What services does My Therapy House offer for autistic children?

My Therapy House provides a comprehensive, multidisciplinary approach that includes Speech Pathology, Occupational Therapy, Early Childhood Education, and Parent Coaching services. We work with neurodivergent children using neuro-affirming, play-based approaches like DIRFloortime. Our team focuses on communication development, social-emotional skills, sensory regulation, and building strong parent-child relationships in a safe and nurturing environment.

How early should I start therapy for my child?

The early years of your child's life are a time of rapid development and learning, making it an ideal time to introduce play-based therapy. Early intervention allows us to support your child in developing their knowledge of themselves and their world by addressing any challenges as early as possible. This helps build a strong foundation for communication, regulation, and social-emotional development.

Do you work with non-speaking children?

Yes, absolutely. We use a variety of approaches and strategies to support both speaking and non-speaking children to communicate in ways that are meaningful for them. Our goal is to help every child feel understood, whether they communicate verbally or through alternative methods. We also help parents learn to nurture and understand their child's unique way of communicating.

Will I be involved in my child's therapy?

Yes, parent involvement is central to our approach. We believe that relationships are the key to your child's development, and as a parent, you are at the centre of this growth. We offer different parent training programs tailored to your specific needs, teaching you tools and strategies to support your child's development at home. Our goal is to empower you to feel confident and grounded in your parenting.

Do you offer flexible scheduling and online therapy options?

Yes, we understand that every family has different needs. We offer flexible scheduling to accommodate shift workers and families with varying circumstances. Our therapists are also equipped to deliver online therapy, which means we can support children and families who live in rural areas or interstate, ensuring your child's development continues no matter where you are.

What makes My Therapy House different from other therapy providers?

Families choose us for our stable, long-term team of highly trained professionals, our warm and intimate environment, and our holistic whole-child, whole-family approach. We're leaders in the field who train other therapists, we have a multicultural team fluent in multiple languages, and we offer exceptional play spaces that children love. Most importantly, we practice transparency in all our communications and create neurodiversity affirming environments that celebrate each child's unique way of experiencing the world.

Pathological Demand Avoidance (PDA)

We help you to give your child agency in their decision-making.

About PDA

“Pathological Demand Avoidance (PDA), also known as Extreme Demand Avoidance, is considered by the National Autistic Society in the UK (autism.org.uk) to be a subtype of Autism Spectrum Disorder characterized by extremely high levels of anxiety, which result in an individual constantly trying to control their environment. This need to be in control and feel safe results in opposition and avoidance of everyday demands, difficulties with emotional regulation, and often severely challenging behaviour.”’ — Dundon, R.

PDA is an extremely debilitating disorder where individuals have difficulty living their lives without feeling the need to control their relationships, conversations and tasks to the point where they cannot function in a social environment without the right support.

PDA in the Therapy Room

When working with a child with PDA in the therapy room, we need to go slowly and make them feel comfortable. Gaining trust and going at the child’s pace are the most important things. As therapists, it is important to let go of our preconceived ideas, agendas, and structures and work with the child on their development, making them feel safe and secure in the therapeutic space.

BREAKING NEWS! Recognition of PDA in Australia

– recent Commonwealth Government acknowledgement of the PDA profile of autism
– WA & SA State Government acknowledgement of PDA
– emerging research
– lived experience
– social media/ books/ workshops/ webinars
– supports & services available for PDAers and families across the country.

What is a demand?

To the individual who lives with PDA, a demand can vary from someone asking direct questions to making suggestions of what they may do. A choice may be a demand. Sometimes, having a schedule whereby you need to get up and go to sleep can be a demand which can trigger great anxiety to the individual with PDA. Others have suggested that being hungry and needing to eat or feeling you need to go to the toilet (biological needs) can also feel like a demand to the person with PDA. Sometimes, not having a schedule is a demand, whereby the person needs to create their own schedule, placing a demand on themselves.

“At its core, PDA is a neurological power struggle between the brain, body and heart.”
— Dr Nicole Carvill

Who can diagnose PDA?

PDA is currently not recognised in Australia, so it cannot be formally diagnosed. However, more and more clinicians, especially psychologists, are starting to recognise that some individuals with a cluster of symptoms, such as Autism Spectrum Disorder with high anxiety and aversion to demands, can be described as having PDA. Therapists are starting to write more about strategies on how to best work with someone who has characteristics of PDA.

What strategies could be helpful to someone who lives with PDA?

