From Newsgroup: alt.buddha.short.fat.guy

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 wasnrCOt 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 rCLAgain?rCY 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 rCLpathological demand avoidancerCY 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 rCLdisabilityrCY 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 rCo 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 canrCOt 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 rCo or in my case hustling a small boy towards the bathroom while ignoring the daily
wailing rCo and towards negotiation, empathy and rCLgentlerCY ways of dealing
with disputes. Yet in most cases negotiation is pointless and counterproductive rCo this is not the Paris peace accords, you are not
Henry Kissinger and he is only four. rCLNegotiatingrCY 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 parentsrCO confidence. Social media is the source of endless discussion by professionals about
the approved way to handle kids theyrCOve 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 rCLadvancesrCY in how to do it. Those who have well-behaved kids congratulate themselves,
rather than admitting that often itrCOs a matter of luck. Meanwhile, those who have unruly or oppositional offspring feel shame and look for official-sounding explanations that donrCOt amount to the (usually false) rCLyourCOre crap at this parenting larkrCY.

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 canrCOt 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 rCo and with perfect teeth too. I canrCOt claim much credit: looking back, I think he did most of the hard work. IrCOm just thankful we avoided professionals with PLD along the way.

Kathleen Stock

--- Synchronet 3.21b-Linux NewsLink 1.2