're going to feel angry and frustrated and I think one of the reasons it's not always understood is that when a PDAer is struggling to be okay and so anxious it's just too much of a luxury to worry about like the impact of their behavior on someone else they're just trying to survive and be okay and PDAers are known for big meltdowns and they can be hard and they can be aggressive but we like to think about them more as panic attacks because in a panic attack people are approached with empathy sensitivity offers of help but when we view meltdowns as a challenging behavior they're greeted as with threats of consequences reminders of expectations and generally frustration and we need to remember that during one of these panic attacks the child won't be able to problem-solve or process your language or information you're offering you're going to talk to us for a second about demands because we all know you know what demands are when they're like do your homework or wash your hands but I hadn't realized that fun things like hey let's go get ice cream after dinner let's watch a movie can also be demands but they offer PDAers I also didn't realize that expectations are demands and returning a greeting just saying good morning to your child or to a student in your school has the expectation that they're going to return the greeting and that is a big demand and can just regulate them and then self-imposed demands so it can be doing things they want to do or even their body's demand to go to the bathroom to eat to drink can be a demand or doing things you want to you finally get a toy you've been waiting for or a book and not being able to read it sometimes just being able to talk is something a PDAer can't make themselves do hopefully some of you have heard about the polyvagal theory which I'm not going to do justice I'm going to talk about it for a minute but it's Stephen Porgas's theory and he talks about behavioral responses always representing how a person's nervous system is regulating the body's response to threat and survival instincts fall under a few categories right so there's engagement connection there's defense fighter flight and then there's life threat which is freeze and he talks about all of us have this thing called neuroception which is a subconscious surveillance of safety and threat in the environment it's like an internal smoke alarm that goes off when there's threat but for PDAers their neuroception is so sensitive in reaction reactive it can sense threat when no one else can see that threat and for me fight flight and freeze is what's underneath all the challenging behaviors I see in people the other things sometimes we lose sight of is that humans are wired for connection that's what's gonna prevent us from going into a fight flight or freeze and it's gonna get us out of fight fight or freeze and sometimes we make the mistake of isolating people when they really need us so PDAers have many shared traits with autistic people which is why mostly PDA is tied with autism most of the books including mine talk about PDA as an autistic profile but more and more other people are speaking up and saying yeah my my child's ADHD and we believe their PDA and other people are saying I think PDA maybe could be a stand-alone diagnosis and the and the real truth is we don't know there has not been enough research and our hope is that in the future there will be but we know how we can support PDAers regardless of kind of what box we're putting them in and PDAers do share traits with autistic individuals differences in the social arena sensory differences in Terraception that reading your internal cues including emotions high anxiety and emotional regulation but many people and maybe some people you know are told they're not autistic because PDAers have frequent eye contact they're more fluid in their social skills they love spontaneity and novelty and not routines especially routines that aren't their idea rewards including praise can trigger them they can be very imaginative and unorthodox and they express empathy and that leads people to be confused so I'm going to talk about support because that is so important and it took me years sorry to admit to understand that supporting a PDAers a mindset not a strategy I I early on heard adult PDAers say he hated the word strategy and I thought oh I use the word strategy and sometimes I still slip out slip up with that but strategies can be kind of rolled out and taken back usually based on what's convenient for us but to support a PDAer it's really a change in mindset it has to be focused on a genuine relationship those are the most important things it has to be overriding we need to choose priorities we need to allow recovery time we have to listen to understand because it's all about understanding and sometimes PDAers respond to humor and that spontaneity but we have to be flexible we need to help PDAers track plan their own routines and schedules because they might need that structure and for us to learn how to use language indirectly including thinking aloud or declarative language but it's all about trust and I think of things as sharing tasks as equal partners when you're wanting something or something's needing to be done by a PDAer be equals share the task as partners which is different than just helping a person empathy helps but it has to be genuine it's so important to realize that stress is cumulative and that's why we have that fluctuating capacity because people's window of tolerance changes all the time so we're not looking for antecedents or triggers we know that behavioral approaches do not work for these kids and we also need to learn that our emotions are contagious I think masking is so complex and we need to partner with PDAers and everyone on being their most most authentic self in their say in the safest way and it's not always safe to be your authentic self so we need to understand that most neurodivergent people can only do tasks that make sense and everything has to be worth the energy and stress it's such an important concept we need to work on helping people understand their inner life including feelings and how to advocate for themselves but first you have to understand your feelings and what you need but we know pressure and being pushed doesn't work things we use to motivate kids feels like pressure and pushing but at the same time PDAers need so much for us from us so not ignoring their needs not letting them just be there's probably some rust green fans watching and my favorite thing he says is that challenging behavior is only a sign or a signal that it's a problem it's not the problem we know that PDAers can go from zero to 60 in a heartbeat and that's for the reason that many are at 50 or 55 as their baseline and they don't know anything else and PDAers work hard to meet our needs and please us and that's why sometimes they negotiate or try to offer other alternatives I still think kids who are being difficult when they do that but they're trying to meet our needs and again everything has to be worth the energy and stress we