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Supporting a child with PDA
  • Amanda
    Posts: 281
    We've updated our self help leaflets so I thought I'd better do the same here too..........

    Supporting a child with PDA
    (Pathological Demand Avoidance)

    Children with PDA often present very challenging behaviour and many of the strategies that would prove helpful for a child with Aspergers Syndrome or autism that doesn’t show traits of PDA, will only work for a limited time or even prove totally ineffective.

    For a child with PDA control is really important and understanding this and the reasons for this need for control will make it much easier for you to work out strategies that will allow both you and your child to handle new situations.

    A lack of control for these children brings about extreme anxiety. Many of them will look at a situation and build around it a multitude of fears and stresses based on what potentially could happen to them while in a particular situation. Many children will create a ‘worse case scenario’ and it will be this that will convince them that they do not want to, or are unable to participate. Children often create this ‘worse case scenario’ when challenged to complete tasks that are within their capabilities. Often poor self esteem and low expectations of themselves will cause them to ‘switch off’ or create an avoidance.
    Not having control of a situation brings will it a whole host of new anxieties.
    ‘If I don’t have control then who does? Who’s going to keep me safe?’
    Letting your child know that when they don’t feel as if they have total control, you do, can help to reassure them.

    ‘Whatever I ask him to do he does the opposite or just flatly refuses or says that he can’t’

    Doing what you want them to do is often really difficult for your child. If they are doing exactly what you want them to do they are giving you control and of course that brings with it all those dreaded anxieties. It is often much more effective to try and find a way of getting them to do what you want them to do but in a way that allows them to feel that the decision has been theirs and therefore they still have control over what they are doing.
    Obviously it’s important that your child does what you need them to do so maybe giving them options and allowing them to make their own decision may help.
    This is where you have to learn to be cunning and makes sure that both options will get them doing what you want them to do.
    Children with PDA often struggle with authority as they just don’t see that there is a difference between parent and child, teacher and pupil and unfortunately because of this confrontation often results in aggression, both verbal and if not de-escalated effectively, physical.
    Giving a PDA child responsibilities can be a really effective way of helping them cope with new situations because not only are you providing them structures, you are also giving them a certain amount of control that may well be enough to help them cope with a situation.
    This might include giving them the responsibility for a younger child on a day out. It may be that this strategy will help them cope much better with a new situation.

    ‘How do I help him cope with all this anxiety?’

    Again trying to make sure that your child has an element of control in a situation is a very positive move. Ensuring that tasks that they find difficult have a beginning, a middle and an end so that they know that although they might struggle at some point it will all be over can help them cope. Children with PDA often respond well to personal praise and often reminding them how grown up they are or are behaving can be beneficial.

    I really thought he wanted to go. He said he did.

    Be aware that some children have a real fear of confrontation which means often they can feel forced into doing things that they don’t really want to do because they have real anxieties around what will happen if they say no. Unfortunately for parents this often means that after the event there is often an angry outburst that lets them know quite clearly how difficult it was for them.
    Many children will try hard to manipulate their way out of a situation they find difficult, for example by pretending to be ill, others will hide or become abusive as a way to avoid a situation. It is important that we always remember and remind ourselves that these behaviours are motivated by anxiety.
    The more you learn to understand PDA and the effect it has on your child the easier it will become for you to predict the sort of situations your child might struggle with and you will then have more chance of putting support into place for them. We cannot wrap our children in cotton wool forever and it is important that we find ways to support them but also acknowledge that the only way to get them used to a new situation is for them to experience it.

    That said there will be times where no matter how much planning you put into place to support your child they will have difficulty coping. When this happens you shouldn’t blame yourself.

    When your child is extremely anxious and feels that they have lost control they will often need to know that you are in control.
    You can reassure them of this by talking to them calmly and quietly. If they see that you are not feeling threatened it will help them feel safe.

    ‘He’s really angry I don’t want to make the situation worse’

    Try not to be confrontational. Trying to make a point at the time they are finding it difficult to cope is not a good idea as this will only add to their anxieties.
    Set strict boundaries and stand by them. It may sound strange but part of the reassurance for your child that you have the ability to keep them safe is often measurable by whether you mean what you say when you say it. For many children your backing down, although you mean well by it, can often be interpreted as a sign of weakness and with weakness come anxiety.

    Humour is often effective in defusing a potentially aggressive situation, but make sure that the child understands that you are joking with them, if they don’t it can increase their anxieties.
    The child also needs to be interested in you as a person of potential authority in their lives, it is important that you stay calm and detached in heated situations and don’t allow things to become personal. You need to re-enforce ‘the rule’ which of course applies to everyone and therefore out of your control. This removes any personal element to the situation and it may be possible for you to sympathise with the child, after all we all have to adhere to rules that we don’t necessarily agree with, doesn’t mean we get away with not following them.

    ‘I don’t understand why he gets so angry’

    Remember that the behaviours you are seeing come from anxiety. If your child is aggressive or destructive or verbally abusive it is not because they hate you it is because they are afraid or confused and feel like they have lost control.u

    When they are calmer and feel more in control remember that many children feel embarrassed and guilty about the way they have behaved. You need to able to deal with what has to be dealt with, but it’s important you learn the ability to draw a line under what has happened, let it go, get back to normality as soon as possible, with no recriminations. Failing to do this may well take away the control your child has regained and the situation may escalate once again.

    In a school environment, where all students are encouraged to accept the consequences of their actions, provided ‘the rule’ is in place, and applies to everyone, it is not usually necessary to labour the point with the student, most often they don’t need to be reminded of whatever sanctions are the norm and doing so will increase anxiety.

    As parents, it’s important to separate the behaviour we don't like, and don't want to reward at the time but our love for them is a separate issue. We love them unconditionally and we need to keep telling them that.

    © The Maze 2006
  • eileen
    Posts: 2
    This is really clear and really helpful.Thank you.Which pamphlets are being updated and wil this site notify us when thhey are ready? Eileen
  • Amanda
    Posts: 281
    Hi Eileen these are information leaflets we produce at The Maze to support our parents in Nottinghamshire, however if you want to PM me an address I'd be happy to send you some

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