Commentary: PDA - what's in a name? Dimensions of difficulty in children reported to have an ASD and features of extreme/pathological demand avoidance: a commentary on O'Nions et al. (2017)

Child and Adolescent Mental Health
Osman Malik, Gillian Baird

Abstract

Pathological demand avoidance (PDA), a term first used by Elizabeth Newson in the 1980s, refers to a collection of behaviours that children will demonstrate to avoid instructions (and tasks) that they perceive as demands. These children are postulated to be averse to anything that is perceived as a demand placed on them. PDA features are commonly encountered in children with autism but PDA is not a subtype of autism nor a separately diagnosed mental, behavioural or developmental disorder in any of the major classification systems (ICD-10 or DSM-5). Such behaviours are not confined to children with autism and debate continues regarding its existence as a distinct phenomenon and if such a phenotype exists whether it is merely a part of autism or a separate condition. We comment on O'Nions and colleagues' study that explores common themes/behavioural traits in children with autism spectrum disorder (ASD) who also fit the phenotypic description of PDA. We explore how the current classification systems capture features of PDA in autism with diagnoses of common comorbidities in ASD (such as disruptive behaviour/conduct disorders, OCD and anxiety), but to many clinicians and parents this seems an inadequate description. What remains t...Continue Reading

References

May 28, 2004·Journal of Autism and Developmental Disorders·Elisabeth HillUta Frith
Jul 23, 2008·Journal of the American Academy of Child and Adolescent Psychiatry·Emily SimonoffGillian Baird
Jul 19, 2013·Journal of Abnormal Child Psychology·William MandyDavid Skuse
Oct 10, 2013·Autism : the International Journal of Research and Practice·Elizabeth O'NionsFrancesca Happé
Nov 16, 2014·European Child & Adolescent Psychiatry·Christopher GillbergEva Billstedt

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Citations

Apr 21, 2020·Child and Adolescent Mental Health·Ann Ozsivadjian
Nov 1, 2018·Child and Adolescent Mental Health·Elizabeth O'Nions, Ilse Noens

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