PDA is Pathological Demand Avoidance Syndrome and can be found in adults and children. It is thought to be on the autistic spectrum and doctors both in the UK and the USA are diagnosing its existence in children. It is often described as a pervasive developmental disorder, which we can take to mean a persistent and all encompassing feature of development. In this case we are discussing children and what social workers need to know in order to help them work with children and parents where this diagnosis has been made and where there may present child welfare concerns.
The diagnosis was first made at the Elizabeth Newson centre, in the United Kingdom.
You will often see the diagnosis as “an atypical autistic spectrum disorder diagnosis of PDA”
Little has previously been known about this syndrome which main characteristics are the following; (this is taken from the Autistic Society website)
“They often have highly developed social mimicry and role play, sometimes becoming different characters or personas.
The main features of PDA are said to be:
- obsessively resisting ordinary demands
- appearing sociable on the surface but lacking depth in their understanding (often recognised by parents early on)
- excessive mood swings, often switching suddenly
- comfortable (sometimes to an extreme extent) in role play and pretending
- language delay, seemingly as a result of passivity, but often with a good degree of ‘catch-up’
- Obsessive behaviour, often focused on people rather than things.
People with PDA can be controlling and dominating, especially when they feel anxious and are not in charge. They can however be enigmatic and charming when they feel secure and in control. Many parents describe their PDA child as a ‘Jekyll and Hyde’. It is important to recognise that these children have a hidden disability and often appear ‘normal’ to others. Many parents of children with PDA feel that they have been wrongly accused of poor parenting through lack of understanding about the condition. These parents will need a lot of support themselves, as their children can often present severe behavioural challenges.
People with PDA are likely to need a lot of support into their adult life. Limited evidence so far suggests that the earlier the diagnosis and the better support that they have, the more able and independent they are likely to become.”
Controversy
There is controversy over if this is a real diagnosis or not. Some medics and families do not agree with the diagnosis of PDA and you will get information from Child & Adolescent Mental Health services stating the child does not have this syndrome but does have the following features:
Example:
“Jack is a child presenting with highly complex emotional behavioural, psychological, social, physical and learning difficulties. He has not been able to develop a secure internal mental framework in which to process worries, anxiety and confusion. He has high levels of anxiety, which appear related to a number of factors:
Ongoing and complex health problems, which contribute to low self -esteem and anxiety about his body
Learning problems which again have a profound impact on his self-esteem
A complicated attachment relationship with his mother in which on the one hand Jack craves his mother’s attention, and experiences extreme jealousy of his father, whilst on the other, presenting as highly oppositional to his mother
Some past experiences of being in an unsettled home environment”
This can be confusing for social workers however what is important is to have a working hypothesis about harm and its attribution. By working closely with other agencies and the family in a multi- agency way the social workers analysis using a working hypothesis will be crucial.
It is important to note that not all children with PDA require child welfare interventions.
Learn how to engage with children appropriately and how to use sensory equipment for communication and engagement. Sign up to our Mailing List for more information and coupon codes to our store at Elevate Training and Development
No comments:
Post a Comment