At My Therapy House, we have been using our trauma-informed practice methods as well as information we have gained about PDA from the UK, and therapists like Raelene Dundon, to work with clients who present with characteristics of PDA. These include:

Working with the child and family to understand sensory sensitivities, special interests, anxiety triggers or challenging behaviour (which may be from therapy itself if they have had traumatic experiences with different types of therapy and therapists), signs of stress and agitation, what the child is good at and what makes them happy and relaxed
Starting therapy sessions where the child is and following their lead, trying not to impose any demands on them – this usually means going slowly and supporting the child to feel that they have control in the therapy session
Developing a sense of safety and trust with the child and their caregiver by establishing a strong therapeutic relationship with them
Making the environment and interactions consistent and predictable
Supporting the child’s regulation strategies by allowing them to regulate in a way that will make them feel calm and trust the person they are interacting with
Recognising when the child is overwhelmed and responding to this straight away
Reframing and reducing demands as much as possible by using declarative language
Being playful, creative and fun in sessions, minimising any direct requests, interactions and demands, and at the same time providing them with opportunities to make choices if this is what they require
Videotaping our sessions for later review to observe the child’s interactions with us and note signs of any demands or triggers we may have placed on the child which we weren’t aware of in the moment.

Do behavioural strategies work?

Unfortunately no. In fact, behavioural approaches can cause more anxiety for individuals with PDA, leading to bigger and longer meltdowns and more withdrawals from interactions and society. Individuals with PDA have a neurological condition: their nervous system cannot cope with demands, so they end up compensating for this by controlling their environment as much as possible to feel safe. It’s something they do not CHOOSE to do but is a matter of survival. A behavioural approach may cause more trauma in the child’s life.

”Due to their differences in neurology, processing and arousal, (it is) likely that PDAers are more susceptible to being adversely impacted by negative life events, and consequently may be prone to experience trauma in their lives… their experience of having their behaviour misunderstood and being forced to comply with directions they are otherwise unable to complete due to high anxiety has led to them experiencing ongoing trauma that further impedes their ability to form relationships with adults and engage in learning activities.” — Dundon, R.

The importance of supporting the individual with PDA and their family.

PDA not only affects the individual. Families have often described it as living their life walking on eggshells around their loved one with PDA. These families have often been through various therapies and have received conflicting advice about managing the individual with PDA, and all traditional behavioural management techniques have been unsuccessful. Parents blame themselves for their child’s behaviour and feel utterly exhausted.

It is important to support families to access various resources and information about PDA, including communities where other families may be going through similar experiences, and find providers around Australia who may have the skills to work with these highly anxious children.

“If we just let kids do whatever they want, they won’t learn. (That’s not it…)

It’s about respecting a child’s emotions, sensory needs, and communication style as the basis for then supporting their learning and development.
It’s not about avoidance — it’s about understanding what makes a task difficult and adjusting the support.
It’s not about avoiding any level of challenge — it’s about presenting challenges in a way that feels safe and possible.
It’s not about removing all boundaries — it’s about setting boundaries thoughtfully, with respect and collaboration.

This doesn’t mean avoiding the challenge. It means creating a safe foundation where your child is ready to try new things, hard things, without overwhelm or trauma responses.”

-Adina Levy (Play. Learn. Chat.)

Where Can I Get More Information?

Books:

The Parents’ Guide to Managing Anxiety in Children with Autism – Raelene Dundon
PDA in The Therapy Room – Raelene Dundon
Declarative Language Handbook – Linda K. Murphy
What is PDA? (printable booklet) PDA Society

Audio and Videos:

The Empowered Parent Podcast – Episode 45: Linda Murphy (Speech-Language Pathologist and Author) – Transforming Child Communication Through Declarative Language Techniques
Sally Cat’s guide to Internalised PDA – An animated explainer
Declarative Language and Screen Time
Declarative Language and Pets
When Parents Lose Their Cool
Going Outside Your Comfort Zone
Nooooo!
My Experience of Pathological Demand Avoidance (PDA)

Web Pages:

Family Support Services

Australian-based:

Pathological Demand Avoidance Australia & New Zealand – A website set up by parents of children with PDA to increase awareness and provide support. It serves as a contact point for families and professionals wanting to learn about PDA and network with others.
PDA for Parents and Professionals (Aus & NZ) – Private Facebook group for parents, carers and professionals to share events, information and tips to support children with PDA at home, school and in the community.
inTune Pathways – Parent Coaching and Online Community, Support and Strategies for families living with PDA

South Australia:

Our PDA Kids Support and Strategies for families living with PDA

Disclaimer

It is important to understand that we, as a practice, are not experts on PDA. We have encountered many highly anxious children in our work and have learnt to modify our therapeutic approaches to support their regulation and give them the agency to build a trusting relationship with us and engage in therapy sessions.

We are providing this information as a starting point to help parents and caregivers understand more about their child’s development. We have listed a number of resources and recommend that families speak to their GP or Psychologist for more specific information.