How To Discipline A Child With Pda

Helpful approaches with PDA – children

1. understanding behaviours.
2. adjusting your mindset.
3. optimising the environment.
4. reducing the perception of demands.
5. being cautious with rewards/praise/sanctions.
6. supporting sensory needs.
7. supporting social interaction & communication.

Meer items

What phrases to use with a PDA child?

Increasingly Parent/Carers tell us of the difficulties they have managing their young person displaying PDA. Hope the strategies in this article helps.Thanks Concept training Limited. PDA is a complex autism spectrum condition which is best described as an ” Anxiety Based Need to be in control” Children with PDA still have significant difficulties associated with the Triad of Impairment, however, they are highly skilled at avoiding demands and masking their difficulties.

Resists and avoids the ordinary demands of life Appearing sociable, but lacking depth in understanding Excessive mood swings and impulsivity Comfortable in role play and pretend, sometimes to an extreme extent Language delay, often with good degree of catch-up Obsessive behaviour, often focussed on people, either loving or loathing them Can be domineering and overbearing Parents often describe a “Jekyll and Hyde” personality Bossy and controlling Often more comfortable with adults than children Often hypersensitive to other’s voices, facial expression etc Can be over familiar with adults and peers May take on the persona of others, i.e. teachers. May go into role in order to comply May have a panic attack or meltdown if highly anxious – these may result in aggression towards others Unaware of impact of behaviour on others Can behave very differently at school /college to home Unable to follow routines if set by others Often have sensory issues – noise, touch, brightness etc

Children with PDA are highly complex and often display behaviours which are very challenging to those around them. There is also a significant impact on the rest of the family when a child has PDA. Although it is recognised by many as being an autism spectrum condition, individuals with PDA do not respond well to traditional autism strategies and far more flexible approach which allows the individual with PDA to believe they are in in control is far more effective.

• The following strategies can be helpful when supporting children with PDA: Remember that ANXIETY is what drives the behaviour of an individual with PDA,
• If you always consider the anxiety rather than the behaviour you are more likely look for solutions and try to help.
• Also remember that sometimes anxiety stops individuals with PDA doing the things they want to do as well as the things they don’t.

Use a flexible, non-directive approach. Use phrases such as, “I wonder how we might.”, “I wonder if anyone can do this?” Be aware of your facial expressions, Individuals with PDA can be hyper sensitive to tone of voice and facial clues, which can often cause them anxiety.

• Offer choices.
• This gives the illusion of control and lowers anxiety.
• Would you like to do X or Y first?” “Would you like to sit here or here to do your work?” Use challenges: I bet you can’t finish this work before me!” Praise indirectly: Let them hear you talking about them in a positive way.
• Or send postcards home to celebrate success.

Use areas of interest to engage and motivate: Look for ways to weave hobbies and interests into work. Reduce pressures and pick your battles. There will be days when anxiety is too high for an individual to comply with any demands. This is fine. You will have good and bad days.

Look for ways you can support so that work gets done, i.e. offer to scribe, or finish things for them. Have a sense of humour! Be prepared to take the mickey out of yourself too!! De-personalise rules. “I am afraid you can’t go outside as its slippery and our Health and Safety rules forbid it” or “It’s the law” Show empathy and sympathy : “I know you find maths really hard.

I do too. Shall we work on this together?” Try to find a balance between routine and spontaneity. This will be dependent on the individual’s mood and anxiety levels. But lots of individual’s with PDA like surprise and don’t like routine if too rigid or set by others.

• Use Complex Language.
• Sometimes it is possible to disguise a demand by wrapping it in complex language and making suggestions which allow the individual with PDA to think that they are in control.
• Rewards need to be individualised, quick and personalised.
• Often group rewards are ineffective and don’t motivate the individual with PDA.

You need to make sure they are motivational and change regularly. Use surprise or spontaneous rewards. “I love the fact you have worked hard, you can go on the computer now! Most importantly! Remember that everyone with PDA is different and should be treated with an individual approach!

How do you discipline a toddler with PDA?

