What is Pathological Demand Avoidance (PDA)?
PDA is part of the Autism Spectrum and used to be known as ATypical Autism because the traits of people with PDA are different to the traits of people with typical autism.
Unfortunately it is still not currently always recognised when diagnosing autism and children are often given a diagnosis of ASD with some form of wording mentioning traits of Demand Avoidance. A lot of areas in the UK won’t diagnose PDA which leaves parents travelling to other areas or even paying privately for a diagnosis to help their child.
Children with PDA resist demands due to anxiety. This can be everyday or unusual demands, good or bad, placed on them by others or even themselves. They will resist demands in many ways including using learnt social skills.
So what are the traits of a child with PDA?
Children with PDA often have a history of being passive in the first year of their lives although some may resist demands from the word go.
The most noticeable trait of a child with PDA is their reaction to normal requests, often reacting extremely or going out of their way to avoid doing what is requested. This can be through shouting and screaming, procrastinating, socially manipulating, excuses or any other means. This extends to all demands, even positive demands and requests.
In social situations you will often find a child with PDA sat watching or joining in on a surface level. Friendships tend to have no depth to them but can appear to be there.
Children with PDA like to feel in control and control situations and can switch between moods. They are often likened to Jekyll and Hyde, switching from aggressive to passive and the other way round very quickly. They might say sorry for doing something and then do it again straight afterwards. They are impulsive.
Unlike a lot of children with ASD, children with PDA enjoy pretend play and role play. This can even be extending to “acting” in everyday situations and they are able to “act” like other children at school in order to cope for instance, often “masking” their PDA whilst there.
How can we help to ease anxiety for a child with PDA?
PDA is a very complex condition and strategies which are helpful for children with autism spectrum disorders may not work with children with PDA. Sometimes children with PDA need to be treated in quite the opposite way.
Because children with PDA are different to other children with Autism Spectrum Disorders, it is good to know their traits so that we can implement strategies which will help them.
The approach will vary from child to child with the main aim of reducing anxiety surrounding demands and making them feel less demanding for the child.
Language used to talk to them needs to be less direct for instance saying “you need to turn your laptop off now” will have a far more extreme reaction than “would you like me to pass you your laptop bag to put it in?” and “we need to go out today” would be better phrased as “I’m going out today, I would really like it if you decided to come”. If you can phrase demands in such a way that the child with PDA feels that they are making a decision for themselves you may just win that situation.
Novelty and variety can work well and Drama or role play can be used to ease demands. Giving choices can also help. Praise, reward and punishment are likely not going to work well with a child with PDA.
Some parents of children with PDA explain it that you have to often go against everything you know about parenting in order to succeed.
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I am not familiar with this type. I don’t know if the U.S. is on board with this or not but our system might not be either. This is something I will have to do more research on. Thanks for educating us about this:)
I dont think it is diagnosed in the US as it is not a DSM recognized disorder unfortunately. The UK is slowly starting to diagnose in some areas, although if not, at least mention the traits in diagnosis. There used to be children diagnosed as having A-typical autism and they are likely to have had PDA. There are petitions around to try and get our govenment to recognise it in order to get more help for these children x
Yeah our most recent DSM eliminated a few disorders and they keep debating whether or not Aspergers should be in the DSM. Kids get help then they don’t. It’s a very confusing system we have.
It seems it. They dont tend to diagnose Aspergers in most places here anymore either. Children that would of got an Aspergers diagnosis in the past are now simply diagnosed as having Autism Spectrum Disorder. It is confusing!
Very confusing and it’s the children that suffer for it in one way or another
I have taught one child with PDA here in the UK but as of say, it not always recognised or it can be diagnosed as something else. You are right in that the way we ask some children to do things is the key….reflecting choice was the way to go with the little one I had or I also used to use his peer group quite a lot to steer him in the right direction…..look what Sam is doing, let’s go and see if we could do that too…..kind of thing. Like you also said…a lot of the time it was due to anxiety. Thanks for the post. I really enjoyed reading it. #mondaystumble
I love the peer group example, thats a great way of steering them in the right direction!
Yes it can work well in school …..not with very young children or some children with classic ASD…they would care too hoots what their peers were doing but it worked with this little chap. 😃
I’m sure my daughter, age 17, has PDA. She also has a genetic chromosome disorder causing her global delays. (I’m positive her dad has HF Asperger’s too). She’s always had trouble at school, and now she’s pulling down her pants, or stripping naked at school. School sees it as bad behavior and she gets punished. A nightmare!!!!!!!!!!!!!!!! If we make a game out of demands, she’s great. VERY complicated!!! I’m in the USA.
Maureen that does sound complicated! It is a shame your daughters school cant do the same and make games out of demands for her rather than punish her.