From: punditster@gmail.com   
      
   On 2/22/2026 11:54 AM, Julian wrote:   
   > Many parents believe pathological demand avoidance is a real disorder,   
   > but pseudo-clinical labels are harming kids, not helping   
   >   
   Thanks for bringing this to our attention. Having nine grand kids in our   
   family, 'm trying to come to grips thinking about some kids and autism   
   and associated syndromes.   
      
   I've thought this over for several years now, as I watched my progeny   
   grow up. So, I studied child psychology in college. My daughter works   
   for Kaiser as an RN.   
      
   Apparently, child self-injury (SI) is common in autistic children. Some   
   studies show they are over three times more likely to engage in   
   self-harm compared to peers.   
      
   This makes communication challenging!   
      
   Behaviors like scratching, biting, or, in severe cases, using tools to   
   cause cuts often serve to communicate distress, manage anxiety, or seek   
   sensory input.   
      
   It's a cry for help. The question is, how to deal with it and what does   
   it mean?   
    > >   
   > When my son was little, he used to complain every time he was asked to   
   > do anything that wasn’t playing or eating biscuits. He had a particular   
   > aversion to the daily routine. Tell him to brush his teeth and you would   
   > get a dramatic, outraged “Again?” followed by an awful lot of fussing.   
   > We had to wrestle him into the bathroom twice a day, and it went on for   
   > years.   
   >   
   > If he was the same age now, I might decide he had something called   
   > “pathological demand avoidance” or PDA. This is thought by some to be a   
   > variety of autism, while others argue it can also attach to ADHD, or   
   > float free of both. Whatever, the basic idea is that unwanted demands   
   > from adults cause persistent anxious refusal in certain children, in a   
   > way that needs a specialist technique to handle. The respected clinician   
   > Elizabeth Newson came up with the idea in the 1980s, but it took a few   
   > decades to catch on. As can be seen by the number of Mumsnet threads on   
   > it, PDA is now virally embedded into parenting discourse, popularly   
   > treated as a disorder or even a “disability” that explains what makes   
   > some challenging kids tick.   
   >   
   > Yet PDA does not appear in any mainstream diagnostic manual. This alone   
   > suggests therapists and parenting coaches should approach the notion   
   > with caution. Unfortunately, there is little chance of this happening,   
   > because the liberal validation is helping to keep many of them in business.   
   >   
   > Here are two basic problems with the concept, though. First, it cannot   
   > possibly be true that every child who really hates being asked to do   
   > things has a disorder. So how do we tell the difference? To be   
   > meaningful at all, PDA cannot be an unfalsifiable hypothesis — so what   
   > do false positives look like in this area? I have searched the   
   > literature for an answer and found none that satisfies.   
   >   
   > Second, the official instruction for parents in this situation is to   
   > stop making direct requests. You are supposed to find more indirect,   
   > collaborative ways to reach your goal instead. That is reasonable advice   
   > for many occasions, but applied generally it is in danger of keeping the   
   > problematic behaviour going. The child will learn that when he is asked   
   > to do something tedious and gives a resounding no, the adult concerned   
   > will modify her behaviour instead. This is obviously not a recipe for   
   > getting an enthusiastic yes the next time. If anxiety is present, there   
   > will be no building up of tolerance either.   
   >   
   > Before you know it, you have persistence, and start to qualify for   
   > professional concern.   
   >   
   > It can’t be a coincidence that a rise in PDA is supposedly happening   
   > just as there is a reduction in socially acceptable ways of dealing with   
   > defiance. The trend is away from laying down the law — or in my case   
   > hustling a small boy towards the bathroom while ignoring the daily   
   > wailing — and towards negotiation, empathy and “gentle” ways of dealing   
   > with disputes. Yet in most cases negotiation is pointless and   
   > counterproductive — this is not the Paris peace accords, you are not   
   > Henry Kissinger and he is only four. “Negotiating” with a young child   
   > who is kicking off usually means giving them what they want and feeling   
   > useless about it. What used to be manageable has become a source of stress.   
   >   
   > A related problem is the general undermining of parents’ confidence.   
   > Social media is the source of endless discussion by professionals about   
   > the approved way to handle kids they’ve never met. Child-rearing is now   
   > presented as a science, not an art; a difficult technique that you   
   > should always be trying to master, keeping up with any “advances” in how   
   > to do it. Those who have well-behaved kids congratulate themselves,   
   > rather than admitting that often it’s a matter of luck. Meanwhile, those   
   > who have unruly or oppositional offspring feel shame and look for   
   > official-sounding explanations that don’t amount to the (usually false)   
   > “you’re crap at this parenting lark”.   
   >   
   > This may seem a niche discussion but I think it points to wider failings   
   > of the therapeutic professions. Some of them have what might be called   
   > PLD: pathological labelling disorder. Yet what counts as dysfunctional   
   > behaviour in children is affected by context. It partly depends on what   
   > a parent feels able to cope with; and this is influenced by trends   
   > within therapy itself. Acting as if parenting is a complex puzzle to be   
   > solved, and neurotically fussing about the range of acceptable   
   > solutions, means pseudo-clinical labels like PDA are only going to   
   > increase in popularity. Worse: perversely, they are harming many of the   
   > kids concerned, not helping. Sooner or later young recipients will   
   > become conscious of the label, and may well go along with the story too:   
   > a disorder is in charge of their minds and bodies, and it can’t be   
   > helped. Again, this is not an inducement to overcoming antisocial habits   
   > that can only hold them back.   
   >   
   > Perhaps for a very few children PDA is a helpful classification, but for   
   > most it is not. After a few years, a lot of gin (mine) and a lot of   
   > shouting (his), my own bolshie little boy turned into a charming,   
   > accommodating young man — and with perfect teeth too. I can’t claim much   
   > credit: looking back, I think he did most of the hard work. I’m just   
   > thankful we avoided professionals with PLD along the way.   
   >   
   > Kathleen Stock   
   >   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)