Try to remain calm and non-confrontational. The meltdown can be likened to a panic attack, so reassurance and a calm approach rather than recriminations or punishment is likely to be more effective. Avoid direct demands like ‘you need to’, ‘you’ve got to’.

How do you stop a PDA meltdown?

Things you can do –

Prevention is better than cure, Be aware of possible triggers and look for signs that anxiety is rising. Anxiety might be expressed in many different ways: increased avoidance, anger, shouting, crying, laughing, not talking, boredom, tics, ‘obsessing’, skin picking, withdrawing, masking and lashing out. Act and adapt quickly to de-escalate rising anxiety – ideally have plans in place that you and the person you’re caring for or working with have collaboratively agreed on in advance for times such as this. Keep calm and level at all times, Shouting or getting angry won’t help either of you, keep your facial expressions and body language as neutral and non-confrontational as possible. Reduce stimuli that may add to the sense of overwhelm – for instance, turn down TV/radio volume, ask others to keep quiet, not intervene and leave the area if possible. Keep communication to a minimum: i nstructions should be short and simple; speak in terms of what you would like to happen rather than what you would like to stop, e.g. “you may feel calmer if you stand still” rather than “stop running around”; try offering simple reassurance, e.g. “it’s OK”. Give emotional and physical space, Take a step backward from the situation, rather than forward into conflict. Encourage access to a safer place, if possible, Some people may prefer to hide away in a den or under a table or cover themselves with a duvet or coat. Physical intervention should be a last resort and only to keep the person or others safe. Be aware of environmental risks, for instance scissors, knives or objects that may be used as a weapon. Other hazards may include glass doors, moving vehicles or proximity to a road. If someone takes flight whilst distressed, provided there are no immediate safety concerns, following at a distance is more effective than chasing after them (because pursuit increases the ‘flight’ response).

Is PDA autism fight or flight?

What is Pathological Demand Avoidance? – Pathological Demand Avoidance (PDA), also known as Pervasive Drive for Autonomy, is a term used to describe a profile of autism. People with PDA can experience a fight, flight or freeze response when faced with demands that threaten their autonomy, which can trigger intense emotional reactions.

Are children with PDA aggressive?

What are the differences between learners with PDA and autistic spectrum disorder (ASD)? –

Passive early history in the first year

Young people with PDA tend to sit on the side lines just watching what is going on. They can be described as ‘actively passive’, letting things drop to the floor from their hands. They develop strong objections to normal requests. This is unlike young people with ASD who tend to lack social response and empathy, and tend to have poor body language and stereotypical behaviour.

Continues to resist and avoid ordinary demands of life

Young people with PDA devote themselves to resisting ordinary demands, and as their language develops this can become worse. They may well acknowledge the demand but then can come up with a myriad of excuses as to why they cannot comply such as, “my legs won’t work”, “the teddy told me not to do that,” etc.

• They may crawl underneath furniture and say that they cannot do something because they are ‘stuck’ and often use fantasy to withdraw, pretending to be a cat or a super hero.
• This is unlike young people with ASD who may be reluctant to follow a demand, but this tends to be by ignoring or shutting out pressure in a non-social way with few direct strategies for avoidance.

Their approach is more direct than devious.

Surface sociability, but apparent lack of sense of social identity, pride or shame

Young people with PDA look more sociable but this is without depth. They have few boundaries and can display uninhibited behaviour that can be shocking. Praise, reward and punishment are likely to be ineffective. Young people with ASD are not inclined to use manipulation because of a lack of social empathy and often there is no impression of sociability.

Lability of mood, impulsive, led by need to control

Young people with PDA can switch from passive to aggressive very quickly. They may apologise yet do the same thing again straight away, whereas young people with ASD are seldom impulsive, tending more to work to their own rules and not put an act on for anyone.

Comfortable in role play and pretending

Young people with PDA can behave to other learners like the teacher. Some lose touch with reality, adopting a ‘video’ character. Young people with ASD tend to be inflexible with a lack of symbolic or imaginative play due to a lack of social empathy.

Language delay, seems result of passivity

Young people with PDA tend to have an early language delay and often a sudden catch up. Their social use of language can appear normal although content may be odd. Social mimicry is more common than video mimicry. Young people with ASD have language which is both delayed and deviant. Their social language skills are poor.

