themselves and others. It involves understanding the reasons for the behaviour and considering the person as a whole - including their life history, physical health and emotional needs - to implement ways of supporting the person.

PBS involves:

understanding the reasons for behaviour which challenge, and assessing the broad social and physical context in which the behaviour occurs including the person's life history, physical and mental health, and the impact of any traumatic life events.

Planning and implementing ways of supporting the person which enhance the quality of life for both the person themselves and their carers.

It focuses on creating physical and social environments that are supportive and capable of meeting the person's needs, and teaching them new skills to replace the behaviours which challenge. 

ASD - What is Autism Spectrum Disorder 

Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. This condition affects how people perceive the world and interact with others. Autistic people can have difficulties with everyday social communication, social interaction, repetitive behaviours and sensory issues. In order for a diagnosis to be made, a person will usually be assessed as having had persistent difficulties with social communication and social interaction and restrictive patterns of behaviours, activities or interests since childhood, to the extent that these limit and impair everyday functioning.

It's estimated that about 1 in every 100 people in the UK has ASD. More boys are diagnosed with the condition than girls.

 

Pathological Demand Avoidance Syndrome - PDA: What is it

According to the National Autistic Society:-

Pathological Demand Avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent. This section explains what a PDA profile is and the  assessment process. It also links to some personal accounts from adults with PDA. It is worth noting that PDA is not a stand alone diagosis but a profile of Autism - ASD.

Strategies and Approaches to Manage PDA

Many parents and teachers find that some of the recommended strategies used with autistic children are not effective for a child with a PDA profile. We explore some useful resources for supporting those with a PDA profile in our guides below. 

The existence of PDA as a ‘diagnostic term’ and how it fits within the autism spectrum is widely debated. With limited evidence-based research there is no conclusive and agreed upon definition of PDA. What is generally agreed upon is what is often referred to as a PDA profile. Here we will detail what is meant by this profile. 

 

People with a PDA profile are driven to avoid everyday demands and expectations to an extreme extent. This demand avoidance is often (but according to some PDA adults, not always) accompanied by high levels of anxiety. 

Although there is no prevalence study as yet, the demand avoidant profile is thought to be  relatively uncommon. However, it’s important to recognise and understand this distinct profile as it has implications for the way a person is best supported.

Demand avoidance isn’t just seen in those with a PDA profile so would need to be seen with a number of other features, as described below.

What are the Features of a PDA Profile

Autism is dimensional, meaning individual profiles can vary considerably depending on the combination of a person’s strengths and difficulties across two key dimensions: 

»how someone relates socially

»the need for sameness, often resulting in repetitive or rigid thoughts and behaviours.

 

People with a PDA profile can appear to have better social understanding and communication skills than some other autistic people, and are often able to use this to their advantage. However, these apparent social abilities can often mask difficulty with processing and understanding communication and social situations.  

 

The distinctive features of a Demand Avoidant Profile include: 

» resists and avoids the ordinary demands of life

» uses social strategies as part of avoidance, for example, distracting, giving excuses

» appears sociable, but lacks some understanding

» experiences excessive mood swings and impulsivity

» appears comfortable in role play and pretence

» displays obsessive behaviour that is often focused on other people.                                                         

People with this profile can appear excessively controlling and dominating, especially when they feel anxious. However, they can also be confident and engaging when they feel secure and in control. It’s important to acknowledge that these people have a hidden disability. 

People with a PDA profile are likely to need a lot of support. The earlier the recognition of PDA, the sooner appropriate support can be put in place.

 

PDA and Assessment

An autism assessment is important as it gives an accurate diagnostic label and identifies what specific support and interventions a person may require. International and American diagnostic manuals do not currently recognise PDA as a separate diagnosis or a subgroup within the autism spectrum. There hasn’t been enough research for PDA to be used as a diagnostic term, but some clinical diagnostic teams do describe it as a profile that they recognise within the autism spectrum. This recognition of need has been found to be helpful when signposting to other professionals for support. 

From an autism assessment It should be possible to get a detailed profile of your strengths and needs, regardless of whether or not they recognise the term PDA. 

A PDA profile is usually identified following a diagnostic assessment for autism.  

To begin the assessment process, ask your GP for a referral to the local adult autism diagnosis service.  

Getting a formal diagnosis can mean access to support, but having a specific profile of your strengths and differences is key to getting the right support. With a detailed profile, support can be tailored to all aspects of life – home, leisure, work – and should be regularly reviewed as your needs change over time. As PDA is not currently recognised as a standalone diagnosis, it is even more important that you have a clear description of needs and strengths so that support and strategies meet your needs at that time of life. 

