PDA. A need for deeper understanding.

After almost 15 years in ABA, I have encountered a few clients who did not respond to “traditional ABA” - prompting, clear directions, etc. These clients exhibited a heightened reaction to seemingly simple requests from others - extreme refusal, inconsistent triggers, potential for aggression or other potentially harmful or destructive behaviors. They learned quickly, but what they grasped the fastest was how to say or do things to trigger others, make them uncomfortable, or to make the interaction so difficult that the other person would back down from the request. Although they had a relatively large vocabulary, they did not use it to request the things they needed or wanted, what they were thinking or how they felt. The behaviors were always intense but not always consistent with triggers or what they looked like. The behaviors were always intense but not consistently linked to specific triggers or appearances. In fact, issues such as school refusal, reluctance to complete grooming or medical needs, and difficulties in interactions with others often worsened over time. These behaviors frequently caused other family members to tread carefully, never knowing what might trigger one of these behavioral episodes, which could last anywhere from a few minutes to several hours.