Obsessive behaviour

Young people with PDA have obsessions which tend to be social in nature. They can be over-powering in their liking for certain others. Most behaviour is obsessive, especially the demand avoidance, and can lead to low levels of achievement. Young people with ASD have obsessions which are rarely social and not focused on demand avoidance.

have caused anxiety to their parents before 18 months of age show stereotypical motor mannerisms show echolalia or pronoun reversal show speech abnormalities in terms of pragmatics show tiptoe walking show compulsive adherence to routines

Young people with PDA are more likely to:

resist demands obsessively (100%) be socially manipulative (100% by age of 5) show normal eye contact show excessive lability of mood and impulsivity show social mimicry (including gesture) show role play (more extended and complete than mimicry) show other types of symbolic play be female (50%)

What are sentence starters for PDA?

It can also help if the adults: –

Use INDIRECT language. At all times try and avoid DIRECT requests. Useful sentence starters such as:

“I wonder if we can” “I can’t see how to make this work” “Maybe we could investigate”

Sow seeds of an idea and allow the child time to process the information. Use drama and role play. Use humour and distraction to lighten the intensity of the demand. Give the child choices, so that they feel that they have some control over what is happening to them: Which shoes do you want to wear? Crocs or trainers? Use child’s interests wherever possible to engage them.

What’s really important for the child, and the adult? What should the adult hold firm? What can they be flexible about?

Remember that the child’s resistance is based on anxiety and offer a calming approach and environment.

Does PDA get better with age?

Demand avoidance in PDA – With PDA, these same types of demands or situations may be avoided for the same reasons. However, pathological demand avoidance is all-encompassing and has some unique aspects:

many everyday demands are avoided simply because they are demands. Some people explain that it’s the expectation (from someone else or yourself) which leads to a feeling of lack of control, then anxiety increases and panic can set in in addition, there can be an ‘irrational quality’ to the avoidance – for instance, a seemingly dramatic reaction to a tiny request, or the feeling of hunger inexplicably stopping someone from being able to eat the avoidance can vary, depending on an individual’s capacity for demands at the time, their level of anxiety, their overall health/well-being or the environment (people, places and things).

A PDA profile is also a spectrum and presents differently in different people. Some individuals may have a more externalised or active presentation – where demand avoidance may be overt, physical, aggressive or controlling. Others have more internalised or passive presentations – where demands may be resisted more quietly, anxiety is internalised and difficulties are masked.

• Many may have a variable presentation, depending on other factors like how well they are managing at the time, the environment, the setting, their age and so on.
• PDA demand avoidance isn’t a choice and is lifelong – it’s seen in infants and remains part of the experience into old age.
• With understanding, helpful approaches from others and finding self-coping and coping strategies, it can become more manageable.

In this blog post Riko (a PDA adult and parent) shares their personal experience of the differences between autistic demand avoidance and pathological demand avoidance.

Is PDA caused by trauma?

A few years ago there was a short exchange regarding the nature of the proposed disorder Pathological Demand Avoidance (PDA). Clinically, PDA superficially appears similar to autism, due its having surface sociability and several anxiety-based restricted and repetitive behaviours and interests (RRBIs), which centre on obsessive demand avoidance.

• Persons with PDA can also have atypical language development and speech delay,
• Initially, Rebecca McElroy explored the possibility it is a form of Attachment Disorder,
• Hilary Dyer countered that we should consider if PDA is a form of Autism Spectrum Disorder (ASD).
• In my view, there is little justification for viewing PDA as an ASD profile, and a good case to view its behaviours as associated with environmental factors or trauma.

