Is your child “refusing” to comply? 

Round & About

Won’t? Or can’t? SEN expert Mary Mountstephen explores Pathological Demand Avoidance (PDA)  

Children who may have PDA are often unable to comply with simple requests that we make every day. Their anxiety levels are so high that they cannot (it’s not a case of not will not) do what is asked. According to the PDA Society in the UK, PDA is generally understood to be a profile on the autistic spectrum, involving avoidance of everyday demands and the use of “social” strategies as part of this avoidance. 

Girls and boys are equally likely to be diagnosed and may do anything to resist quite normal requests , but appear socially able. PDA is not a stand-alone diagnosis. It is generally considered a profile within the autistic spectrum and an appointment with your GP is often the starting point to the process, following ongoing consultations with your child’s SEN co-ordinator and class teacher. 

The National Autistic Society provides very useful information for parents, family members and schools in understanding more about PDA. 

Amira is nearly seven years old. She is playing in the living room with some toys. Mummy says: “Put your shoes on now Amira, we’re already late for school.” ‘I can’t do it. I hate my shoes, I’ll do it later,” Amira replies after Mum has asked her five times. “My feet hurt and my hands are too tiny… I need some water first…” 

In school sometimes Amira sits with a group of children for a short time so  that she can feel positive about taking part, if she feels calm. But sometimes, she suddenly feels really angry or upset, or in a panic for no reason. It can be very scary for her and for other children. She may throw things around, scream or shout. 

Parents might observe difficulty interacting with others, rough play, shouting and screaming if they don’t get their way and rapid mood swings. Adults who don’t know these children might think they’re rude or naughty. There may be a mismatch between communication skills and their understanding and insight into these interactions. They often have high levels of anxiety, anger and stress. They can appear socially able but will resist and avoid “normal” activities. 

I have devised small credit card-sized cards that parents and schools can hand out to helpers, school trip volunteers and professionals such as dentists and opticians. The card explains, for example: “Nico is not naughty, his developmental profile means he may have difficulties doing what you ask.” The reverse of the card provides basic advice and guidelines.  

It’s important not to leap to conclusions. However, if you are concerned about your child’s behaviour, please do seek support. I can advise on suitable resources, but you need to have your concerns recognised. Your child may present as “naughty”, but you will instinctively know if they need specialist support. 

Try to focus on your own wellness and mental health as well and practise moving away from challenging circumstances. Breathe!