Welcome to the final part of Charlie's story. Go back to Part 1, Part 2, and Part 3 to catch up if you missed anything.
There's one piece of Charlie's profile I haven't talked about yet.
His mom mentioned it almost as an aside near the end of our first call. She was describing how she handles transitions with him… how she learned years ago that if getting into the car seat wasn't his idea, it wasn't happening.
"If it's not his idea, he's not doing it. Ever."
She felt embarrassed admitting this, like she was being too permissive. It’s almost like she expected me to reprimand her and tell her she’s the whole reason he’s struggling.
What I actually said was: that makes complete sense. Because what she was describing is a PDA (pathological demand avoidance/ pervasive drive for autonomy) profile — and it adds a complex, but very important layer to all the strategies we’ve discussed so far.
A brief intro to PDA
A huge caveat- I am still quite a beginner when it comes to learning about PDA. I learn most from PDA North America, LowDemandAmanda and AtPeaceParents. I’ve never taken a PDA course. I only started learning about PDA after I left the clinic, so while I can certainly think of clients I’ve had in hindsight who would clearly meet this profile, I can’t claim to have clinical experience in supporting it.
With that aside, here’s what I do know.
PDA stands for Pathological Demand Avoidance — though a lot of people in the neurodiversity-affirming space have moved toward calling it Pervasive Drive for Autonomy, because that framing gets closer to what's actually happening.
It's a profile most commonly seen in Autistic individuals, though it’s not exclusive to autism. The defining feature is a nervous system that experiences demands or requests — any demands, even ones the person wants to comply with — as a threat.
When Charlie's mom says "brush your teeth," his nervous system processes it as pressure. And pressure, for a PDA nervous system, activates the same fight-or-flight response that a physical threat would. This is what feeds those big refusal or avoidance behaviors.
That's why traditional approaches — reward charts, firm limits, counting to three can actively make things worse. You're adding more pressure to a system that's already treating pressure as danger.
Why was this important? Because Charlie's suspected PDA profile made it difficult for his mom to be able to suggest sensory strategies. Her toolbox could be full of dozens ideas and it would be useless if he refuses to try them.
Mom's Intuition
Again, she really did have such great intuition. She was already doing a lot of the “right things” for a PDA approach.
First, she gave him information before transitions instead of instructions. In the PDA world, they call this using declarative language. "The car's warming up so we can leave soon." vs "Get your shoes on."
She built his homeschool curriculum around his interests and let him move through it at his own pace (from what I've learned, many PDA families turn to homeschooling). She worked emotional regulation content into their lessons. She never forced the calming strategies; she modeled them, and she waited until he was ready.
She'd learned through trial and error that indirect, declarative language worked. That giving him ownership worked. That the appearance of choice (even when the outcome was the same) worked best for him.
This is consistent with what I’ve learned from experts in this space. Low demand, indirect language, collaborative framing, maximum autonomy. They remind us that a nervous system that sees demands as threats needs a very different entry point.
How To Work This Info Into The 4 PM Crash Out
A lot of the strategies that work well for dysregulated kids don't work cleanly with a PDA profile. You can't just say: Go do some heavy work. Try the punching bag. Let's do a body check-in. All of those are demands. Even gentle, well-intentioned ones.
Charlie's mom couldn't walk up to him at 3:40pm and say okay, time to throw ice cubes on the patio. Charlie might receive that as pressure, which would add to the dysregulation already building (the opposite of what we were going for).
So instead, we talked about gentle, non chalant invitations (also called strewing). Leaving the dinosaur excavation toys out. Putting the clay on the counter and the frozen cake pan on the patio table with a mallet nearby. Available to join completely on his own.
She could also try starting the activity herself, with his sister or on her own, in a space where he could see it. Not inviting him directly. Not asking. Just... doing it. And leaving room for him to wander over.
For a PDA nervous system, "this is here if you want it" feels completely differently than "I think you should do this."
What we learned from Charlie
Charlie is a kid who taught himself multiplication, designs elaborate imaginary worlds, and can hold a surprisingly sophisticated conversation about how his brain works — when it's his idea to have that conversation. He already knew exactly what he needed, just not how to ask for it. And his mom was already picking up on these clues, I just helped her put them together for a plan.
The most important takeaway for his mom was that with a kid like Charlie, you can't push him toward regulation. You have to build an environment where regulation can happen, and then you get out of the way and let him have control.
Thanks for being here! I’ll see you next week with a brand new case study.
Disclaimer: These case studies are inspired by real-life clients I have worked with, with permission from their parents to share. Some aspects of the case are authentic, and other details are added to include more variability for our discussions. None of the strategies and advice here substitutes medical advice, diagnosis or intervention with an Occupational Therapist.
LAST REMINDER: The Webinar is happening this Thursday, June 18th at 9:30 AM PST
Join us for free to learn what tweaks you can make to your child's screen time routine so you don't have to go fully unplugged (unless, that's what you're aiming for). I'll help you feel better about those research headlines you might be seeing, and introduce you to a brand new emotional regulation game that will help your child actually calm down WHILE THEY'RE PLAYING IT.
Grab your free webinar ticket here
Continue learning from me:
Responses