Pathological Demand Avoidance Syndrome (PDA) is now considered to be a part of or one of the Autism Spectrum Conditions (ASC) which is a fact that has recently been endorsed by the National Autistic Society (NAS) and reflected in their website. What is PDA?
Many parents upon reading the the diagnostic criteria have a light bulb moment. For the first time they may find themselves actually reading a set of diagnostic criteria that fits their child like a glove.
Prior to reading about PDA their child may have received a mix and match of diagnostic terms from clinicians in an attempt to accurately describe their child. These may include Atypical Autism, Pervasive Development Disorder Not Otherwise Specified often accompanied by the co morbid diagnosis of Oppositional Defiant Disorder (ODD), Attention Deficit Hyperactivity Disorder (ADHD) and Reactive Attachment Disorder (RAD) to name but a few.
What a mix and match of diagnostic terms doesn’t achieve, for many parents, it to provide them with an accurate description of their child. More importantly it often doesn’t sign post either the parents or other professionals to the correct strategies and understanding of the child.
PDA can have an overlapping diagnostic profile with other conditions such as Typical ASC, ADHD, RAD and ODD. But individuals with PDA, while sharing some of the features of those conditions, will also exhibit features unique to the PDA group. The following links help to explain the similarities and the differences between PDA and other diagnostic conditions.
PDA is an Autism Spectrum Condition due to the underlying difficulties with social interaction, communication, imagination and obsessions. However the central difficulty for individuals with PDA is the need to be in control at all times of their immediate environment so that a chaotic world feels more predictable. This control is often gained by avoiding any demands or suggestions made by others and by also being in complete control of other people including family, peers and so on.
This need to be in control stems from high anxiety levels and can elicit certain behaviours especially when the individual does not feel in control. The behaviours that the anxiety causes may be mistaken for ODD, RAD or ADHD. It is important to note that PDA is not a new term to describe any of the these other conditions and is not a term to describe a combination of these other conditions.
For parents that have read the diagnostic criteria for PDA and feel that this may accurately describe their child much more concisely than any current diagnostic terms that may have been attributed to their child then the following information may also help.
The following questionnaire has been used for research purposes and contains the PDA items included in the ‘Diagnostic Interview for Social and Communication Disorders’ (DISCO) Wing et al 2002 Parent Interview – Behaviours Related to PDA
Also, due to a growing research base, O’nions et al were able to compile the Extreme Demand Avoidance Questionnaire (EDAQ). This is also useful questionnaire, for parents to complete, to determine if their child may have an elevated risk of having PDA. EDAQ
My You Tube videos also detail different aspects of PDA and may be useful to watch You Tube videos about PDA
The You Tube videos, by Neville Starnes, no 1-5 discuss the features of PDA in detail Diagnostic criteria for PDA, common features and characteristics of PDA and does my child have PDA