Add PDA to ICD-11 urgently so the school refusal can be dealt with appropriately

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My four-year-old son has been off nursery for over three months now due to nursery refusal. Underpinning his avoidance is a high anxiety about conforming to everyday demands and of not being in control of the situation, even the mention of nursery sends his anxiety levels off the scale. 

My son's EHC plan is not fit for its purpose as it does not accurately reflect his level of need, and this is a reflection of me not being listened to and my son's needs not being understood. My son is supposed to start a mainstream school this Sep that was named on his EHC plan against my wishes.

LA has rejected my request for deferment saying that it is not in my son's best interest not to start the school this September although there is no plan in place on how to resume his attendance at nursery or the importance of a transition to school if attendance at the nursery can be resumed.

At the TAC meeting, I have requested the network to watch the video footage of difficulties dropping my son at nursery, and his nursery refusal which was also witnessed by the Speech and Language Therapist at nursery at the end of April.

As the CDT - Child Development Team refused to provide an information about my son's nursery refusal or failure of ASD interventions applied to LA despite all my efforts to communicate this EHC Coordinator made an assumption that my son is simply refusing to attend because he is 'bored'.

When I set on a quest to obtain a differential diagnosis for PDA also known as Pathological Demand Avoidance ( autism sub-type ) for my son as 'typical' ASD interventions were having more of an adverse effect on him, my son already has a diagnosis of ASD since Mar last year I had no idea about the challenges that were to follow.

I was puzzled by my son's autism as children with ASD I saw at special needs nurseries were nothing like him. I had a light bulb moment when I came across the PDA profile in children with autism. As a result, I have attended the PDA conference in Reading and parental program for PDA in Norwich.

The CDT disagreed that my son may have PDA and refused to engage further in exploring PDA strategies, instead, I was asked to go back to my son's GP and pursue the PDA assessment myself.

After a year of waiting and chasing my son's GP, a request for an assessment has finally been approved however I was told that my son can only be assessed at South London and Maudsley which specialises in mental health and has no specific policy for PDA.

As autism is a neurodevelopmental disorder and not a mental health issue, it is not unreasonable to expect that an assessment is carried out by experienced clinicians specialising in the area of Autism Spectrum Disorders (ASD) including PDA and not mental health professionals.

The lack of support I've experienced from a variety of services means that families like mine are often relying on their own research to work out how to support their children. Thanks to LA and CDT I've been left without support until the end of Oct while I go through an appeal process at the SEND Tribunal.

I've also made a complaint to HNS on 6th June. The NHS has not addressed my complaint appropriately, therefore, it had to be reopened however they did find a time to make a safeguarding referral to social care. 

The 2018 survey conducted by the PDA Society highlights that the school environment does not work for many children with PDA. If this is the case then both children and parents should be supported appropriately and not ignored, dismissed, penalised, reported to social care or sent to attend parenting courses that do not work for children with PDA as PDA is not a parenting issue and most importantly left without any support because they've reached the ultimate avoidance - nursery/ school refusal.

After consulting with IPSEA - Independent Parental Special Education Advice I understand that education does not necessarily need to take place in the school setting as incorrectly advised by LA if the child's high anxiety and demand avoidant behaviour is preventing them from attending the setting as LA has a duty to provide Education Otherwise than at School under s61 Children and Families Act 2014 for such children.

Thank you

I would like to thank Sidings Early Years ( my son's nursery), PDA Society and IPSEA for all their support and advice and everyone who signed this petition, much appreciated.

Essential Reading:

Survey of Professionals

Teachers Guide to Understanding PDA

Education: Stories of PDA

New global diagnostic manual mirrors U.S. autism criteria ( NO MENTION OF PDA )

The £70 million council costs of fighting – and losing – against parents at the SEND Tribunal

Image Courtesy of PDA Booklet

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