 

ADHD - Attention Deficit Hyperactive Disorder

Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that makes an individual more likely to have short attention spans, be impulsive and hyperactive.

Most cases are diagnosed when children are 6 to 12 years old and it can have a big impact on a child’s ability to learn at school. ADHD often occurs alongside other problems, most commonly depression, but also anxiety or sleep disorders among others.

The symptoms of attention deficit hyperactivity disorder (ADHD) can be categorised into two sets of behavioural problems:

symptoms of inattentiveness

symptoms of hyperactivity and impulsiveness

It is not fully understood whether these problems are an extreme form of normal behaviour, or part of a separate range of behaviour.

Types of ADHD

A person with ADHD usually has symptoms characteristic of one of the three subtypes of the condition. The subtypes are:

»ADHD mainly inattentive

»ADHD mainly hyperactive-impulsive

»ADHD combined

If your child has symptoms of all three behavioural problems - inattentiveness, hyperactivity and impulsiveness - they may have ADHD combined, which is the most common subtype of ADHD.

Alternatively, if your child has symptoms of inattentiveness but not hyperactivity or impulsiveness, they may have ADHD mainly inattentive. This form of ADHD is also known as attention deficit disorder (ADD).

Childhood ADHD is more commonly diagnosed in boys than in girls, but this may be because disruptive behaviour, which the diagnosis may be partly based on, tends to be more common in boys than girls.

Girls with ADHD often have the mainly inattentive form of the condition, which may make them quiet and dreamy and can sometimes go unnoticed. It is therefore possible that ADHD could be underdiagnosed in girls, and could be more common than previously thought.

ADHD can cause problems in a child's life, and can often lead to underachievement at school, poor social interaction with other children and adults and problems with discipline.

What Are The Signs and Symptoms of ADHD

The symptoms of ADHD often persist from childhood into teenage and adult years. However, the symptoms of ADHD can be more subtle in adults and affect them in a different ways to children.

Symptoms in children and teenagers

The symptoms of ADHD in children and teenagers are well defined. The main symptoms of each behavioural problem are detailed below.

Inattention

The main symptoms of inattentiveness are:

» a very short attention span

» being very easily distracted

» making careless mistakes, for example in schoolwork

» appearing forgetful or losing things

» being unable to stick at tasks that are tedious or time-consuming

» being unable to listen to or carry out instructions

» being unable to concentrate

» constantly changing activity or task

» having difficulty organising tasks

Hyperactivity

The main symptoms of hyperactivity are:

» being unable to sit still, especially in calm or quiet surroundings

» constantly fidgeting

» being unable to settle to tasks

» excessive physical movement

» excessive talking

Impulsivity

The main symptoms of impulsiveness are:

» being unable to wait for a turn

» acting without thinking

» interrupting conversations

» breaking any set rules

» little or no sense of danger

If your child has ADHD, their symptoms usually become noticeable before the age of seven, with a diagnosis usually made between the ages of three and seven.

What Are the Causes of ADHD

The causes of ADHD are not clear, but we know that people who have a parent or sibling with the condition are much more likely to be affected. It has also been suggested that low birthweight and premature birth may play a role too.

How is ADHD Treated

Both behaviour therapy and medication can be used to improve the symptoms of ADHD. Behaviour therapy focuses on helping a person to control their behaviour, while medication can help improve attention span and reduce impulsive behaviour.

 

How We Will Work - Consultation

 

PBS ADHD Consultancy

We carry out Qb Assessment for ADHD diagnosis. A Qb test takes approximately 15 to 30 Mins. Results will be ready and can be given straight away after the test is completed. 

 

Consultancy Services Offered

»ADHD Qb Test/Check

»ADHD Qb Test/Check Analysis and Interpretation of Report  

»ADHD Qb Test/Check and Report  

 

What is a QbTest

A QbTest is a computer-administered test that objectively measures cognitive performance and activity levels. QbTest combines a Quantified Behavioural Task (QBT) with a high resolution motion tracking system that uses an infrared camera to follow a reflective marker that is attached to a headband. The test objectively measures the three core signs of ADHD: hyperactivity, inattention and impulsivity, to provide quantitative assessment of a patient’s activity level, ability to pay attention and inhibit impulses. QbTest is FDA cleared and is used for assessing the core symptoms of ADHD according to DSM-5 and ICD10. QbTest can be used in the assessment of ADHD and treatment follow-up for patients aged 6-60 years. The test is not affected by language, reading or mathematical skills.

