Pathological demand avoidance

Pathological demand avoidance (PDA) is a proposed sub-type of autism spectrum disorder. Characteristics ascribed to the condition include greater refusal to do what is asked of the person, even to activities the person would normally like. It is not recognized by either the DSM-5 or the ICD-10 and is unlikely to be separated out now that the umbrella diagnosis of 'ASD' has been adopted. In 2011 it was suggested that these symptoms could represent the condition oppositional defiant disorder (ODD). It was proposed in 1980 by the UK child psychologist Elizabeth Newson.Pathological demand avoidance is not recognized by the DSM-5 or ICD-10, the two main classification systems for mental disorder. To be recognized a sufficient amount of consensus and clinical history needs to be present, and as a newly proposed condition PDA had not met the standard of evidence required at the time of recent revisions. However, DSM-5 also moved from sub-type classification to the use of ‘Autistic Spectrum Disorder’ which allows for the behavioural traits of different profiles to be described.As of 2014 there are no recognized diagnostic criteria. Proposed criteria by Newson include:Newson first began to look at PDA as a specific syndrome in the 1980s when certain children referred to the Child Development Clinic at Nottingham University appeared to display and share many of the same characteristics. These children had often been referred because they seemed to show many autistic traits but were not typical in their presentation like those with classical autism or Asperger's syndrome. They had often been labelled as 'atypical autism' or PDD-NOS. Both of these terms were felt by parents to be unhelpful. In 2003 she published in Archives of Disease in Childhood for PDA to be recognized as a separate syndrome within the pervasive developmental disorders.