How can I support my child with Pathological Demand Avoidance (PDA)?

Pathological Demand Avoidance (PDA) is a ‘behaviour profile’. People with a PDA profile avoid everyday demands and expectations. This demand avoidance can be accompanied by high levels of anxiety.

There is some disagreement on whether it should be an official diagnosis. But many NHS trusts and Children’s Services are starting to acknowledge PDA more.

PDA: a teenager in leggings and a blue coat sits with their legs stretched out. They are facing away from the camera and their hair is in a messy bun.

What are the main features of PDA?

Children and young people with PDA may:

  • resist and avoid the ordinary demands of life;
  • have excessive mood swings and impulsivity;
  • be comfortable with roleplay and sometimes pretend to an extent that feels extreme;
  • show obsessive behaviour, especially about other people.

How can I support my child?

  • People with PDA can require a lot of support. The sooner you can recognise the behaviours, the sooner you can seek support. Make sure you speak to your GP or the Special Educational Needs Co-ordinator (SENCo) at your child’s school.
  • It’s important to remember that your child isn’t trying to challenge or frustrate you. When their behaviour feels difficult, they may be struggling to adapt to not being in control of their environment.
  • Spend some time thinking about the demands on your child. These might seem small and insignificant but can be just as tough. Some demands are indirect. For example, “it’s already 8:30am” can be an indirect demand for your child to hurry up. Some demands are completely silent, such as raising your hand for someone to give you a high five.
  • Your child may be able to cope with demands more on some days than others. Try to learn what impacts this. It could be which people they spend time with, or the environment around them.
  • Prioritise the demands on your child, depending on how much they can cope with that day. Try to prioritise the demands that keep everyone safe. For example: not hitting other children is non-negotiable. But you might be able to compromise on what they wear for the day.
  • Learn your child’s triggers. Try to plan out their day so they can avoid triggers, if possible. Make sure you include activities which you know they will find relaxing in their schedule.
  • Pose demands as a problem that needs solving instead of something they have to do. “Can you take some shopping into the house?” is a demand. Instead, you could ask: “how am I going to get this shopping from the car into the house?”
  • Reward systems can work well for many children. But children with PDA may not respond well to them. Rewards highlight how compliant a child has been and this might be a negative thing for a child with PDA.
  • The National Autistic Society has a guide for parents and carers of children with PDA. It includes more advice and research on the topic.
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