Pathological Demand Avoidance

This section is for questions relating to therapy, assessment, formulation and other aspects of working with people in mental health services.

Re: Pathological Demand Avoidance

Postby lingua_franca » Fri Aug 01, 2014 3:15 pm

PsychedOut wrote:I think I see things a little differently to some of what has been said here. Although agree with many of the points made!

I completely agree with Miriam's warning of generalising one way or another and agree that there is definitely a cluster of children with co-morbid social communication difficulties and conduct difficulties. I would also agree that a PDA label could be incorrectly used to gloss over interpersonal problems within a family or for children with disordered attachment. (although I don't think the quote Lizzabadger posted should be attributed to me?)


I was the person who wrote that. To be extra clear, I don't doubt that children who fit the PDA profile are on the autistic spectrum - I just feel that what some people call 'PDA' (and I can never see that without thinking of public display of affection :oops: ) is the product of ASD plus attachment difficulties. In families that are experiencing interpersonal problems, it can become very easy to locate those problems within the child who has ASD - child is obviously disabled, child obviously needs support, child consequently becomes a useful pincushion on which all the family's difficulties can then be stuck.

From what I can see, bearing in mind that I'm not qualified, it seems that the major difference between neurodevelopmental and attachment problems are that neurodevelopmental problems are lifelong and they are associated with a certain cognitive profile, in a way that attachment difficulties are not. People with autism, for example, often have executive functioning difficulties, may be very logical in their thought, etc., and these characteristics would still be there even if they had received the most stable attuned parenting possible. You don't need to be able to show something on an MRI to know that it's neurodevelopmental. I think it is important to be aware that autistic children can also have attachment problems - that it isn't a case of either-or - and that in order to support them effectively we should pay close attention to how attachment difficulties might interact with autistic traits. This involves recognising the qualitative differences beneath the surface similarities, which seem very difficult to pick apart.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
lingua_franca
 
Posts: 696
Joined: Tue Sep 14, 2010 11:29 pm

Re: Pathological Demand Avoidance

Postby lizzabadger » Fri Aug 01, 2014 5:53 pm

****Horrendous ignorance alert ******

Sorry for asking probably an extremely stupid question but don't children with, at least more severe, autism have poor attachment by definition? Ultra-simplistically speaking If you conform to the stereotype of prefering objects to people etc. you are never going to attach properly, are you?


***End of horrendous ignorance alert. Sorry - I really know nothing about this field but would like to learn. Well I know some things about autism but nothing about attachment ***
lizzabadger
 
Posts: 133
Joined: Wed Jul 13, 2011 8:52 am

Re: Pathological Demand Avoidance

Postby Ruthie » Tue Aug 19, 2014 2:46 pm

Interesting article.

I see autism as a difference and it may be harder for someone with autism to develop secure attachments. However, people with autism certainly can and do develop attachments (secure and otherwise) to people. If you think about a child with autism who is born into a family where they are accepted for who they are, their strengths nurtured and adaptations made to accommodate the things they find difficult versus the child whose family tries to stomp out their autism, overstimulates them and does not recognise or value their strengths. What might the outcomes be for each child?
If God invented marathons to keep people from doing anything more stupid, the triathlon must have taken Him completely by surprise.
User avatar
Ruthie
Moderator
 
Posts: 3098
Joined: Sat Mar 24, 2007 11:32 pm
Location: London

Re: Pathological Demand Avoidance

Postby lizzabadger » Tue Aug 19, 2014 4:00 pm

Many thanks, Ruthie. I will have a read.
lizzabadger
 
Posts: 133
Joined: Wed Jul 13, 2011 8:52 am

Re: Pathological Demand Avoidance

Postby Claire1112 » Thu May 18, 2017 9:56 am

i realize that this thread has gone quiet but i wondered if anyone has any up to date research around the value of discussing this profile with families and strategies / ideas around working with it?
Claire1112
 
Posts: 48
Joined: Sun Mar 13, 2011 2:30 pm

Re: Pathological Demand Avoidance

Postby miriam » Thu May 18, 2017 9:51 pm

I remain skeptical about a diagnosis that emerged from a specialist neurodevelopmental disorder service looking at kids with what local services had often conceptualised as family difficulties, maltreatment, attachment or other non-organic sources of difficulties under a solely neurodevelopmental framework. I also remain hugely uncomfortable about "making unfounded allegations" being labelled as a symptom of an organic condition, as it discredits the future disclosures of that child. So I wouldn't work with this label, and would go back to first principles and work with the issues in the individual and the family without it.
Miriam

See my blog at http://clinpsyeye.wordpress.com
User avatar
miriam
Site Admin
 
Posts: 7245
Joined: Sat Mar 24, 2007 11:20 pm
Location: Bucks

Re: Pathological Demand Avoidance

Postby lingua_franca » Sun Jun 11, 2017 3:36 pm

Miriam, can you point me to where making allegations is being presented as a symptom for PDA? Discussion about the validity and usefulness of the EDAQ has just come up among some of my former colleagues, and I'm trying to understand the perspective of those who see it as a helpful tool. I look at the EDAQ and so many of the behaviours it asks about are either textbook among traumatised kids or don't seem to have any significance at all ("Likes to be told he/she has done a good job" - that would be most children, I'm thinking!). But there is no mention of unfounded allegations on there. I agree that the whole construct of PDA sets children up to be disbelieved about disclosures, as it encourages people to see anything they do as the consequence of innate neurodevelopmental problems, but I'd be curious to read what has been said by its proponents on this issue.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.
lingua_franca
 
Posts: 696
Joined: Tue Sep 14, 2010 11:29 pm

Previous

Return to Clinical Issues

Who is online

Users browsing this forum: No registered users and 3 guests