PDA was originally proposed to be entirely genetic or biologically caused, with the behaviours and difficulties seen in PDA not caused by environmental factors or by trauma. Yet our current understanding of mental disorders is that they lack any firm evidence for diagnostic biomarkers,

• Moreover, it is potentially negligent to view PDA behaviours as not originating from environmental factors or trauma,
• There is substantial debate surrounding PDA.
• Crucially, the validity and specificity of PDA is not established,
• Moreover, there is no consensus over how to conceptualise PDA, or how to diagnose it,

PDA might be a form of Personality Disorder, At least three Non-autistic persons are present in PDA research samples, including one with Attachment Disorder with a total Autism Diagnostic Observation Schedule (ADOS) score of one, PDA might be seen in up to a few per cent of the human population,

PDA might not be caused by autism and thusly, is a ” double hit “, in that persons with PDA display possible precursors of Schizotypal Personality Disorder, Similarly, a ” triple hit ” of autism, anxiety and conduct problems, Needless to say, if PDA is either: seen in non-autistic persons, its behaviours are not directly caused by autism, or is comprised of features external to autism; it cannot be an ASD subtype.

Perhaps, PDA represents a new type of disorder ? There are clinical differences between PDA and autism, including: (1) PDA strategies that involve novelty, spontaneity and humour contradict the traditional autism approaches that rely on structure; (2) The fantasy/ roleplay PDA trait is often absent or delayed in autistic persons ; (3) The frequency and variety of manipulative behaviours expressed by persons with PDA are not seen in autistic persons; (4) Surface sociability issues in PDA are attributed to deficits in social identity, not to deficits in Theory of Mind, as is thought to be the case for autism ; (5) Dyer argues that anxiety drives a person with PDA’s need for control and its titular behaviours.

The PDA literature recognises anxiety is a co-occurring difficulty for autism, Collectively, these differences should exclude PDA from ASD and become the differential markers between the two conditions. While Elizabeth Newson discovered PDA, it is often overlooked that she created her own diagnostic grouping ” Pervasive Developmental Coding Disorders “, which contained: autism, dyslexia, dysphasia and PDA.

Newson did this partly to make sense for caregivers and teachers, and because she viewed ASD as being too narrowly defined, Over time this diagnostic grouping evolved into Newson’s ” The Family of Pervasive Developmental Disorders ” diagram, Importantly, this diagram accepts Classic/ Kanner’s autism and Asperger’s Syndrome as both overlapping each other and based on the triad of impairment.

PDA is conceptualised separate from triad of impairment, but connected via genetic and environmental links. PDA has six core traits, more than the triad of impairment. This matters, as the latter underpins modern autism diagnostic practice, The low functioning ASD pole contains additional learning difficulties, but these are co-occurring conditions to it.

Classic / Kanner’s autism can be diagnosed without these. The diagram also includes Specific Language Impairments, but this is not a recognised autism subtype or a Pervasive Developmental Disorder. A similar situation applies to how some PDA supporters view the Neurodevelopmental Disorder, Attention Deficit Hyperactivity Disorder (ADHD) as an ASD,

Effectively, PDA has never actually been an autism subtype. Dyer worked almost exclusively with those she thought had PDA, gaining comparatively limited exposure to what PDA might fully look like. Professor Christopher Gillberg posits PDA is common and is a co-occurring condition for: Anorexia Nervosa, ADHD, some behavioural phenotype syndromes, Epilepsy, Japanese construct of Hikikomori, Language Disorders, school refusal and selective mutism.

Vitally, it must be said absence of evidence is not evidence of absence. There is more evidence other professional’s opinions on PDA, like Rebecca McElroy, are as valid as Hilary Dyer’s. Multiple studies suggest aetiology of PDA might be from environmental factors or trauma and supporting form of Attachment Disorder or Personality Disorder.

The latter are viewed as maladaptive responses to stress. Some varieties are specifically associated to attachment difficulties, such as Borderline Personality Disorder. An interesting case study has possible signs of attachment issues. There are associations between Conduct Disorder, ADHD and PDA. Two adult community samples found associations between PDA behavioural indicators of personality disorder.

Some research suggests that PDA can be explained by interaction of various common co-occuring conditions, and the majority of these conditions are associated to childhood trauma/ aversive experiences, Many of the features assessed by PDA’s validated screening and diagnostic tools are associated with trauma,

1. Combined with the numerous problems fitting PDA in the autism spectrum, it is reasonable to view PDA’s aetiology as being related to trauma or aversive experiences.
2. We are in the age of participatory research for service users,
3. The evidence I have discussed suggests that PDA is seen in non-autistic persons, and these individuals have equal rights to a PDA diagnosis and research.

