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Pathological Demand Avoidance (PDA)

This complex condition is part of the autism spectrum. Research is increasingly providing new information about how it affects individuals and their daily life.

This complex condition is part of the autism spectrum. Research is increasingly providing new information about how it affects individuals and their daily life.

People with pathological demand avoidance syndrome (PDA) will avoid demands made by others, due to their high anxiety levels when they feel that they are not in control.

The condition was first described by Professor Elizabeth Newson in the 1980s. PDA is a lifelong condition and individuals and their family often require different amounts of support depending on how the condition affects them.

The central difficulty for people with PDA is their avoidance of the everyday demands made by other people, due to their high anxiety levels when they feel that they are not in control. Hence the name of the syndrome: pathological demand avoidance.

Some signs and symptoms include:

  • Resisting ordinary demands; exhibiting challenging behaviours
  • An inconsistent profile of ability and need; this may change daily
  • Appearing sociable on the surface but lacking depth in their understanding (often recognised by parents early on)
  • Excessive mood swings, which may switch suddenly
  • Comfortable (sometimes to an extreme extent) in role play and pretending
  • Language delay, seemingly as a result of passivity, but often with a good degree of ‘catch-up’
  • Obsessive behaviour, often focused on people rather than things.
  • Sensory needs and sensitivities

People with PDA can be controlling and dominating, especially when they feel anxious and are not in charge. They can be enigmatic and charming when they feel secure and in control.

Some parents describe their PDA child as ‘Jekyll and Hyde’. It is important to recognise that these children have a hidden disability and often appear as a typically developing child to others. Many parents of children with PDA feel that they have been wrongly accused of poor parenting through lack of understanding about the condition. These parents will need a lot of support themselves, as their children can often present severe behavioural challenges.

ISLTS Ltd provides a bespoke approach to working with individuals and families of children who present with pathological demand avoidance. Post graduate training and close links with relevant professionals and practitioners allows for a comprehensive approach to its treatment and management as part of speech and language therapy intervention.

Further information about this condition may be found at www.pdasociety.org.uk

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