Pathological Demand Avoidance (PDA) is a condition noted in children who consistently refuse to do simple activities, like putting on their shoes. However, it’s important to note that PDA is not a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
What PDA Looks Like
Children with Pathological Demand Avoidance are often described as oppositional, defiant, disobedient, and manipulative. But, here’s the thing: We believe the PDA behavior is due to the child’s inability to meet the demands of their environment due to anxiety and lagging skills. It’s not that they don’t want to meet the requests that are made of them, but rather, they can’t.
At Asheville Family Counseling we’re always looking for ways to “reframe” challenging experiences so that we can look at them as opportunities to question assumptions and create new meaning. Finding new ways to look at the problem often helps us find creative solutions for them, but most of all it helps us feel connected to the people we love the most.
The Problem with Unilateral and Uninformed Solutions
Of course, as a parent, it can be challenging to understand and deal with a child’s concerning behavior. But things can get better quickly. I recently worked with a couple whose child is identified as having Pathological Demand Avoidance. In one session, I asked them to describe their morning routine before school. This is the time when they see the most challenging behaviors).
The dad said, “Well, I give options. Like ‘Do you want to put on your shoes now or after you play with Lego’s for 10 minutes?’” The child chose to play with Lego’s. But then refused to put on their shoes after the 10 minutes. I smiled and shared that their morning isn’t going well, in part, because although it seems like he was giving the child choices, he really isn’t. He’s really using what we call “Nice Plan A.”
Plan A is when a parent decides what the solution to a problem is. But the solution is unilateral, meaning it comes solely from the parent. And it’s uninformed, meaning they really don’t know what’s making it difficult for the child to do the thing. The mom laughed and said, “All we do all day is Nice Plan A.”
So, what can we do instead? The Collaborative and Proactive Solutions (CPS) Model is always my go-to, but it takes time to really learn and have facility with the model. So the following are some tips that might help your child and you.
Tips for Helping Your Child:
Again, PDA is not widely understood, and there’s really no consensus on how to treat it and still much research that needs to be done to fully understand it. However, here are some things that can help.
As you read this list, keep in mind that not only children with PDA, but also all people, benefit from these conditions. Therefore, instead of saying “children with PDA,” I’m saying “people” in order to drive this point home.
- Understand your child’s triggers. People often have specific triggers that can cause them to become anxious or upset. By identifying these triggers, you can help your child avoid situations that may cause them distress.
- Give your child real control. Having a sense of personal agency often helps people feel more secure. For example, let your child choose whether to wear shoes or NOT to wear shoes. (If they decide not to wear shoes, we can find plenty of creative solutions for that too.)
- Use positive language. If you tell people what to do, they’ll often get defensive and reactive. Instead of giving commands, use positive language to suggest activities or tasks. For example, maybe you usually say, “You need to clean up your room now.” Now you could say, “Let’s clean up the room together.”
- Create a routine. People (especially those with anxiety) often find comfort in routine. Creating a predictable daily routine can help your child feel more secure and in control.
- Provide sensory input. People with anxiety often find it helpful to regulate their emotions with activities like jumping on a trampoline or lying under a weighted blanket.
Tips for Helping You
- Be patient and understanding. Living with someone who has a strong desire for personal autonomy can be frustrating and challenging. But it’s important to be patient, understanding, and compassionate – first for yourself and then for your child. Always try to remember that your child’s behavior is not a result of disobedience or disrespect. They’re not trying to give you a hard time. They’re actually having a hard time.
- Seek professional help. Parents who live with challenging kids need lots of support and at Asheville Family Counseling, we’re happy to help!
If you’d like to find out how we can help, call/text Asheville Family Counseling at 828-761-3149. We’ll set up a completely free, 15-minute exploratory session.