A Parent’s Guide to Pathological Demand Avoidance
All children need to be coaxed from time to time (or constantly) to do the hundreds of tasks we expect from them throughout the day. Having to tell a child to put on their shoes three times before school every day is not necessarily a pathology, it is a typical developmental range of concentration and independence. However, children with pathological demand avoidance (PDA) traits have a really hard time doing what is expected of them, even when they really want to. These children struggle to the point where it prevents them from spending the day at home or at school.
The label “pathological” referring to regular disruption of daily functioning can be stigmatizing. Some people prefer the term “pervasive (or constant) desire for autonomy” to recognize that the child’s behavior is driven by anxiety so overwhelming that he loses the ability to make decisions for himself.
According to the Child Mind Institute , people with PDA make great efforts to avoid tasks that seem demanding to them, and this may be a trait of children with autism. There is still debate about whether PDA traits are directly related to autism, and whether PDA can exist without a diagnosis of autism.
PDA research began about 20 years ago, and experts are still unsure why some people experience it. Explanations include:
- Children with PDA may not recognize the structure of adult social power over children.
- This is caused by differences in social learning, not defiance.
- Children with autism may not be motivated by social expectations in the same way that neurotypical children are.
- It may be due to anxiety, trauma, or other psychological issues.
- Behavioral expectations are perceived as a threat to the child’s autonomy, which triggers a neurological reaction of anxiety, attempts to gain control, relapse or panic.
A 2021 systematic review of 13 studies on PDA in children and adolescents found one problem with understanding PDA in children: researchers rely on adult reporting rather than exploring the child’s point of view.
How can you recognize the PDA in your child and try to see things from their point of view rather than bumping their heads?
Signs that your child may have PDA
Developmental psychologist Elizabeth Newson pioneered the study of PDA with her 2003 publication describing 8 traits she observed in children with PDA:
- In infancy, they were passive and less engaged in (or not interested in toys) during the first year of life.
- They use “social manipulation” to avoid tasks such as making excuses, distracting, avoiding conversation, or focusing intensely on something else.
- They may appear sociable at first glance, but may have inappropriate social responses.
- They exhibit extreme mood swings and impulsiveness.
- They are comfortable playing pretend and role-playing games.
- Sometimes they had an early speech delay, which they compensated for in early childhood.
- They may exhibit obsessive behavior, especially with a person.
- They may have epilepsy or neurological symptoms such as clumsiness and gross motor delay.
If you notice that your child’s requests to complete any task result in what seems like an extreme level of excuses, distractions, and withdrawals on a regular basis, consider talking to a child development professional about CCP. Avoidance behavior can escalate into nervous breakdowns, aggression, running away from you, or panic attacks.
The CCP can also cause children to resist implied expectations, even if they are not direct demands (for example, the whole class has lunch at the cafeteria at 11:15). Refusal to complete certain tasks should not be confused with a lack of ability. . This can be especially difficult at school when children avoid schoolwork and their grades suffer, even though they are intellectually capable of doing the job.
In fact, people with CCP may really want to do what is expected of them, but struggle with the anxiety that comes when they are faced with demands.
How you can help your child with PDA
If you feel like your child’s reaction to a “normal” request is extreme, try to recognize his discomfort at the request as anxiety. The PDA Society has developed this mnemonic device to help you learn PDA parenting skills. Try PANDA:
- Choosing Battles: This can come across as loosening the rules, blandly explaining why certain things must be done, and acknowledging that not all tasks are possible.
- Anxiety Management: Be mindful of your child’s concerns with anxiety, sensory input, and communication. Reduce insecurity and keep arousal low. Support their distress as if it were a panic attack.
- Negotiate and Collaborate: Ask your child to contribute to the problem and remain calm.
- Mask the requirements and manage them: rephrase so that it doesn’t sound like you’re demanding. (Talking about expectations can trigger anxiety and increase avoidance.) Do the task together.
- Adaptation: Use humor, distraction, and pretending to make the task more novel or exciting. Allow some extra time so the clock doesn’t add pressure and have a plan B.
If your child is not motivated by expectations, find out what motivates them to make the task seem more self-directed. For example, they can practice spelling words if it earns them their favorite boring adventure points later on.
Finally, tailor what you consider “winning”. You may need to break down small tasks into even smaller steps and note any progress.
The PDA Society has compiled an extensive list of tips for helping children with PDA. They cover the following:
- Understanding PDA Behavior
- Customizing your thinking
- Environment Optimization
- Decreased perception of requirements
- Be careful with rewards, praise or punishment
- Support for your child’s sensory needs
- Support social interaction and communication
- Support for emotional well-being
Using different approaches will help you develop an individual strategy that works for your child.
Check out these resources to help you and your child better understand the CCP: