Five Minute Guides to PDA

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Five Minute Guides

Pathological Demand Avoidance PDA

What is PDA?

PDA is a rare type of anxiety disorder in which the individual is unable to comply with demands made by others. It is believed by many to be a sub-type of Autistic Spectrum Disorder (ASD) though others believe it to be a separate condition. There is variance in the severity and range of symptoms presented by each person.

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How does PDA affect a child?

PDA can prevent a child from complying with requests to do things. When they are giving instructions to follow they may:

Pretend not to hear sometimes by humming or singing

Politely give a reason why they can’t comply

Procrastinate with the intention of avoiding the request

Use distraction so the adult forgets the request

Use imaginary reasons why they can’t do it

Become upset and cry

Become angry and aggressive

Run and hide

Children with PDA tend to be very controlling as this minimises demands made of them. They can be charming and endearing but can be very socially manipulative. As babies PDA children tend to be very passive and parents may describe them as 'easy'. Language development tends to be slightly delayed though most will then appear to catch up quickly and demonstrate good talking skills. They struggle to recognise social boundaries and social hierarchy. However, they often master social niceties such as saying please and thank you and will often respond to a demand with a polite decline. PDA is characterised by rapid mood swings and when adults try to reinforce requests their polite excuses may quickly escalate in to angry and aggressive outbursts. Parents may describe them as being like 'Jekyll and Hyde'.

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How does PDA affect social relationships?

Children with PDA will struggle to form friendships. They are often bossy and controlling and unwilling to accept the play ideas and suggestions of others. Many will lash out angrily over very minor disagreements and this can make other children naturally wary of them.

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How does PDA affect relationships with adults?

PDA children have poor understanding of the status of adults. They will engage with strangers as comfortably as with adults they are familiar with. They will be consistent in their behaviour: demonstrating their range of avoidant behaviours and showing no regard to the presence of others when having a meltdown.

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How does PDA affect a child at school?

Parents may not always be fully aware of the strategies they have developed to manage their child's PDA behaviours. They may frequently avoid situations that give rise to meltdowns. Pre-school provision like nurseries may also indulge the child's play and make few demands. This can mean that school can be the first place when concerns around the child's behaviour are raised. School involves constant demands from teachers and other staff and the PDA child will increasingly struggle with these as the expectations about compliance are reinforced. It is not uncommon for children with PDA to receive exclusions following violent outbursts in school.

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How do you support a child with PDA in school?

Children with PDA do not respond to normal behaviour management techniques or those for supporting children with ASD. They commonly require a dedicated key worker who can flexibly and patiently manage their anxiety over tasks and minimise disruption to others. PDA children often respond to novelty and this can be used to encourage learning.

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Who can diagnose PDA?

Diagnosis, if available, can only be made by a medical professional such as a specialist paediatrician or clinical psychologist. Referral will generally be via your own doctor.

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How is PDA diagnosed?

Currently there are not international agreed criteria for PDA and there is a lot of discussion and local variability about whether it should be diagnosed or not. Many children with PDA behaviours may therefore receive other diagnoses such as Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and/or Oppositional Defiant Disorder (ODD).

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What are the benefits of diagnosis?

Getting the correct diagnosis is essential in helping both parents and professionals gain a greater understanding of the child's needs. This can help inform the strategies used in school and may give access to additional services and support.

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PDA

Five Minute Guide to ODD

A handy printable version of this five minute guide suitable for handing to parents, school staff and other professionals and carers. Use 2-sided printing (set printer to flip on short side) and fold in half to produce A5 leaflet.

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Got more than five minutes?

You may be interested to read more:

PDA

PDA Management

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