Often is it tricky to discern in pre-schoolers what is expected based on their stage of development, and what might suggest that they could fit a PDA profile (Pathological Demand Avoidance). Many pre-schoolers will display avoidance of demands to some extent, however when it is causing significant disruption to day-to-day life then it may be beneficial to investigate further. For many children with PDA, they may not display obvious difficulties until the demands placed on them exceed their capacity, often this may not happen until they reach formal schooling.
No two children will present the same way. The examples in this post are general and may not capture every PDA child.
For professionals, the PDA society has created a helpful resource document: Identifying & Assessing a PDA profile – Practice Guidance you can find it here: Identifying & Assessing PDA – PDA Society
PDA is a profile of Autism so PDAers may display the following Autistic features….
- Differences in social communication. PDAers are often socially motivated, display eye contact and can engage in conversations. What I have noticed is they may seem to take longer to process social situations which, for a pre-schooler, might present as finding it hard to keep up in play situations, wanting to play the same game on repeat, or being controlling of the rules of the game. They might also struggle to answer direct questions when they are in demanding situations.
- Differences in the way they process sensory information. They may be more sensitive to sensory input, for example they might…. become upset by the sound of things like motor bikes, mowers, hand dryers in public toilets, babies crying. They might dislike messy play, walking on sand or grass, different textures of clothes or completing grooming tasks such as hair washing, hair cutting, having nails cut etc. They might be particular about foods they will eat, the way it is presented or the temperature of the food. They might be particularly active and seek out high intensity movement like running, jumping, climbing, swinging.
- Differences in the way they play. They may become completely immersed in topics of particular interest or use toys in different ways to what they were intended.
In addition, they might also display the following characteristics which are specific to PDA:
- Avoid everyday demands. In a pre-schooler this might look like refusing to get dressed or change into pyjamas at night. Our son went an entire winter refusing to wear long pants or a jumper. It might include refusing to bath. Being very selective about what they will eat. Refusing to use the toilet. Melting down when it’s time to transition into the car to leave the house or being unable to attend Daycare or Kindergarten settings (many will also be able to attend and mask their differences). They might also find it unbearable having to wait and be unable to participate in structured extracurriculars.
- Use social strategies as part of avoidance. In response to suggestions our pre-school aged PDAer might… politely decline (and just say, no thankyou), he might distract us or suggest an alternative (saying, I’ve got an idea we could do this), he might negotiate (saying hmm, I’ll do that this afternoon, or I’ll do that on Sunday, I’ll clean my teeth in the morning), he might make excuses (I can’t get that, the grass is wet), he might feign physical incapacitation (he might pretend to be a baby and say carry me, baby hasn’t learned how to walk yet), he might withdraw into fantasy (Our son will often communicate through his comfort toy so on the way somewhere he might say, Luna is feeling a bit worried and needs me to stay in the car with her).
- Appear sociable, but lack some understanding. As mentioned above, they have a tendency to use eye contact and have reasonable conversation skills however it comes with a huge energy cost. An example of this, When our PDAer was engaging in therapy and attending daycare he would mask and appear to be coping, however when we got home he would become non-verbal, curl up in a fetal position on the couch and be unable to engage in anything for the rest of the day other than watching TV, he would be aggressive with his sister and he would meltdown easily over the tiniest things. Some days he would completely shut down and fall asleep at out of character times and often he would experience disturbed sleep- night terrors or extreme early wakings. Parents might be left saying that their teachers report they are fine at school and think that they need more structure at home when in fact, the child has just been holding it together and then explodes or shuts down at home.
- Display intense emotions and mood swings This might present as difficulty with emotional regulation, impulsivity and unpredictability dependent on where their tolerance levels are at. If they are pushed beyond what they can cope with the behaviours that we see could include situational mutism, crying, yelling, hitting/kicking, throwing or running away. This is not the child being intentionally uncooperative, defiant, manipulative or abusive. They are exhibiting a protective stress response. For many PDA kids, if they are in the right environments with the right people, the extent of their differences might appear quite minimal. However, put them in the wrong environment with the wrong people and they become completely disabled.
- Seem comfortable in role play. They often have incredible imaginations. Some examples might be taking on the persona of an animal, communicating through pretend play or using fantasy as an avoidance strategy.
- Have a need for control which is driven by anxiety or an automatic ‘threat response’ in the face of demands. Anytime they perceive a loss of control it is triggering a build-up of anxiety. That anxiety and stress can then accumulate until they are unable to cope.
- Focus intently on other people. Some PDAers might be particularly obsessed with a certain family member or friend. For my son, he can certainly be very controlling of what people do, who helps him things, and what people are allowed to say in play situations. It appears to be especially apparent for people that he relies on for co-regulation, an example, he coped for the first year at day care, I think, mostly because he had a beautiful friendship with one other little boy who filled his co-regulation need, he would become upset if this child was away or wanted to play with someone else or do something different.
- And then the real kicker… They have a tendency not to respond to conventional approaches in support, parenting or teaching. This is what can be so hard for parents, teachers and professionals to manage. Typical parenting advice such as routines, visual schedules, firm adult-imposed boundaries, rewards and consequences might make the situation worse.
Does this ring true for you? What made you realise that your pre-schooler fit a PDA profile?