It is time, I argue, for inclusive scientific method-based PDA research. Richard Woods

Is it bad to punish an autistic child?

Two Words: Gentle Consistency – Children with autism pick up on things differently than other children. For example, your child may not pick up on the irritation in your voice when you ask them not to do something. These misunderstandings can make traditional discipline techniques less effective.

1. Your child might not understand the consequences of their actions, which can be frustrating.
2. However, you should refrain from any kind of physical or verbal punishment that could have a negative effect on your child.
3. Instead, be gentle with your words and actions.
4. If your child is screaming and having a tantrum, keep calm and don’t raise your voice.

All children learn through imitation, so try and respond to your child’s behavior clearly and gently. And now for consistency. Consistency is the key to safe, effective discipline. Most children with autism respond well to structured discipline, perhaps due to their desire for sameness and routine. Consistent discipline can also alleviate some of your child’s anxiety, a common characteristic of autism.

What parenting style is best for autism?

Parenting Styles to Avoid When Raising a Child With Autism – Ventura Psychology Services Raising a child with Autism Spectrum Disorder involves many challenges, because your child may not often c ommunicate, play, or behave like their neurotypical peers. Sometimes, these behaviors can confuse or overwhelm parents, but parent s can bring out strengths and abilities you may not even have realized your c hild possessed.

Helicopter parenting can stunt a child’s development, This is true for any child, but it’s especially important not to constantly hover over children with ASD because when you do, you prevent them from achieving independence and self-determination. It’s important to allow your child to experience the challenge of trying new things, enjoy success, learn from others, and learn from failure. If your child presents with behaviors that pose a safety risk however, then close supervision or safety precautions are often warranted. Competitive parenting can affect both you and your child negatively, When you feel like you’re competing with other parents, it can cause you to develop a feeling that your child and your parenting are not up to par. When yo u feel this way, it may impact you and your child’s self-image. Free-range parenting is inappropriate for children with Autism Spectrum Disorder, Children with ASD need higher levels of focused parental engagement, with parents who help them learn how to socialize, converse, pretend, ask questions, investigate the world, and build other important skills. Perfectionist parenting creates unrealistic expectations, Some children might thrive under “tiger” parenting, but those children do not often have ASD. While it’s important to have high ideals for your child, it’s also crucial that you don’t set your sights on goals that will only frustrate and upset both of you. Permissive parenting can cause serious problems in the long run, While you shouldn’t set your expectations too high, you also need to make sure you don’t set the bar too low. Children with Autism Spectrum Disorder need to experience the feeling of confidence that comes with accomplishment. Frenetic parenting can overwhelm your child, School, therapy, and other activities are important in helping your child learn and grow, but too much packed into the schedule can leave no room for practicing new skills and interacting with others. Children with ASD are still children and need time to play an d rest, When you’re scheduling activities, make sure to work in some calm, unfocused parent and child time.

If your child has been diagnosed with Autism Spectrum Disorder, is here to offer support. Founded in 2006, we provide behavioral and psychological services to people with ASD and related disorders in a nurturing environment that offers support for the entire family.

Is PDA actually autistic?

Listen to this story: Pathological demand avoidance (PDA) is a contentious term. Over the past 40 years, some clinicians have used it to describe a set of personality and behavioral traits exhibited by autistic people who tend to refuse to cooperate with others’ requests.

1. But the term is missing from the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases, which psychiatrists and psychologists use to make official diagnoses.
2. Those who favor the term say it has merit — if not as a diagnosis, then at least as a way to describe a personality type that is common among autistic people.

Other professionals say it is too narrow and subjective to be clinically useful, and that it pathologizes an autistic person’s preferences and autonomy. Here we explain what scientists know about pathological demand avoidance and its connection to autism.

