Pathological Demand Avoidance?? Anyone Heard of That?


Roll With It
I was watching an older video from the UK and a very difficult child was tentatively evaluated as having this disorder. They set the parents up with a specialist center to help them handle it and things got a lot better for the little girl. I don't know if it is recognized in the US or not. (Of course my kids have not been evaluated for many years, so I would not know!)

I find it fascinating. It seems to be something that higher functioning children use and I would think more girls than boys would use it. I base this on studies I have seen that show that girls hide their autism by becoming mimics. I know I did things that the other girls did just because it seemed that I was supposed to do them, not because I wanted to do them or because they made any sense to me. Heaven knows dolls and especially Barbies were about the dumbest things in the world to me. I played with them because other girls did and it seemed to make adults, especially my grandmother and aunts, happy. Girls do that.

This syndrome is a way of controlling their world. They cannot understand or cope with so many things, and it all probably seems very difficult. So they throw fits and refuse to do things. The little girl in the show was 9 or so and had been "permanently excluded" from school because of her behavior. The parents clearly had no idea what to do with her. They had been to various experts already and had always been told it was their fault. Doesn't that sound familiar!!! The parents had never even had anyone suggest that the daughter could be on the autism spectrum.

The show defined PDA as a form or subset of autism where the child feels extreme anxiety when faced with even the smallest of demands, leading to violent outbursts or refusing to leave the house. PDA can be coped with by keeping demands to a minimum by turning them into games or blaming them on another authority. For example, "You don't want to go to school and I don't want you to go to school but the Queen says you have to go to school." Or in the US, "the President says you have to go to school."

It takes the blame off of the parent and can cut down the arguments. The mom in the video used timers as an authority to tell her child when she had to stop doing something. "The timer says you have to brush your teeth and go to bed now." would be one example. I would caution you with this. My aunt and uncle used this with my cousins. They used it back on my aunt and uncle. "The clock says it is time to have ice cream, Mother." (This was a parenting method that was recommended to them in the sixties when my cousins were in elementary school.) I don't know if all kids would pick up on this, but the smarter ones probably will.

I just wondered if anyone here would be interested in this or would find it helpful. It is very new, so it is not in the DSM or ICD at this time. Here is a link to some information about it: Pathological demand avoidance - NAS


Well-Known Member
Huh. Well, if there is such at thing, my grandson has it. Maybe it's like the Oppositional Defiance Disorder. Fits like a glove when you look at many of the characteristics, but isn't really meant to be a clinical diagnosis with an accepted treatment plan, right? I dunno.


Well-Known Member
Sounds like Miss KT's father, who has been fully supported by his mother for the last twenty years. He resisted my efforts (all right, orders) to get a JOB already (one of the reasons for our divorce), is very charming and has plausible excuses for everything, and he wears people out.


Shooting from the Hip
This is Pat, right down to a T. Unfortunately, no one suggested any ways to work with it until he became defiant...