No one’s parenting journey is easy, and unfortunately, it usually doesn’t get easier as you get older. Many parents faced with a defiant or stubborn child immediately feel like they are dealing with a “spoiled child.” But sometimes, these behavioral disorders are a sign of something bigger going on—like pathological demand avoidance or PDA (and no, definitely not “public displays of affection…that’s a completely different thing”).
When you face a meltdown with your child, they may stamp their feet in protest because they feel they have no control over their life. We can all relate to this, right? Although pathological demand avoidance also stems from a need for control, it does not explode like a regular tantrum. Because this is not a very common diagnosis, it is often overlooked in children who resist authority and demands.
To help you learn more about PDAs, we interviewed experts to get more insights. Here’s what they say parents should know.
What is a handheld computer?
If you’ve heard of pathological demand avoidance before, chances are it’s because it showed up in your five-year plan. Parents who discovered the diagnosis through their own family experiences have shared their stories on social media platforms.
But what do real pros and experts think about PDA, how to diagnose it, and how to fix it? “PDA is a profile of the autism spectrum,” shares Sharon Kaye-O’Connor, LCSW, autism psychotherapist and autism educator. “PDA stands for ‘pathological demand avoidance,’ but some PDA self-advocates instead call it ‘persistent autonomy drive,’ viewing profiles through a more neurodiversity-affirming, less pathologizing lens.”
What are the characteristics or “symptoms” of PDA?
“People with PDA are autistic, so they naturally have other autistic traits, such as sensory problems, communication or social differences, and may have special interests. People with PDA may be good at masking their autistic traits,” Kay- O’Connor said. “For people who fit the profile of PDA, demands may trigger anxiety or a fight-or-flight response. When autonomy is perceived to be threatened, people with PDA may struggle to maintain their autonomy.”
In other words, people with PDAs are triggered when they feel out of control.
How to distinguish PDA from typical childhood “stubbornness”?
This is where things get particularly tricky. In most cases of meltdowns, outbursts, or resistance, both the “stubborn” child and the child with PDA want the same thing: more control over their lives. So, how do you know if your child is just being stubborn, or if they have a PDA? First, consider whether your child exhibits any of the autistic traits Kay-O’Connor mentions.
If you’re not sure, there are other ways to tell the difference between PDA and stubbornness.
“Honestly, it’s hard to separate PDA from general stubbornness in children,” says Lauren Kerwin, Ph.D., associate professor and founder of the DBT Collective in Los Angeles. “However, what is unusual about PDAs is the lengths children and teenagers will go to a lot of energy to avoid needs – whereas a child’s stubbornness or naughtiness is often motivated by a desire to use energy At least Possible amount of energy.
Kerwin also explained that many children with PDA may exhibit impulse control issues, mood swings, and obsessions with certain things or people as a way to avoid demands or assert some sense of control.
Do PDAs look different in toddlers and teenagers?
“For younger children, PDA may look like ignoring you when you ask them what a certain shape or color is, refusing to go to the bathroom on principle, refusing to share toys at preschool, never wanting to put on shoes or coats, Run and leave whenever you need to take a bath/shower, etc.,” Kerwin said.
What about older children? “[They] “While in school, they may refuse to complete assignments or ‘go with the flow’ because they believe it is what the teacher is asking for,” Colvin said. “It may be difficult for teachers to understand their academic abilities. These students may become disorganized as a result.” They also use a variety of strategies to avoid adult demands, including distraction, negotiation, lying, and even confusing others to achieve their ends.
How do you help a child who uses a PDA?
Support, validation, and empathy go a long way.
“For a child diagnosed with autism spectrum disorder, it’s important for those around the child to understand when and why the child is experiencing need avoidance, what is important to the child, and how the child is developing need avoidance,” Dr. Andrea said. “These things can be used to create a way to work with the child, to make the task more engaging, to set a timetable and reminder of expectations and upcoming changes, and to help the child understand the importance of the task.
Turner stresses that adults must also be open to taking an honest look at their own behavior to see what they can do to help reduce demand avoidance and negative reactions to it.
“It’s also helpful to remember that children in general, and especially children with developmental and other differences, don’t have much control over their environment,” she added. “Many children with autism spectrum disorder and other disabilities People who are undergoing various treatments, have very strict behavioral plans to follow, and often have greater expectations for compliance than their peers who are considered neurotypical, so avoiding tasks may be a way for them to communicate.
Therefore, positive interactions in life that do not require adults to make any demands, especially those that often make demands, can indeed promote children’s cooperation: “Allowing children to choose an interesting activity and lead the interaction can build trust and set the stage for future development.” Lay a good foundation for interaction.
Between the pandemic and mom-shaming, it can be hard to want to ask for help. However, dealing with any type of diagnosis should not be tackled alone. From online support groups to more specialized doctors and therapists, getting your child the support they need early on will go a long way toward helping them succeed as they age.
“Traditional autism interventions may not be effective for children with PDA,” Kerwin said. “It is critical to treat PDA with tailored support strategies that include building trust, reducing anxiety and working with the child to develop strategies to manage and reduce demand avoidance.”
If you think your child may have a PDA profile, talk to your doctor. If you don’t like their response, get a second opinion. Or a third opinion. Talk to parents and online support groups until all resources are exhausted. Doctors have extensive training, and people often question their expertise, but there’s also a lot to be said for a mother’s intuition. At the end of the day, no one knows your child better than you.