• How did the term originate? The late Elizabeth Newson, professor of psychology at the University of Nottingham in the U.K., coined the term in 1983 to describe a syndrome in which a person resists and avoids the ordinary demands of life, even when complying is in their best interest.
• According to Newson, the syndrome’s behaviors can include trying to distract the authority figure who made the request, making excuses, withdrawing into fantasy and avoiding meaningful conversations, possibly to such a level as to lead to meltdowns or panic attacks.

Signs of PDA typically manifest early in life, Newson noted. Since then, she and other clinicians and researchers have refined the definition to emphasize how people with PDA use social strategies to avoid demands and to mask anxiety or underlying processing and communication issues.

1. Newson and her colleagues also outlined how to deal with children who have a PDA profile, by using approaches that differ from those commonly used with autistic children, even though children described as having PDA have autism.
2. Rather than providing the children with a highly structured routine, for instance, they emphasize novelty and variety.

Discussion of PDA has been confined mostly to the U.K, With social media dissolving international borders, though, people in the United States are gaining awareness of the concept. What is the relationship between pathological demand avoidance and autism? Newson originally described PDA as a pervasive developmental disorder, different from ‘classic autism,’ as some then called it.

She argued that it is a distinct syndrome on the autism spectrum — like Asperger syndrome, which was folded into ‘autism spectrum disorder’ with the publication of the DSM-5 in 2013. More recently, clinicians and researchers have described PDA simply as a ‘ profile,’ a group of behaviors that can be used to describe many autistic people, but not a distinct syndrome or diagnosis.

The PDA Society, a U.K.-based nonprofit, describes PDA as ” a profile on the autism spectrum,” And the U.K.’s National Autistic Society calls PDA a profile that first requires an autism diagnosis. There is insufficient evidence to support PDA as an autism subtype or an independent condition, according to a 2018 study,

Others say the concept is still useful, even if it is not concrete. “My own clinical view is that it is a behavior profile seen in some autistic children and young people. However, it is not clear what this ‘profile’ is — it could be a personality type interacting with autism; it may be something else entirely,” says Judith Eaton, consultant clinical psychologist and research associate at King’s College London in the U.K.

“I prefer to think about it as children with complex needs, who need an individualized support program, regardless of what we call it.” Why is the term ‘pathological demand avoidance’ controversial? PDA has not found widespread acceptance with clinicians, especially in the U.S.

Part of the issue is that even if PDA represents a real phenomenon, it means different things to different people, and it is unclear how useful the designation is, says Catherine Lord, distinguished professor of psychiatry and education at the University of California, Los Angeles. More strident critics of the term argue that autistic people who assert their own choices that are contrary to their parents’ or teachers’ wishes are not exhibiting symptoms of a condition.

They are simply exerting their autonomy, wrote Damian Milton, senior lecturer in intellectual and developmental disabilities at the University of Kent in the U.K. Calling this resistance ‘pathological’ rests firmly on the ableist preferences and values of the person whose demands are not being met.

Another problem is that PDA positions a pattern of behavior as a symptom of a diagnosable condition, without considering the context of the behavior, says Devon Price, clinical assistant professor of psychology at Loyola University in Chicago, Illinois. This context includes which demands a child is refusing and why, Price says.

Perhaps they need assistance or are exhausted. Or perhaps they do not want to go along with a task being forced on them, Price says. “If a child isn’t on board with what’s being demanded of them, then what we call PDA is actually a really powerful act of consent and self-advocacy.” Many educators and mental health providers expect children to comply with instructions, regardless of whether they understand or agree, Price says.

So any struggle or hesitation is pathologized.” What is the evidence in support of pathological demand avoidance? Few robust studies exist to either support or refute the validity of PDA, and those that do exist are small. Children exhibiting a PDA profile likely make up a small percentage of the autistic population, and many seem to grow out of it by adolescence or adulthood, a 2014 population-wide study revealed.

In a group of 27 children scoring high on measures associated with PDA, 26 had autism, according to a 2015 study, That study also showed that this group tended not to cooperate with authorities, using strategies such as apparent manipulation or attempts at shocking behavior to create a distraction.

Avoidant behaviors in children described as having PDA are often triggered by phobias, novelty and uncertainty, a 2017 study reported. Girls score higher on a measure of PDA traits, the Extreme Demand Avoidance Questionnaire (EDA-Q), than boys, according to a 2013 study, But researchers have not widely adopted the EDA-Q.

