In any family, it can be difficult to balance the needs of individual children within the family unit.  This can be even more difficult for a family when they have a child with PDA. The effects on brothers and sisters can be extremely difficult for them to cope with and may cause them a great deal of stress, anxiety, upset and, in some cases, resentment.

Some of the difficulties that siblings may experience

  • Other children in the family may often bear the brunt of verbal and violent outbursts & meltdowns from their sibling with PDA.  Unpredictability can leave siblings on edge when at home.
  • They may feel stifled and controlled by their sibling with PDA as they play or seek to avoid outbursts.
  • It can be very distressing for them to witness their sibling with PDA having a meltdown, and at times, parents struggling to cope.
  • Consistent and focused attention on their sibling with PDA may result in other children feeling left out and resentful.
  • The child with PDA may appear to be treated differently – with more flexibility, and getting away with things that their siblings would not, leading them to feel that it is very unfair.
  • Individuals with PDA may often appear to be intensely jealous and actively try to prevent positive interaction between their sibling and their parents.
  • ​It can be embarrassing for brothers and sisters when their friends come over to play if their sibling with PDA is constantly trying to influence things or is displaying unusual or shocking behaviour.  Some miss out on playdates altogether.
  • ​Family outings can be difficult to manage as a child PDA may struggle to cope. Last minute cancellations, meltdowns and determined dictating of activities all leave the sister or brother feeling left out.

Strategies to try to reduce the impact that living with a child with PDA has on their siblings

Trying to find a balance between allowing siblings to have as typical a childhood as possible, combined with the many adaptations that they will need to make for their sibling with PDA, can be difficult to achieve.  These are some ideas and suggestions of strategies that might help for you to adapt as needed.

Educating siblings about PDA

Many families educate their other children about PDA from a young age.  This can help siblings to develop a genuine understanding of their brother or sister’s difficulties, why this causes them to behave and act in the way that they do and why their parents use a more flexible parenting approach towards their sibling than they do with them.
The understanding can help brothers and sisters to cope with the different expectations that parents may have of them, and help them to feel they are part of the support network.

Working on PDA strategies

Parents can work with their other children on developing their own strategies that they can use. For younger children, drawing pictures or making a poster of helpful things that they can do is one approach. Ideas might include keeping calm, moving away when their sibling becomes angry, asking for help from an adult instead of reacting back.  By identifying triggers which may lead to a meltdown, a sibling may learn to pre-empt such situations and ask for help. This can be exhausting for siblings but the more they practice the better they will get and ultimately everyone will benefit.

Safe and private space

Some families find it helpful to provide siblings with their own safe place within the home which is out of bounds for their sibling with PDA; a place where they can feel relaxed and calm in the knowledge that their private space will not be invaded.  This can be a difficult but important boundary to maintain.

Quality time

Spending time with siblings separately can help both. This may be difficult for some families so ask for help from others if needed -  family, friends or respite services.
Even just spending as little as 15 minutes each day doing things of their choice can be hugely beneficial. If this is difficult see if you can improvise, for example, some parents even collect their other children or child from school during lunch time (it is not a legal requirement for a child to be in school at lunchtime) and use this period of time to engage in quality time.

Whole family time

It is important to still try to maintain time as a whole family to develop relationships between siblings too. Try short outings that have been carefully planned with the children involved, or activities in the home, such as watching a film (and avoiding competitive board games!)

Parenting approaches

It can be helpful to try to develop a similar parenting style for all children within the family unit. This can help to reduce any feelings of unfairness and confusion. Many parents may follow a philosophy of Gentle / Positive Parenting for all of their children which is similar to the Ross Greene approach.  Here, parenting would consist of talking, problem solving, working as a team and negotiating with all their children to resolve difficulties and issues, although parents may need to have different expectations of suitable behaviour, according to the varying needs and capabilities of each individual child. Other parents may feel that it is important to maintain a more traditional style of parenting for their other children. In these cases, educating their other children and explaining why their sibling is parented differently to them may help to reduce any feelings of resentment.

Support for siblings

Being the sibling of a child with PDA can be extremely difficult and siblings may require support themselves to cope with what can be, at times, a complex and challenging family environment. It is important that parents are aware of the effect that living with a sibling with PDA can have on the emotional well-being of their other children.

  • Small but regular acknowledgments that they are loved and noticed can also help to maintain a sense of wellbeing for siblings of children with PDA.  This could include the smallest of things like putting a little note in their lunchbox or sending a text message for older children.
  • Help children to know that their concerns will be taken seriously and that it is good to talk about things.  A good starting point is to empathise and acknowledge the feelings of the child.  If possible, think of some options that could resolve or reduce some of the child’s concerns. If this isn’t possible because the situation can’t be changed, work to help them to develop emotional resolve to deal it.
  • Siblings may benefit from having regular respite outside of the home with either a parent, other family member, family friend, at a friend’s house, with another suitable adult or with a respite service provider. 
  • It can also be helpful for siblings to have people that they can talk to who aren’t directly involved with the family.  They may not want to discuss certain matters with their parents for fear of adding to their stress or causing upset. Sometimes it may be helpful to seek support for siblings from services that can offer counselling as well as those services that can offer practical respite.

Further information - siblings


Can I tell you about pathological demand avoidance syndrome? by Ruth Fidler & Phil Christie (age 7+)

Children with Pathological Demand Avoidance Syndrome (PDA) a booklet for brother and sisters, can be ordered from the Autism East Midlands Diagnostic Centre, Tel no: 0115 9609263 email: 

Question and Answer sheet for siblings

Hilary Harvey is the parent of two children, one of whom has a diagnosis of PDA. She has compiled a Question and Answer sheet which is an extremely useful resource for parents and siblings.  It contains lots of practical help and advice of how to explain and answer common questions, that the sibling of a child with PDA may ask, in a child friendly manner.
Download Siblings Q&A Sheet

Case studies

Hilary has also written a very personal account of how her family have approached the difficulties associated with trying to simultaneously meet the needs of two children, one of whom has a diagnosis of PDA.  This provides a wonderful illustration of how she developed and incorporated many ideas and strategies into her own daily family life.
Download Siblings Case Study

Many of the other case studies on our website also touch on the impact on family members

In recent coverage about young carers, CBBC Newsround featured PDA sibling Oliver - you can view the clip here and read more about the impact having a sibling with PDA has here.

​Help and Support

​​Our Support and Advice resource contains signposts to services that can offer further advice and services for siblings.

Further information – family resources

You can find further information, leaflets, websites and webinars in our extensive list of family resources and webinars.

Further reading and information about PDA

Further information about PDA can be found in the following areas of our website.

The National Autistic Society also provide an increasing amount of information about PDA.

Please note that the PDA Society are not making any recommendations nor is responsible for the content of sites and links that are external to the PDA Society.

Please contact us if you discover any broken links.