PDA is short for Pathological Demand Avoidance. The term was introduced in the 1980s by Professor Elizabeth Newson of the Child Development Research Unit at the University of Nottingham, UK, to describe a group of children whose main characteristic was “an obsessional avoidance of the ordinary demands of everday life” (Newson 1990). In addition, the children tended to have sufficient social skills and understanding to enable them to ‘manipulate’ other people to avoid doing what was expected. Tactics they used often included delay, attempts at distraction, running away, involving others in imaginary play and explosive – perhaps violent – outbursts.

Why do PDA children behave as they do? The best way to understand it is that the children have a need to remain in control. If they don’t feel in control, their anxiety increases sharply, causing unusual behavior. It’s not wilful; they can’t help it!

Unsurprisingly, parents, carers, teachers and other professionals find children like this exceptionally hard to deal with. Complicating matters, the child’s behavior is likely to appear deliberate or wilful. So the child can simply be seen as ‘naughty’. In turn, this may anger adults and lead them to punish the child. Sadly, adults usually find that conventional child-rearing techniques, including punishment, simply do not work with PDA children. Indeed they may make matters worse. Too often, a repetitive spiral occurs, ending with the child losing all self-control and having a ‘meltdown’. These incidents – which may be dangerous for everyone involved – are likely to be very distressing.

PDA has come to be recognized in the UK as an autism spectrum disorder (ASD). However, it is less recognized in other countries, including the United States.

How to handle PDA children? If PDA is driven by anxiety and the need to be in control, it follows that parents and others should aim to reduce the child’s anxiety, while trying to ensure that as many as possible of the ‘ordinary demands of everday life’ are met.

Whilst simple to give, this prescription is often extremely difficult to follow. It requires adults to behave calmly, deliberately, and counter-intuitively (eg not punishing the child) in what may be very trying circumstances, such as a ‘meltdown’ in public. Carers may need to come up with imaginative, non-threatening solutions at times of high drama (and embarrassment, perhaps).

Given that PDA is a form of autism, it may be a lifelong condition with no ‘cure’. Perhaps the most to be hoped for is that PDA children can gradually be helped to modify their behavior to enable them to ‘fit in’ sufficiently and achieve more of their potential. The parents coping best with their PDA children tend not to challenge relatively minor problem behaviours, instead often ‘going with the flow’ and only taking a firm stand over those issues they regard as non-negotiable.

Reference
Newson E (1990) Pathological Demand Avoidance Syndrome: Mapping a New Entity Related to Autism? Inaugural lecture, University of Nottingham.

Further reading
One excellent, up-to-date source is What is Pathological Demand Avoidance? on the website of the National Autistic Society in the UK.