Adults who score high on the EDA-Q tend to be antagonistic, disinhibited and disagreeable, according to a 2018 study. “Larger-scale studies are needed, but I know from talking to people that there doesn’t seem to be the interest or the appetite to pursue that as a research project,” Eaton says.

Is PDA anxiety based?

The main characteristic of PDA is high anxiety when demands are made on the person. Demand avoidance can be seen in any child with an ASD but when the avoidance reaches pathological levels, major difficulties arise. This is the main criterion for diagnosis. People with PDA become experts at avoiding demands.

Is PDA autism or anxiety?

Perhaps the best way of thinking about PDA is as a way of describing a range of anxiety-driven behaviours where the child or young person seeks to talk their way out of or avoid everyday seemingly reasonable requests because they trigger anxiety.

Is PDA caused by bad parenting?

What is the low demand approach for PDA? – Pathological Demand Avoidance is a behavioural profile of Autism characterised by an avoidance of what are considered ‘everyday’ demands and expectations to an extreme extent. PDA is believed to be driven by high anxiety and an intolerance of uncertainty.

PDA children present as highly controlling with rapid mood swings and intense emotional dysregulation. They also tend not to respond to conventional parenting, teaching or support approaches. The low demand approach for PDA entails reducing or eliminating all demands and expectations placed on a PDA child in an attempt to try and alleviate their extreme anxiety, overwhelm and dysregulation.

Under a low demand approach, any pressure on your PDA child to do things they typically find demanding, for example attending school, bathing, or brushing teeth, should be reduced or removed and any restrictions that your child particularly struggles with, such as limiting access to technology or certain foods, should be set aside or not enforced.

Basically, you reduce or remove anything your child finds too demanding on the premise that this will reduce the pressure and stress on their brains and bodies, allowing them (and yourself) a more calm and manageable existence. In order for this to happen, a low demand approach (also referred to as ‘going low demand’, ‘low demand parenting’ or a ‘demand detox’) may need to be maintained for months, years, or in some cases, indefinitely.

It’s hard to say where the low demand approach originated, but the earliest published reference I have found is from the PDA parenting blog, The Learning Curve, which in 2018 published a post titled “The Principles of a No Demand or Low Demand Approach & How it has worked for Us.” Unfortunately I can’t provide a link as the blog is no longer available to read online, but other PDA parenting blogs that mention a low demand approach reference The Learning Curve’s blog post as the origin of the concept.

Can you grow out of PDA autism?

Pathological Demand Avoidance Home How is Pathological Demand Avoidance Diagnosed? How is Pathological Demand Avoidance Treated? Physiotherapy Therapy for Pathological Demand Avoidance Occupational Therapy for Pathological Demand Avoidance Speech and Language Therapy for Pathological Demand Avoidance Why Us?

There is no cure for PDA. Treatment interventions can be difficult for individuals with PDA as the nature of the disorder means that the individual is obsessively concerned with avoiding any demands placed upon them, including treatment methods. Wording of demands is important; they must be indirect in nature and are often more effective if they are short and not confusing.

1. Therapists working with individuals with PDA are prepared for avoidance tactics and strategies to overcome avoidance demands.
2. It is important that individuals are provided with plenty of time to enable them to process information.
3. If an individual with PDA performs a task correctly they should be praised to emphasise their personal qualities, failure should not be recognised as this will reinforce this behaviour.

