What is Pathological Demand Avoidance?
PDA is now recognised as a profile of autism, albeit a distinct one. Children and adults with PDA will appear similar in challenges to those diagnosed Autistic.
Social Communication challenges
Restrictive and repetitive behaviours - often viewed to be rigid or obsessive
Sensory defensive or sensory seeking behaviours
Social interaction difficulties
One of the most sincere challenges for a child who may have PDA is the failure to diagnose correctly. There are pervasive and distinct differences so how do we as educators spot the signs to help ensure the correct referral pathway.
A child with PDA their rigidity is in their need to avoid demands and control situations, which can often lead to the child appearing extremely impulsive in their emotions and behaviour, as they react to demands as they perceive them.
Children with PDA often can appear sociable and highly socialized, but simultaneously fail to recognise boundaries.
A child with PDA will react to demands placed on them. They may appear highly impulsive, emotional and engage in higher risk activities.
A child with PDA may have a history of language delay, but unlike some of their peers on the autism spectrum they may show rapid catch up. Language is not always disordered and facial expressions are often describes as 'normal' or not like a child with autism. This can change with demand avoidance and this is key. Content can become disorganised and at best odd, when a child is trying to avoid a demand placed upon them.
Demand avoidance is also specifically different and would be categorised as extreme. This may include what many would consider everyday tasks. The high and persistent consistentcy to continue to avoid certain tasks is almost always indicative of PDA - especially if there have been evidence based interventions.
Anxiety & obsessive resistance
Like children and adults on the spectrum - anxiety play a key role in determinants of behaviour choice.
Any circumstance that elicits anxiety will almost certainly illicit extreme resistance and avoidance to complete the activity. As default a person with PDA will have a n exceptionally difficult time overcoming their own expectation or system for how something must be done. Which will appear in rigid and what is often described as extremely obsessive behaviours.
Extreme demand avoidance is the key determinant when diagosing and can only normally be done by a professional who has experience in PDA.
Almost 100% of children SEN World has worked with who have been diagnosed as PDA, were previously diagnosed without the distinct profile and were 'autistic'.
What to do if you suspect a child has PDA.
Speak to your SENDCO/ learning support and ask for tailored support specific to PDA. Reassessment would be required, if the child has never previously been assessed. Ensure the correct referral and assessment pathway for PDA is followed.
If you are a parent speak to your GP/Primary care physician and school.
For more advice SEN World can be contacted 24/7 and can direct parents & educators to appropriate professionals.