How do I help my child with PDA?

Pathological demand avoidance (PDA) is one of the most commonly discussed topics by parents on parent forums. Children who show pathological demand avoidance avoid everyday demands and requests to an extreme level. This can include avoiding attending school, going out to social events or simply completing everyday tasks in the home or at school. Clearly this has a massive impact not only on the child but the whole family.

Parents constantly ask about research based information on this topic. Despite this need there has surprisingly been relatively little research on this topic. Over the next few months we are going to tap in to the research that is available and develop a series of blogs and other resources starting with today’s post.

One of the areas that has received some attention in the research literature is the relationship between demand avoidance and ‘intolerance of uncertainty’. We have previously blogged about intolerance of uncertainty where children find it very difficult if they don’t know what is going to happen in advance and feel a strong need to follow a routine. A review of the literature has shown that intolerance of uncertainty is very strongly related to anxiety in autistic children.

There has now been some research carried out looking at the relationship between intolerance of uncertainty and demand avoidance led by Aaron Raj at the University of Hertfordshire. This study found that intolerance of uncertainty was related to demand avoidance. The researchers interpreted these children’s extreme avoidance of demands as reflecting an effort to control the environment and what is happening around them. One way to help a child with PDA then is to reduce uncertainty and the impact of surprises. This is often difficult in everyday life but keeping to a routine and letting the child know well in advance of any changes that are going to happen when that is possible can help. Sometimes these changes or plans being visually presented to them can be helpful.

This University of Hertfordshire study also found that sensory sensitivities were related to demand avoidance. Like other areas of functioning, it is not surprising that PDA reflects multiple underlying areas of difficulty. At EPIC Think Learn we emphasise the importance of understanding the range of difficulties that lies behind a neurodivergent child’s behaviour. We have previously blogged about sensory processing difficulties and their impact on neurodivergent children.

EPIC Think Learn takes a neurodiversity affirmative approach to understanding and supporting the behaviour of neurodivergent children. This means we are not focused directly on ‘fixing’ a child’s behaviour but instead our focus is on understanding how it comes about. We are focused on how the adults who care for these children can make changes to their routines and activities to try and reduce the emotional, sensory and cognitive (thinking) overwhelm that is often contributing to the difficulties these children show. In light of this then helping a child to deal with intolerance of uncertainty and sensory sensitivities by understanding their role in behaviour and trying to reduce overwhelm is important.

The EPIC Think Learn team have had requests for resources and webinars on the topic of PDA more than any other topic. Over the next few months we are going to develop and release a number of resources including infographics, videos and will host a webinar on our parent platform on 10^th November 7-9pm delivered by PDA expert Laura Hellfeld.  To attend the webinar and to access recordings on related topics such as anxiety, emotion regulation and sensory processing join our parent platform here.