Blog

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Back-to-school time can bring a LOT of big feelings for PDA kids and us! New routines, new teachers, more expectations, earlier mornings, and less downtime can feel overwhelming.Here are a few things that may help make the transition a little easier:🌸 Keep it Low Demand Try not to turn the weeks before school into a checklist of everything your child needs to be doing. Slowly ease back into routines and give them plenty of flexibility.🌸 Give Choices Whenever possible, give your child some control: "Do you want to get dressed before or after breakfast?" "Which shirt do you want to wear?"Having a sense of control can make a big difference for a PDA child.🌸 Expect a Little "After-School Crash" Your child may hold it together all day at school and then completely fall apart at home. This is very common with masking.Try to make after-school time a recharge time rather than jumping straight into homework, chores, or questions about their day.🌸 Work With the School Help your child's teacher and Educational Assistant understand that "refusal" isn't always simply a choice. Too many demands, anxiety, sensory overload, or exhaustion can all make a task feel impossible.Share what works at home and talk about things like breaks, flexible language, choices, and reducing unnecessary demands.🌸 Watch for Burnout If you notice more meltdowns, school refusal, exhaustion, anxiety, aggression, or difficulty with everyday things, it may be a sign that your child's load is becoming too much.Don't wait for them to completely crash before making adjustments.💗 And Most Importantly... Your child doesn't have to start the school year perfectly.Some days will be great. Some will be hard. That's okay.The goal isn't to make our kids comply with every demand. It's to help them feel safe, understood, supported, and capable of getting through the day.Sometimes the best back-to-school strategy is simply:"Let's make this easier." 💗

Back to School

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Sometimes it’s hard to be happy in the moments that are supposed to be happy.Because what is ordinary for everyone else can feel extraordinary for you.It’s just soccer practice.Other parents are sitting on their phones, chatting with each other, barely watching.Because for them, this is normal.But for you, you’re watching every second.Because you know how hard it was to get here.You know that there have been times when leaving the house felt impossible. Times when activities were too overwhelming. Times when anxiety, demands, burnout, or dysregulation made something as simple as soccer feel completely out of reach.So you’re sitting there feeling incredibly proud……and incredibly sad.Because you know this moment may not always be possible.Next week might be different.Next month might be different.And you know that for other families, they don’t have to wonder whether their child will be able to participate next time.So while everyone else sees soccer practice…you see a moment you never want to take for granted.You see progress.You see courage.You see how far your child has come.And sometimes you feel the grief, too — the grief of knowing that something that comes so naturally to other families can be something you have to celebrate as a huge achievement.Both feelings can exist at the same time.You can be grateful and sad.Proud and exhausted.Happy and grieving.And that doesn’t make you ungrateful.It makes you a parent who knows just how much it took to get there. ❤️

When Ordinary Moments Feel Extraordinary

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If you have a child with PDA, you may have heard the term PRN medication and wondered what it means.PRN stands for “as needed.” Unlike a medication that is taken every day at a set time, a PRN medication is prescribed to be used when a child is experiencing a particular level of distress or specific symptoms.For some PDA children, a doctor or psychiatrist may prescribe a PRN medication to have available during periods of severe anxiety, agitation, panic, or dysregulation.The idea isn't to use medication to stop a child from refusing, saying no, having a meltdown, or avoiding a demand.Instead, when appropriate, it may be used to help reduce overwhelming distress and support the child in getting back to a place where they can feel safe and regulate.What might that look like?A child may become so overwhelmed that they are:<ul><li>Extremely anxious or panicked</li><li>Aggressive or highly agitated</li><li>Trying to run or escape</li><li>Unable to communicate</li><li>Unable to access their usual coping strategies</li><li>Staying dysregulated for a prolonged period</li></ul>In these situations, having a PRN medication available may be one tool in the family's toolbox.But medication should never replace PDA-informed support. Reducing demands, offering choices, giving space, co-regulating, lowering pressure, and understanding what is underneath the behaviour are still incredibly important.If your child has been prescribed a PRN medication, make sure you understand when to use it, how much to give, how often it can be given, what side effects to watch for, and when to seek additional help.For some families, a PRN medication can provide another option when their child's distress becomes overwhelming.It isn't about making a child easier to manage.It's about helping a child through moments when they are struggling to manage themselves. 🩷

What Is a PRN Medication for a PDA Child?

