![]() The instrument that they have developed is a 26-item parent questionnaire that appears to be easy to use and with preliminary good-excellent psychometric properties. O’Nions and co-workers (2014) have developed a “trait measure” for PDA (“the EDA-Q”), a measure that appears to hold considerable promise for research, and clinical practice. Experienced clinicians throughout child psychiatry, child neurology, and paediatrics attest to its existence and the very major problems encountered when it comes to intervention and treatment. Even though PDA has attracted quite a bit of clinical attention in the UK and other parts of Europe (including Scandinavia), virtually no research has been published in the field so far (Newson et al., 2003). The “disorder” was first heard of in 1980, when Elisabeth Newson, in a speech to the East Midland Section of the British Paediatric Society, presented the first twelve cases of what she believed to be a ”new” and separate syndrome and that she referred to as PDA. Or, it could be the other way around: PDA is not a variant of any of these disorders but represents a relatively unique behavioural phenotype with multiple comorbidities, much like any other “child psychiatric disorder”. However, the avoidant behaviour is quite often “publicly displayed” and with no feeling for the inappropriateness of the, sometimes even, exhibitionist style of extreme demand avoidance (EDA).Ĭhildhood onset PDA (which will be what is assumed when referring to PDA in the remainder of this text) has been suggested to be a variant of autism spectrum disorder (ASD) or of oppositional-defiant disorder (ODD), but it is more likely that any kind of early symptomatic syndrome eliciting neurodevelopmental clinical examinations (ESSENCE) (Gillberg, 2010), including language disorder, mild intellectual disability, ADHD, ODD, and/or ASD could be the underlying or associated problem in PDA. These behaviours in terms of expression of affection are rather the opposite of those associated with the commonly used meaning of PDA. The behaviours “used” in maintaining avoidance range from openly oppositional or manipulative to “extreme shyness”, passivity, and muteness. ![]() Boys and girls with “this kind of PDA” will do anything to avoid meeting demands of adults and children alike. A group of children presents with a rather peculiar type of oppositional behaviours, sometimes now subsumed under the label of “pathological demand avoidance” syndrome, also increasingly referred to as PDA. If you work as a clinician or researcher in the field of neurodevelopment, paediatrics, psychiatry, or clinical psychology, it is possible that your primary associations may take a different route. When you hear (or rather see) the acronym PDA being used these days, you usually associate it with shorthand for “Public Display of Affection” and you think about acts of physical intimacy in the view of others. ![]()
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