Assessments will be used to identify problems or difficulties in the following areas:

Communication skills – expressive and receptive language Social skills Sensory processing Motor skills – gross and fine Learning ability

PDA can be treated by a number of professionals within a multi-therapy approach. Professionals who are often involved in the assessment and treatment of individuals with PDA include:

Speech and language therapists Physiotherapists Occupational therapists

For most individuals with Pathological Demand Avoidance there is a great need for their educational needs to be met. It is vital for these individuals to have 1:1 support normally through a teaching assistant or key worker. Educational needs for an individual with Pathological Demand Avoidance can be summarised under three main areas:

Keeping the child on task for substantial periods throughout the school day Ensuring that what they appear to be learning they are actually absorbing and retaining – many children with this disorder will appear to be learning but may not be processing or absorbing the information. This may occur when the child feels that fewer demands will be made of them if they appear to be attentive Ensuring that there is a minimal degree of disruption to other children – not all children with Pathological Demand Avoidance are disruptive, however, this may occur if they are trying to resist social demands

Whatever the child’s intellectual ability they will function at a level below what they could achieve due to the fact they will be active in being passive, often working harder to avoid the demand than they would have done if they had accepted it. It is therefore important that educational support is aimed at helping the child tolerate being educated to allow them to reach as much of their potential as possible.

• Support required for children with Pathological Demand Avoidance is extensive.
• It is important that professional and parents/carers know that what works on one day may not be effective the following day due to the highly variable nature of this disorder.
• Health professionals can provide valuable help and strategies for parents/carers of children with Pathological Demand Avoidance enabling them to deal with situations that may arise within a home setting and helping them to meet the child’s continuing needs whilst maintaining a happy home environment for everyone.

To arrange an assessment with one of our therapists please contact us by emailing [email protected] or calling 0330 088 6693,

Do children with PDA grow out of it?

10. Children with PDA grow up to be adults with PDA – Just like the overriding autism diagnosis, Pathological Demand Avoidance is a lifelong condition. It won’t simply go away or be grown out of, but can be helped by others around using the correct strategies.

It has been a huge comfort to us to hear from adults with PDA and to know that the future can be rosy. Julia Daunt is a PDA adult who has written a book called Being Julia and her website, Me, Myself and PDA offers a real insight into what it is like to live with PDA. Riko Ryuki is a PDAer and parent to three autistic/PDA kids who shares great information at Riko’s PDA Page on Facebook.

I also urge you to watch this video where Isaac Russell talks about experiences with Pathological Demand Avoidance, It’s eye-opening.

What are sentence starters for PDA?

It can also help if the adults: –

Use INDIRECT language. At all times try and avoid DIRECT requests. Useful sentence starters such as:

“I wonder if we can” “I can’t see how to make this work” “Maybe we could investigate”

Sow seeds of an idea and allow the child time to process the information. Use drama and role play. Use humour and distraction to lighten the intensity of the demand. Give the child choices, so that they feel that they have some control over what is happening to them: Which shoes do you want to wear? Crocs or trainers? Use child’s interests wherever possible to engage them.

What’s really important for the child, and the adult? What should the adult hold firm? What can they be flexible about?

Remember that the child’s resistance is based on anxiety and offer a calming approach and environment.

Can you have PDA and not be autistic?

Pathological Demand Avoidance in Kids All kids avoid doing things they’re asked to do from time to time. But some go to extremes to avoid or resist anything they perceive as a demand. Avoidance can take many forms, including making excuses, creating a distraction, intense focus on something else, withdrawing, escaping, or having a meltdown or panic attack.

1. Panic attack Onset of a sudden intense, overwhelming, and incapacitating fear, along with palpitations, dizziness, and a sensation that one is dying.
2. That pattern of behavior is called pathological demand avoidance, pathological demand avoidance A pattern of behavior in which kids go to extremes to ignore or avoid anything they perceive as a demand.

PDA is most often seen in people with autism. or PDA. It is seen most often in people diagnosed with autism spectrum disorder. autism spectrum disorder A spectrum of developmental deficits that begin in early childhood and may include impaired reciprocal social behavior, communication, and language, as well as restricted and repetitive thoughts and behaviors.

Many individuals also have cognitive impairments. These conditions have been thought of as a set of disorders, but are now being considered one disorder that presents along a spectrum. People with PDA tend to have an adverse reaction to being told how to behave or what to do, even when it’s something that’s an ordinary part of their daily life — and even when it would benefit them.

It’s called pathological when the avoidance is extreme and interferes with functioning at home or at school. In kids who fit the PDA profile, resistance is sometimes mistaken for willful defiance, says Cynthia Martin, PsyD, clinical director of the Autism Center at the Child Mind Institute.