say PDA North America the juice has to be worth the squeeze we ask a lot of PDAers we last ask a lot of neurodivergent kids and everything takes a toll and sometimes we can't make things better but we can avoid making things worse so here's my nagging slide resist the urge to give consequences or threaten them you don't have to worry about holding them accountable adults lecture and talk too much and in part of that we dismiss their reality we try to convince them otherwise we remind rules and expectations and that's never what's getting in the way we express this appointment and I do not believe we need to process after the fact what happened whether it's a mistake a misbehavior a meltdown we can just move on we have many opportunities where we can use the information we've learned proactively otherwise usually feels like shaming we can just let things go and we don't have to get stuck and we're letting a kid get away with bad behavior we can think of behavior as an iceberg and some of you may have seen this before when we talk about behavior and when we write behavior plans we are just focusing on that tip of the iceberg that little tiny observable part but where we need to support or all the things happening under the iceberg sensory differences learning disabilities social differences anxiety and even the history of school disciplinary practices when we address these underlying issues the behavior takes care of itself and many people find pda because their child's in burnout and I had not expected that so we need to work to prevent burnout from individuals and there's things we can do and so much of what we need to do is about managing our own nervous systems so we can co-regulate with our pdaers that they need that connection they need a calm nervous system to regulate their nervous system so that's what we need to do is even though self-care is a luxury we need to do it and we're gonna make mistakes so we need to just be honest that we're going to make mistakes because it's part of being human and we're not going to always be able to regulate our nervous systems pda North America as I mentioned is a growing nonprofit we have all kinds of resources and we hope you spend some time on our website no one has ever turned down because of financial limitations for any of our pre-recorded webinars and trainings or even our virtual conference and I am just so happy that you all are here all right so Q&A yes Diane thank you so much for that presentation I have a notebook full of notes and I know that the listeners here today really appreciated your time and expertise so I wanted to actually start out with a little bit of kind of brass tax a number of people wondering if you can help them differentiate between oppositional defiant disorder and pda and just understanding the differences and why it might matter to understand the differences yeah it's it's a hard one I mean in a perfect world I'm going to choose my words wisely and a perfect world ODD wouldn't exist in my mind because it's not helpful and it just kind of describes what we're seeing it doesn't give any useful information but I've come to realize and change my opinion that we can't make it disappear because it's the only thing available to so many humans especially people who live in marginalized communities and members of the black and brown populations the global majority so ODD is not neurodivergence and it is different in that most people consider ODD behaviors as intentionally pushing back against authority where pda don't even think authorities a thing you know they're um so it's it's not that pda can't make themselves do things they really want to do and that is so different than ODD deers um ODD pda works so hard to please um adults and they talk about that all the time but they're unable to make themselves do things so they're they're different I think one of the important things is when someone is diagnosed as ODD to not stop there and to dig deeper and look to see if there's neurodivergence um it may be autism it may be ADHD it might be learning disabilities but I feel like there's generally other things going on too and um and not everyone has access to the resources to get um a diagnosis of you know a neurodivergence or a learning disability unfortunately it that is not available to everyone hmm that was a very illuminating distinction thank you for that um it kind of along those lines um just another point of clarity um that though pda is more common among autistic children and teenagers it's not exclusive correct correct okay yeah and we don't really know research wise and because of autism you know the understanding changing so rapidly you know all these things are hard to say and we don't have research to say um I do one thing I want to make sure I mentioned is in my opinion using the pda approach won't hurt anyone you know so because it's really about being attuned and responsive and even if you're not sure your child is pda especially if what you've been trying isn't working there's no harm in kind of looking at this pda approach and trying it um I will say a number of people your your slides of advice to parents much of that advice is almost the opposite of what we've heard before I'm tired well when I've added a new one just that last week saying um attunement and responsiveness is so much more important than consistency and when I was a parent young parent I'm still a parent but when my kids were young and when I was a private practice social worker and a school social worker I typed about all the time about the importance of consistency and well I don't believe in that at all I think being responsive and attuned to where your child is in the moment is is so much more important and it kind of is how we treat each other when we're being kind you know like if um if I like usually make dinner and I've had a horrible day and I would say to my husband I'm like I can't make dinner tonight if he'd say well you know it's your job like I'm assistant like you always do like that's not gonna make me feel good where if he's like oh yeah today why today is the day you can't make dinner I get that here I'm gonna just sit still I'm gonna I'm gonna have a cup of tea I'm gonna make dinner like doesn't that feel better doesn't that make the relationship better I just don't know why we can't treat kids that way it's what I find works um and I've always kind of had that impression it kids I just kind of um let all my training get in the way I think um to and I know and we talked about this and before people are really judged when they parent differently they're judged by mothers-in-laws siblings neighbors teachers doctors therapists like oh you're too indulgent you're too permissive your child's never gonna learn consequences are how people learn and there's so much judgment out there and that's why I think for parents in this kind of was mentioned on the whole parents of a pdf need to find community with other families who have similar kids who are parenting the same way because it gets lonely and it's hard to fight all that judgment and we we