Their demand avoidant behaviour is rooted in an anxiety-based need to be in control. Individuals who present with this diagnostic profile are driven to avoid everyday demands and expectations to an extreme extent. displays obsessive behaviour that is often focused on other people.appears comfortable in role play and pretence.experiences excessive mood swings and impulsivity.appears sociable, but lacks understanding.uses social strategies as part of avoidance, eg distracting, giving excuses.resists and avoids the ordinary demands of life.The National Autistic Society includes the following as distinctive features of a demand avoidant profile: ‘Demand avoidant behaviour’ is included in the National Institute for Health and Care Excellence (NICE) pathways guidance as a sign and symptom of possible autism. PDA is defined by Newson et al (2003) as “an obsessional avoidance of the ordinary demands of everyday life” and it is now recognised as part of the autism spectrum, a view endorsed by the National Autistic Society. When their needs are reassessed during my involvement with these children and their parents (or adults and their families), their presentations are often found to be best described as a pathological demand avoidance (PDA) profile of autism. Many parents are told that there’s nothing wrong with their child and that their parenting is at fault, with professionals suggesting how parents can rectify their perceived ‘inadequacies’. These efforts are sadly often counterproductive and futile. ![]() Parents often tell me that their local authority has recommended they attend a weekly parenting course so they can learn to set appropriate boundaries and manage their children more effectively. Whilst all cases are unique, there’s one thing that all these individuals seem to have in common – traditional parenting or conventional behaviour strategies, even those recommended for autism spectrum disorder (ASD), don’t work. ![]() Whereas some individuals have an existing diagnosis or multiple diagnoses, in other cases they have no diagnosis at all. Increasingly in my work, I’m coming across young people and adults whose presentations are complex – they might have a combination of autism, attention deficit hyperactivity disorder (ADHD), dyspraxia, hypermobility and dyslexia, to name a few. By Cathleen Long, Independent Social Worker
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