Jekyll and Hyde or Pathological Demand Avoidance Syndrome (PDA)?

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Updated January 3rd, 2016. This post will be updated on an on-going basis

I have written this blog specifically to educate, advocate and provide awareness for an unknown syndrome in Australia, called Pathological Demand Avoidance (PDA) Syndrome.  Many children are misdiagnosed with other conditions and/or parents are sent on parenting courses that are ineffective or make things worse for these types of children.

Presently, Pathological Demand Avoidance (PDA) Syndrome is not recognized in Australia and is not recognized by the DSM5. It may be confused with intermittent explosive disorder, oppositional defiant disorder and other disorders or conditions. It is extremely challenging to find support or assistance for PDA in Australia. Many professionals are unaware of PDA. However, the National Autistic Society in the UK has recognized PDA as a form of Autism (http://www.autism.org.uk/about/what-is/pda.aspx#). This is a most progressive and positive move.

Over my career, I  have worked with some of the most behaviorally and emotionally disturbed children (and adults). I have worked with a number of children and adults (in two countries) who have been described by their family members, school officials, educational consultants, as “naughty”, “Jekyll and Hyde”, “bi-polar”, “schizophrenic”,”possessed” or even “a devil’s child”. I have worked in private special needs school, hospital psychiatric, outpatient and inpatient and private practice settings. In one professional development session I attended, a psychiatrist suggested “these children needed to be thrown out the window on the drive by past school” (in order to help them overcome their anxiety). I have seen and heard it it all, and I can tell you, these children do not need to be thrown out windows and are not possessed by any “devil”, although they can and do behave in some very scary ways, at times.

Presently Pathological Demand Avoidance (PDA) Syndrome is not recognized in Australia and is not recognized by the DSM5. It may be confused with intermittent explosive disorder, oppositional defiant disorder and other disorders or conditions. It is extremely challenging to find support or assistance for PDA in Australia. Many professionals are unaware of PDA. However, the National Autistic Society in the UK has recognized PDA as a form of Autism (http://www.autism.org.uk/about/what-is/pda.aspx#). This is a most progressive and positive move.

Pathological Demand Avoidance Syndrome (PDA) is a term by Elizabeth Newson, used to describe children and adults who have an extreme need for control that is led by high levels of anxiety. They have difficulty coping and complying with day to day activities and their behaviors are out of proportion to the task being requested of them (for example, a violent act over being ask to pick up a toy). They have a lack of sense of a social hierarchy and have been described by others as socially manipulative and having anger management difficulties, which may include growling, grunting, spitting, hissing, violence and/or swearing. They may have a “look” in their eyes that is indescribable and/or scary to the parents(S) and family members.

The word ‘pathological’ is used to describe the avoidance as impairing their ability to function. Avoidance is used in many ways and the strategies are manipulative in a social way to avoid a demand. I have seen children use distraction, a multitude of excuses, stories and/or lies, negotiation and arguing, screaming and biting, hostility, attacking other people and/or becoming violent, running away, hiding, engaging in highly embarrassing activities in public, withdrawing into a fantasy world and acting like animals, just to name a few strategies.

Socially, children with PDA appear to have better or more social skills, however they do not have full empathy. I have observed them use empathy to control and/or manipulate others or a situation, but there is a stark lack of emotion involved. They may use their intellect to manipulate others.

At times, these children can appear as though they are just like any other child and at other times, they can be extremely challenging. These types of children are extremely moody, highly anxious, love role play and pretending, may have sensory sensitivities, tend be be bossy and domineering, and may not realize that they are a child, in the true sense of a little person. Some believe they are animals, rather than human. If you believe your child has PDA, typical parenting or even Autism parenting strategies will NOT usually work.

If you think your child has PDA or traits of PDA please read the following books. I am also available to consult with by emailing me at tania@aspiengirl.com

There are specific assessment tools to assist with diagnosing PDA.

Recommended reading

Duncan M, Healy Z, Fidler R & Christie P (2011). Understanding Pathological Demand Avoidance Syndrome in children. London: Jessica Kingsley Publishers.

Fidler R, Christie P (2015). Can I tell you about Pathological Demand Avoidance Syndrome? London: Jessica Kingsley Publishers.

I had the pleasure of attending one of Dr. Greene’s conferences in North America and I cannot recommend his work enough.

Greene, Ross W. (2014). rec. 5th edition. The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children

Greene, Ross W. (2014). Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them

Greene, Ross W., & J. Stuart Ablon (2005). Treating Explosive Kids: The Collaborative Problem-Solving Approach.

 

Sherwin J. A. (2015). My daughter is not naughty. London: Jessica Kingsley Publishers.

Recommended  Resources

Dr. Greenes’ Centre for Collaborative Problem Solving

http://www.ccps.info/

Streaming Video or DVD: Explosive, Noncompliant, Disruptive Aggressive Kids at http://www.cpsconnection.com/store

You don’t have to wait for Dr. Greene to be speaking in your area to watch his one-day overview of the CPS model; you can watch streaming video or download MP4 video or MP3 audio formats.

Recommended Australian Resources

http://www.thepdaresource.com/pages/groups.html

If you know of a professional in Australia who works with PDA, please let me know and I will add them to the ‘PDA Professionals list’, by emailing me at tania@aspiengirl.com

Look for my new book on PDA and females, coming 2016

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Copyright, Tania Marshall, 2014-2016