For parents of children with Pathological Demand Avoidance, it is as though their child has been born with a built in no. You might say ‘come and look at this picture’ and get a response of ‘no’ or ‘why?’ It can be very frustrating since it turns everyday comments into a battle. The child may react in this way because they are afraid of failure or it may be the feeling of loss of control is stressful for them. PDA often appears on the assessment for a child diagnosed as being a high functioning autistic.
Before I suggest some ways of handling a child who has the PDA syndrome I want to write about another group of vulnerable children. These are children with Attachment Disorder. Much of the work on this condition was carried out in this country by a team led by John Bowlby. Their research noted that children who experienced an abrupt separation from their primary care giver between the ages of 6 months and 3 years could grow up with this disorder.
The attachment disorder syndrome includes:
· Feelings of emptiness
· Reluctance to trust others
· No sense of belonging
· Feeling rejected
· Feels calmer when alone than in company
So what do High Functioning Autistic children and Children with Attachment Disorder have in common? They both have a tendency to respond to requests negatively. They may say ‘why’? Or they may say ‘no’ to reasonable demands. Even more infuriating, they may simply ignore you! It is important to remember that the children did not choose to have PDA. The reason they resist the demands made of them is because they are insecure and so have a need to feel in control. Of course it is necessary that you are actually in control as responsible parents. Although the children seek control because they are insecure, if they feel you are not in control, they will become even more insecure. You are their parents, their role models and the people they love most.
There is no instruction manual listing how to manage children with PDA. All children are individuals and you, as parents will often know what will work best with your child. I suggest you try not to get in conflict over food. This is particularly important if your child is on the autistic spectrum. Children on this spectrum (which is often known as ASC or autistic spectrum condition) have heightened senses and can be very picky eaters for that reason. However, go along with their pickiness - the important thing is that they eat. They usually tolerate a wider range of food as they grow up. It is often effective to give children a binary choice. Do you want to tidy your room now or shall I read you a story first? Most children have a sense of humour, even those who incline to take things literally. If you can engage their sense of humour, they may relax enough to stop seeking control. Sometimes you need to signal you are joking, use a phrase like only joking or LOL so they relax. Whatever you do remember you are doing the best you can for your children and, although they have PDA which is not their fault, it is certainly not your fault either. You are wonderful and so are they.
Roger Green MBACP