The central difficulty for people with PDA is their avoidance of the everyday demands made by other people, due to their high anxiety levels when they feel that they are not in control. Hence the name of the syndrome: pathological demand avoidance. Individuals and their family often require different amounts of support depending on how the condition affects them.

People with PDA can be controlling and dominating, especially when they feel anxious and are not in charge. However, they can also be enigmatic and charming when they feel secure and in control. The term ‘Jekyll and Hyde’ is often used in reference to people with PDA. 

Signs and Symptoms:

• Resisting ordinary demands; exhibiting challenging behaviours
• An inconsistent profile of ability and need; this may change daily
• Appearing sociable on the surface but lacking depth in their understanding (often recognised by parents early on)
• Excessive mood swings, which may switch suddenly
• Comfortable (sometimes to an extreme extent) in role play and pretending
• Language delay, seemingly as a result of passivity, but often with a good degree of ‘catch-up’
• Obsessive behaviour, often focused on people rather than things.
• Sensory needs and sensitivities

It is important to recognise that children with PDA have a hidden disability and often appear as a typically developing child to others. Many parents of children with PDA feel that they have been wrongly accused of poor parenting through lack of understanding about the condition. These parents will need a lot of support themselves, as their children can often present severe behavioural challenges.

The condition was  only first described by Professor Elizabeth Newson in the 1980s. However, the good news is that research is increasingly providing new information about how it affects individuals and their daily life. Increased awareness, information and understanding helps our trained staff to provide a bespoke approach to working with individuals and families of children who present with pathological demand avoidance.

Our speech and language therapy intervention offers a comprehensive approach to treatment and management through post graduate training and close links with relevant professionals and practitioners. 

Further information about this condition may be found at www.pdasociety.org.uk