 

The QbTest system consists of the following components:

» Client software installed on a Qbtech machine, used to administer the test system

» Responder button, used in the attention and impulse control test

» Infrared camera that tracks the patient’s movements

» Reflective marker (worn on a headband by the patient) for motion tracking

» Quick Reference Guide (this manual)

» User Manual, Technical Manual and Sample Cases Manual

» Stimulus card

» Camera stand

» Measuring tape

» QbTest Behavior Observation Form 1.1

 

QbTest for 6-12 years and 12-60 years take 15 minutes to complete. During the test two different grey dots appear on the computer screen, one at a time. The task is to press the responder button when a grey dot appears and withhold pressing when a crossed out grey dot appears on the screen. QbTest (12-60 years) takes 20 minutes to complete. During the test four alternating symbols appear on the computer screen; a blue circle, a blue square, a red square and a red circle. The task is to press the responder button each time a symbol of both the same colour and shape is repeated.

 

What is a QbCheck

A QbCheck is an FDA/TGA cleared and CE marked online ADHD test that supports early identification, assessment and treatment of ADHD, for individuals aged 6-60 years old. It is a computer-based test that objectively measures the core signs of ADHD: Hyperactivity, Impulsivity and Inattention.

 

QbCheck combines a computer task with breakthrough facial recognition technology by use of a web camera. During the test an individual uses the spacebar to respond to targets and his or her motor activity is registered by the web camera. No images are captured during the test. The test will take either 15 or 20 minutes.

 

QbCheck is based on the same principle test structure as QbTest and therefore benefit from the same documentation as QbTest including peer-reviewed studies showing improvements in diagnostic precision, differential diagnosis and clinical outcomes when used in addition to other relevant clinical information.

 

Please note a QbTest/Check is not a substitute or replacement diagnosis for ADHD. Therefore a full clinical assessment is required by a qualified specialist to diagnose a patient with ADHD.

 

PBS ASD Consultancy

Consultancy Services Offered

»ASD - ADOS Assessment

»ASD - Behaviour Support Plan  

»ASD - Autism Virtual Coaching (Online)  

 

ADOS Assessment

What is an ADOS Assessment

ADOS stands for Autism Diagnostic Observation Schedule. An ADOS is a semi-structured assessment of communication, social interaction and play (or imaginative use of materials) for individuals suspected of having autism or other perversive development disorders. 

If you or your child is on the autism spectrum, getting a diagnosis, and a better understanding of their needs can be a positive thing. 

 

ASD - Behaviour Support Plan - Face to Face 

We provide ASD Consultation to ASD children and adults. Our Behaviour Support Plan (BSP) begins with an initial consultation session and last for one hour. This is a face to face support plan.  

 

We offer 3 Behaviour Support Plans: Gold, Silver and Bronze; each one comprise of three critical components:

1.Consulltancy / Assessment of client's behaviour and skills

2.Development of a Behaviour Support Plan (BSP) 

3. To support the client to live a more enriching, fulfilling life post assessment/diagnosis

 

BSP Bronze

1 Hour Initial Consultation 

ADOS-2 Assessment 

6 Counselling / CBT/ABA Treatment Sessions

2 Coaching Sessions

Advocacy (telephone only)

Development & Implementation of Behaviour Support Plan

 

BSP Silver

1 Hour Initial Consultation 

ADOS-2 Assessment

8 Counselling / CBT/ABA Treatment Sessions

3 Coaching Sessions

Advocacy/Assessment Report

Development & Implementation of Behaviour Support Plan

 

BSP Gold

1 Hour Initial Consultation 

ADOS-2 Assessment

12 Counselling / CBT/ABA Treatment Sessions

4 Coaching Sessions

Advocacy/Assessment Report

Development & Implementation of Behaviour Support Plan

 

The overall goal is to enhance the person’s quality of life, thus reducing the likelihood of challenging behaviour occurring in the first place.

 

To learn more about the above services you can contact us by booking a free 15 minutes appointment on our website (Contact us page) or you can call us directly between 9 a.m and 6 p.m. Outside of working hours, you can complete and send the contact form to us and we will email/call you back as soon as possible. 

 

By contacting us, you will have the opportunity to gain further information about how PBS can help you or your child. We look forward to hearing from you.