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If your child with a PDA profile picks at their skin, you are definitely not alone.Skin picking can be incredibly difficult to watch—especially when it leads to sores, bleeding, scabs, or scars. And the more we tell them to "stop picking," the more difficult it can sometimes become.So what is actually going on?🌸 Why Might a PDA Child Pick Their Skin? For some children, skin picking can be a way of managing stress, anxiety, overwhelm, or dysregulation.A child may pick when they are:<ul><li>Feeling anxious or worried</li><li>Overwhelmed by demands</li><li>Bored or under-stimulated</li><li>Tired or dysregulated</li><li>Seeking sensory input</li><li>Trying to soothe themselves </li><li>Experiencing a strong urge that is difficult to resist </li></ul>**It’s also worth knowing that some medications can increase or worsen skin picking. If you notice a change after starting or adjusting a medication, talk with your doctor about whether it could be contributing.🌸 You May Hear Different Names for It Depending on the reason behind the behaviour, you may hear terms such as:Skin picking – the everyday term most parents use.Excoriation disorder – the clinical term used when recurrent skin picking causes significant damage or distress and becomes difficult to control.Body-focused repetitive behaviour (BFRB) – an umbrella term that can include behaviours such as skin picking, nail biting, or hair pulling.Sometimes skin picking can also look OCD-like, particularly when a child feels driven to remove an "imperfection" or feels unable to leave a scab alone.These terms can overlap, but they aren't necessarily interchangeable. The important thing is understanding what is driving the picking for your individual child.🌸 What Can Help? There isn't one solution that works for every child.You might try:Reduce the stress: Look at what is happening around the times your child picks. Is there a particular demand, transition, or situation that seems to trigger it?Provide something else to pick: Fidgets, putty, textured toys, fabric, or other sensory activities can give busy hands something safer to do.Protect the skin: Bandages, hydrocolloid patches, clothing, or other protective coverings can help prevent picking while wounds heal.Keep hands busy: Drawing, crafts, Lego, sensory activities, or even playing with a pet can sometimes help redirect the urge.Avoid constant reminders: Repeatedly saying "Stop picking!" can increase attention, anxiety, or the sense of demand. Try a gentle redirection instead.💗 Most importantly... Skin picking isn't something a child necessarily does because they "won't stop."Sometimes their body is trying to regulate something their words can't express.Instead of only asking:"How do I get them to stop?"Try asking:"What is their body telling me?"💗 Understanding the reason behind the picking can be the first step toward finding a safer and more supportive way to meet that need.

Skin Picking or BFRB

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Caring for a PDA child can mean being “on” all the time—managing emotions, advocating at school, navigating demands, appointments, routines, and everything in between.It can be exhausting.And sometimes parents feel guilty about needing a break. But respite isn't a luxury. It's support.🌸 Respite Gives You a Chance to Recharge Even a few hours can make a difference. Use that time to rest, run errands, spend time with your other children, see a friend, go for a walk..or do absolutely nothing!!!&nbsp;🌸 Respite Can Help Prevent Burnout When we're constantly helping our child regulate, it's easy to forget about our own nervous system.Taking a break can help you return with more patience, energy, and capacity.And respite can benefit your child too. It can help them build relationships with other trusted adults and develop confidence and independence.💗 You Are Allowed to Take a Break Using respite doesn't mean you're failing or that you love your child any less.It means you're taking care of yourself so you can continue taking care of them.You can't pour from an empty cup. 💗

The Benefits of Respite Care

Trying to find the “right” medication for ADHD and PDA symptoms can feel completely exhausting. There are so many options — stimulants, non-stimulants, anxiety medications, mood medications — and every brain responds differently. One medication helps focus but increases anxiety. Another helps emotionally but causes fatigue, irritability, weight gain, or too much weight loss. It often feels like constant trial and error, and honestly, it is so hard watching your child go through that.What makes it even harder is just how complex the brain really is. ADHD and PDA are not simply about attention or behavior. They involve anxiety, executive functioning, emotional regulation, sensory overwhelm, nervous system responses, transitions, and so much more.Sometimes I genuinely cannot understand how the science still is not further ahead. It is frustrating, heartbreaking, and just plain hard — for both our child and us — watching yet another medication either not work at all, or work somewhat but come with side effects that simply are not worth it.That said, I still hold onto hope. I recently had a conversation with a pediatrician who felt there is a strong likelihood that PDA could eventually be recognized in a future version of the DSM. Could you imagine? PDA being fully recognized in North America. Less gaslighting. Less fighting to explain what our kids are experiencing. Easier access to the right supports. But most importantly, recognition could open the door to more research funding, better understanding, and hopefully more targeted medications and supports!

DSM & Medication Research

PDA Support