(PDA) is a pervasive developmental disorder. PDA is related to, but separate from, what is currently termed the autistic spectrum, namely autism and Asperger syndrome. Individuals with PDA are typically socially manipulative with people, and are thus superficially socially skilled, which sets them apart from autism and Asperger syndrome.
People with PDA usually have good eye contact, and use this to good effect when socially manipulating others. They lack self identity, and children find it difficult to recognise that they are not adult, and seldom identify with other children. While people with PDA usually know how others should behave, they are unable to include themselves within these expectations. They are often imitative of inappropriate behaviour, and it is for this reason that, wherever feasible, support should be given in mainstream school to provide them with as normal a peer group as possible. They show an obsessive need to dominate in social interactions, and to ensure that everything is done on their own terms, and often come across as overbearing. It is helpful to view this behaviour as a defensive strategy that is borne out of deep anxiety about the demands that they fear will be made of them, and a need to control their environment to prevent this.
People with PDA seem to feel an urgent need to avoid the ordinary everyday demands placed on them, to a pathological degree which is not normal laziness or timidity. Their social skills allow them to use excuses; distraction attempts (such as ‘Wow, look over there!’ just as you are asking for their cooperation), or controlling the interaction by refusing to speak or trying to drown out your voice with speech or singing (according to the child’s personality) are all very common. For more descriptive details of ways in which different children try to resist demands, please refer to the Diagnostic Criteria section.
People with PDA may remind others of autism/Asperger syndrome. However, because they do not fulfil those criteria precisely, or have other features that are unusual in autism and Asperger syndrome, they may have been described as having ‘atypical’ or ‘non-typical’ Asperger or autism, or ‘Pervasive Developmental Disorder n.o.s’ (not otherwise specified).
Children with PDA usually under-achieve in school compared with what is perceived as their ‘true’ potential, only producing the barest minimum of work. This is reflected by frustrated teachers in comments such as ‘I know he could do better if only he tried’ or ‘She must be more intelligent than she seems because she’s so devious!’ Some children try to keep a very low profile, trying to blend in to avoid any attention being drawn to them, and this has been described by some as the ‘Camouflage Effect’; however, when they receive unwanted attention they may become actively disruptive. Some hit out or swear as another way of stopping imminent demands. These two types of PDA behaviour both seem anxiety-induced and might be described as ‘actively passive’ to ‘actively disruptive’; they could be seen as possible sub-groups, but some children move from one type of behaviour to another at different ages. It is important to remember that these children do not choose to behave in these ways. It is their inability to cope with what they perceive as the stress of everyday demands that manifests itself differently according to their individual personalities, and possibly underlying cognitive deficits and neurological pathologies.
Examples of PDA VS. Aspergers Syndrome statistics
PDA children are LESS likely:
- to have caused anxiety to parents before 18 months of age
- to show stereotypical motor mannerisms
- to show (or have shown) echolalia or pronoun reversal
- to show speech anomalies in terms of pragmatics
- to show (or have shown) tiptoe walking
- to show compulsive adherence to routines
PDA children are MORE likely:
- to resist demands obsessively (100%)
- to be socially manipulative (100% by age five)
- to show normal eye contact
- to show excessive lability of mood and impulsivity
- to show social mimicry (includes gestures and personal style)
- to show role play (more extended and complete than mimicry)
- to show other types of symbolic play
- to be female (50%)
The above data is taken from Pathological Demand Avoidance syndrome: Discriminant Functions analysis demonstrating its essential differences from autism and Asperger syndrome: Elizabeth Newson and Kathryn le Marechal, Early Years Diagnostic Centre and University of Nottingham, England.
People with PDA can become obsessive about particular individuals or relationships. They tend to show a high level of impulsivity, excitability and sometimes violent behavior, often associated with these obsessive interests, and occasionally involving harassment of another child or adult. Their obsessive interests are qualitatively different from those seen in autism/Aspergers.
Like all children with a pervasive developmental disorder, people with PDA will have certain communication problems, although these may be masked by their superficially high social skills of distraction and avoidance, thus the underlying deficits can be quite easily overlooked. Semantic pragmatic language (the social use of language, including body language) may also be affected, but not to the degree found in autism and Asperger syndrome. Bizarre content of language is more common than in autism, sometimes due to interest in fantasy.
Individuals with PDA tend to have over-active imagination as opposed to under-active, and this clearly sets them apart from Wing’s description of the autistic Triad of Impairments. Individuals with PDA quite often become confused as to the boundaries of reality and imagination (as they also do with other boundaries). They may submerge themselves into characters that they have modeled themselves on, either from TV or from real life, and sometimes they can seem to have lost touch with their ‘real’ selves. Many children with PDA take on the role of their teacher in great detail, and will tell other children what to do (much to their annoyance!) Keeping the tolerance and sympathy of other children in the classroom can be a difficult task for teachers who are trying to meet the needs of a child with PDA.
Most of the characteristics mentioned tend to persist in various forms into adult life, but research in this area is not extensive at present. The prevalence of PDA compared with autism is presently not known.
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