kind of internalize all those judgments because we're human and it leaves us to to make mistakes. That's a great point um one of the sticky areas that people are asking about is this idea of the accountability um and how to navigate this well for for parents and educators that um our kids are going to be faced with accountability needs in their adult lives how do we walk that tightrope do do we let them fail and and take responsibility for their actions um it's so tricky do you have advice for that piece of the puzzle specifically? yeah it's so tricky and and the reality is it all depends to like on the context in your child and their age in the situation um two and I think sometimes we blend accountability with like consequence two I mean I think it's different when your child like hurts a sibling feelings or breaks their toy or um be talking about how they can repair that relationship like you know it might be doing a drawing or making cookies for the you know the sibling versus losing in their um tablet because they were mean to the sibling you know it's it's there's different ways to look about look at accountability and and we do just have such a consequence basis not like a growth basis too um and I think some it comes of the understanding of what went wrong what actually happened to like what um like what was going on and can we prevent it next time because the adults do need to add proactive support often too um and and I think narrative virgin kids often need more support or different support or more interdependence than independence sometimes too and I think sometimes if we're too focused on accountability it can be really scary for kids who are struggling and it can make them feel very misunderstood if we are giving the impression that we think they were in control of their behavior or they could have um prevented what happened but these are big important hard questions absolutely so hard we have um one educator here who um I think um encapsulated this well and and she wrote are there any expectations that classrooms and schools can can realistically hold a student with pdf accountable for if your typical expectations such as doing a teacher assigned task or taking notes or listening to the teacher is something that causes them anxiety um and may you know trigger an outburst um a lot of educators wondering that they want to be helpful and they are struggling for how to approach walk this tightrope of expectations and realistically being attuned but also having 32 other students in the classroom right right and and that's why we just launched our pdf and education um course because it is so complicated um yeah I was just talking to a school today about what if like there's a fire drill you know um can't we need to expect the student to be able to leave and and i'm like of course however things are more complex um if every expectation feels at that level to the student then that kind of emergency situation is just one more expectation and requirement those need to kind of stand out also when everything is relationship based and you understand a students need and you have trust like in that situation you're going to be able to like put your armor on that kid and say oh this must I know these things are so loud and stressful I'm going to walk with you out let's talk about um that video game that you love so much you know that they're going to meet that students needs and help them meet that expectation I think with work it's going to vary I think some days the students might be able to to do um a task in the classroom and other days they might need a break outside of the classroom to go to some other supportive adult or they might be able to need to do an alternative that they might quietly draw because that might not be a time so I think it's that flexibility but once you build that trust and the student knows if they can handle something they can opt out and it doesn't have to escalate to be a big deal and nobody's going to force it things can calm down there's a lot that can be done to support pda students but generally it's not just little tweaks it's a paradigm shift so the answer to a big big question it's a huge question um I will mention once more that um Diane has provided a wealth of links and information back to the pdanorthamerica.org her website um there is so much to explore there I encourage everyone to do that and as a final question I will just ask um do you offer support groups or resources specifically for parents of children with uh who are twice exceptional who have pda and also are gifted and talented this seems like such a tricky dynamic it is and we're we're doing a webinar on it um this spring and we have all different kinds of support groups and we have um they're pure lead they're free and we have many twice exceptional kids as part of our community and it is tricky these are tricky kids these are very tricky kids um and that need everyone who is educating and treating parenting a pda or needs a village and a lot of support the kids need a lot of support and so do families and professionals and um yes spend some time on our website because we um want to be there for you all well uh Diane thank you for kicking off the support this was such an incredibly insightful and helpful uh webinar we so appreciate your expertise and your contributions to our community oh i so um and great i'm so grateful for the opportunity thank you so much and thank you to everyone who joined us today um i mean a lot of people asking if they can um get a replay and and the uh copy of the slides yes we will follow up in a few hours after the live event um and if you want to access the event resources later you can always visit attitudemag.com and search for podcast 590 um if you're listening in replay mode you can just click on the episode description and please know that our full library of attituded webinars is available as a podcast it is called the ADHD experts podcast and it's available on most streaming platforms so to make sure you don't miss any future attitude webinars you can sign up to receive our free email newsletter at attitudemag.com/newsletters we hope everyone has a lovely holiday season and we hope to see you in the new year thanks for more attituded podcast and information on living well with attention deficit visit attitudemag.com that's adhditudmag.com marketing is hard but i'll tell you a little secret it doesn't have to be let me point something out you're listening to a podcast right now and it's great you love the host you seek it out and download it you listen to it while driving working out cooking even going to the bathroom podcasts are a pretty close companion and this is a podcast ad did i get your attention you can reach great listeners like yourself with podcast advertising from lip synads choose from hundreds of top podcasts offering host endorsements or run a pre-produced ad like this one across thousands of shows to reach your target audience and their favorite podcasts with lip synads go to lip synads.com that's 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