Pathological Demand Avoidance In Children & How To Manage It

If you have been around children for any amount of time, you are very likely aware that they very often resist being told what to do and even enter bargaining by saying things like “just five more minutes?”

However, if your child often goes to extremes in response to being told what to do and seems to find it genuinely painful, they could be experiencing something called Pathological Demand Avoidance, and, according to the Child Mind Institute, this is most common in autistic people.

The Child Mind Institute said: “This avoidance is called “pathological” because it interferes with their functioning at home or at school. At school, these kids often resist doing classwork even though it’s not hard for them.

“This makes it hard for teachers to know what they can do. At home they may refuse to do routine things like taking a shower or getting dressed, so parents end up doing a lot of things for them that they could be doing themselves.”

This can take many forms, including making excuses, intensely focusing on something else or even withdrawing or having meltdowns.

Jo Richardson, an autistic person who campaigns for autism awareness explained her experience of PDA saying: “PDAers’ demand avoidance can apply to every single instance where they perceive a demand; this could be getting up in the morning, eating, drinking, going to see a movie that they have been really looking forward to going to, playing with a new toy etc.

“It is uncontrollable and all encompassing.”

Action for Children recommend taking the following steps to support a child with PDA:

• Remember that if you’re feeling frustrated, this isn’t your child’s intention
• If you do recognise these behaviours, ensure that your child is getting the support that they need. Make sure you speak to your GP or the Special Educational Needs Co-ordinator (SENCo) at your child’s school.
• Spend some time thinking about the demands on your child. These might seem small and insignificant but can be just as tough. Some demands are indirect. For example, saying “it’s already 8:30am” can be an indirect demand for your child to hurry up. Some demands are completely silent, like raising your hand for someone to give you a high five
• Try to learn which demands feel the most difficult for your child and try to readjust so that your child doesn’t feel quite so pressured
• Prioritise the demands on your child, depending on how much they can cope with that day. Try to prioritise the demands that keep everyone safe. For example: not hitting other children is non-negotiable. But you might be able to compromise on what they wear for the day
• Pose demands as a problem that needs solving instead of something they have to do. Saying, “can you take some shopping into the house?” is a demand. Instead, you could ask: “how am I going to get this shopping from the car into the house?”

The National Autistic Society have prepared a letter for parents and carers of children and young people who experience demand avoidance to send to schools and local authorities in situations where support may be being denied or withdrawn with reference to this characteristic

You can download the letter here.