Pathological demand avoidance

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pathological demand avoidance is a pervasive developmental disorder identified by Elizabeth Newson. She conducted her research at the Child Development Research Unit, University of Nottingham, England, and later at the Early Years Diagnostic Centre, Nottingham.

Diagnostic Criteria

In contrast to most individuals with autism spectrum disorders, individuals with PDA possess superficial social skills and seem to have a theory of mind. They often engage in manipulative, domineering behavior. The defining criteria are:

  1. Passive early history in the first year, resisting ordinary demands and missing milestones
  2. Continuing to resist demands, resorting to tantrums, distraction techniques
  3. Surface sociability, but apparent lack of sense of social identity, pride or shame
  4. Lability of mood and impulsivity
  5. Comfortable in role play and pretending
  6. Language delay, seemingly the result of passivity
  7. Obsessive behavior
  8. Neurological signs (awkwardness, similar to autism spectrum disorders

Controversies

Many autism advocates and researchers view PDA as simply an expression of an autism spectrum disorder. The National Autistic Society states, "We do not agree that this is a separate syndrome. Each of the behaviours Professor Newson describes can be found in some individuals with any form of autistic spectrum disorder. They can be found on their own or in any number in any combination. It is when all or almost all appear in an individual that Professor Newson would apply the label of PDA."[1]

References

PDA contact group forum - support for parents and professionals [2]