A profile, not a pile of diagnoses.
The useful question is not “which diagnosis caused this behaviour?” It is “what does Mia need in this situation, and what evidence helps us understand that?”
Mia Lawson
Mia is a fictional 14-year-old who loves animals, digital art, swimming and knowing the plan before the day begins. She communicates verbally, uses short written checklists well and is much more confident when adults are predictable and give her processing time.
Mia’s behaviour is interpreted in context. Diagnostic information can help explain vulnerability, processing load and support needs, but direct observation, health information, communication and functional assessment remain essential.
The overlaps matter.
Tap an interaction to see how two or more parts of the profile may combine in everyday situations. These are formulation examples, not automatic conclusions.
Language × anxiety
When Mia is worried, the amount of language she can process drops. A long explanation delivered at the exact moment she is unsure can increase uncertainty rather than reduce it.
- Use fewer words when stress rises.
- Pair speech with a written or visual anchor.
- Check understanding through action, not “do you understand?”
Translate labels into support needs.
This layer helps a team connect the diagnostic picture to the functions that matter during real interactions: planning, regulation, communication, learning, sensory processing and connection.
01Executive functioningInhibition · working memory · planning · shifting
02Threat + regulationStress · uncertainty · fight / flight / freeze
03Learning + memoryEncoding · retrieval · generalisation
04CommunicationUnderstanding · expression · repair
05Sensory processingNoise · movement · crowding · internal signals
06Social connectionBelonging · interpretation · safety
What each label contributes—and what it cannot tell us.
Open each diagnosis. The structure keeps the explanation practical: what it means, likely functional implications, what might be observed, what support should do, and the limits of diagnosis-only reasoning.
01Autism Spectrum Disorder · Level 2Social communication differences + restricted / repetitive patterns requiring substantial support⌄
Predictability, interpreting social information, flexibility, sensory processing and communication under stress may all require active support.
Distress with unexpected change, strong preference for known routines, literal interpretation, focused interests and increased overload in noisy group settings.
Make the plan visible, explain change early, reduce unnecessary ambiguity, protect regulation strategies and teach social expectations explicitly.
Deep interests, strong recall for preferred information, honesty, persistence and comfort with predictable systems can become powerful learning anchors.
02ADHD · combined presentationDifferences in attention regulation, inhibition and activity level⌄
Holding instructions in mind, waiting, stopping an impulse, organising materials and sustaining effort on low-interest tasks may require external structure.
Starting before instructions finish, losing track of multi-step tasks, frequent movement, rapid responding or difficulty returning to a task after interruption.
Shorten steps, externalise the plan, reduce long verbal instructions, build movement in proactively and make the next action obvious.
High energy, humour, creativity, rapid idea generation and strong engagement when a task is meaningful or novel.
03Developmental Language DisorderPersistent difficulty understanding and/or using spoken language⌄
Long sentences, abstract language, fast questions, hidden meanings and verbal-only instructions can create more load than Mia’s conversational style suggests.
Quick “yes” responses, guessing, delayed replies, topic shifts, frustration, silence or apparent refusal after language-heavy demands.
Use plain language, one idea at a time, visual or written supports, processing pauses and opportunities to show rather than explain.
Visual learning, familiar scripts, concrete examples and written key words can help Mia demonstrate more than verbal questioning alone reveals.
04Mild Intellectual DisabilityCognitive and adaptive support needs that affect everyday learning and independence⌄
New learning may require more repetition, practical demonstration and support to generalise from one person, setting or example to another.
Strong performance in familiar routines alongside difficulty with novel problem solving, abstract consequences or tasks containing several hidden steps.
Teach concretely, demonstrate the end point, practise across settings and avoid withdrawing support simply because one routine has become familiar.
Repetition, routine, meaningful roles and practical learning can build stable skills and confidence over time.
05Generalised Anxiety DisorderPersistent and difficult-to-control worry across everyday situations⌄
Uncertainty can consume processing capacity, make transitions harder and increase reliance on reassurance or avoidance.
Repeated checking, reluctance to start, seeking certainty, physical tension, irritability, tearfulness or withdrawal when expectations feel unclear.
Increase predictability without creating endless reassurance loops, use gradual exposure only where clinically appropriate, and build tolerable steps with clear endings.
Mia can identify some early worry signs and responds well to written plans, choice, trusted adults and predictable preparation.
Make the environment do more of the work.
The highest-value strategies are usually the ones that reduce avoidable load before Mia needs a behaviour to communicate that the situation is too much.
Communication access
Short sentences, visible key words, one instruction at a time and enough silence for processing. Avoid rapid rephrasing while Mia is still working on the first version.
Predictability + transitions
Show what is happening, what is changing, what is staying the same and what “finished” looks like. Use countdowns only when they genuinely help.
Sensory + regulation
Plan quieter work areas, movement and recovery time before known high-load periods rather than waiting for escalation.
Choice + control
Offer two real options, make “not now / help / break” available, and avoid presenting a predetermined outcome as a choice.
Learning design
Demonstrate, practise in small steps, repeat across contexts and use strengths such as digital art or animals as engagement bridges.
Relationship + co-regulation
Use a calm, private, non-shaming response. When stress is high, connection and clarity come before explanation or correction.
Capacity changes with context.
Good PBS tracks the conditions around the person as carefully as the behaviour itself. These are the kinds of contextual variables the team would keep testing.
Conditions where things tend to go well
- Known staff and a visible plan
- Tasks broken into short concrete steps
- Quiet work area with movement available
- Choice between genuinely available options
- Time to process before another prompt is added
Conditions that increase load
- Multiple adults speaking at once
- Unexpected changes without a visual update
- Long language-heavy tasks
- Public correction or perceived criticism
- Late-day fatigue and crowded environments
Protective factors to preserve
- Strong relationship with Mum and older sister
- Trusted learning support teacher
- Swimming, animals and digital art
- Written schedules and checklists
- Mia’s emerging ability to ask for a break
Questions still requiring assessment
- Which transition features are most predictive of escalation?
- How much does sleep quality alter afternoon capacity?
- Which break requests are independently initiated?
- How consistently are strategies implemented across staff?
- What outcomes follow escalation in different settings?
The team should be able to hold this.
The point of a diagnostic explainer is not to create more jargon. It is to help the people around the participant make better moment-to-moment decisions.
Mia’s support picture in four moves.
A creative, relationship-oriented teenager who does best when expectations are visible, concrete and predictable.
Language, executive-function, learning, sensory and anxiety-related loads can compound. Capacity is lower when several demands arrive at once.
Reduce verbal load, externalise the plan, preserve regulation and choice, teach across contexts and respond without shame.
Functional hypotheses remain provisional until direct data show which antecedents, outcomes and implementation variables reliably matter.