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Patholigical Demand Avoidance Syndrome

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Researching school refusal and came across PDA syndrome.  

 People with PDA will avoid demands made by others, due to their high anxiety levels when they feel that they are not in control. 

Anyone else heard of this syndrome?  It has more widespread acceptance in the UK.

Just so much of it sounds like Pandas son . . .  think there is definitely some overlap.

Worth looking into . . . 



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Our daughter was recently pulled from school for school refusal... we are just now getting her a PANDAS diagnosis after three years... the refusal was manageable up until last spring (after she got strep again.) I think it is mainly because the inflammation plus the anxiety makes it hard to concentrate (ADHD-like symptoms), plus she has recently developed auditory sensitivity that she did not have early on. She had just started middle school/fifth grade and I think the bigger school, the banging lockers, the crowds and the accompanying noise just got too overwhelming for her. She kept screaming, "You don't understand!" over and over again when I tried to drag her in. In other words, it never felt like a control thing to me, but more like her 10-year-old way of letting us know she was in over her head and needed relief. 

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Personally, it sounds to me potentially like another instance of labeling a set of behaviors, rather than digging down into the genesis of the behavior.  School refusal and flat out avoidance of stressful (or to be more precise, potentially stressful) activities have been, in our experience, a classic presentation of high anxiety.  And if that high anxiety is the result of an autoimmune disorder, then you can slap any label you want on it, but that doesn't change what it is at its root.  If UK professionals are treating this "syndrome" to address the behaviors but aren't extending beyond that surface to address the underlying cause, the response is likely to be incomplete and without staying power, IMHO. 

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I totally agree with your assessment - it is most likely instance of labeling a set of behaviors without looking at the cause.   Many diagnosed with PDA syndrome share similar characteristics of those diagnosed with PANDAS - high anxiety, school refusal, PDD-NOS.  Is PDA syndrome really  describing a manifestation of auto immune disorder?   I would say very possibly.

Truthfully,  to me,  the value is not in the label of PDA syndrome but rather in the strategies that have been identified to help those with the presentation similar to PANDAS - namely the high anxiety and school refusal.   Because not only do we battle in treating the auto immune disorder, we battle with its presentation.  And to me, the latter is actually the harder of the two battles.

It is already tough to deal with the high anxiety/school refusal, but it is even worse when the prescribed strategies don't seem to work AT ALL.     But what they have determined with PDA syndrome is that normal strategies DO NOT WORK FOR THIS KIDS.  To me, this is huge!   This so correlates with our experience!  So now we might have some better ways to deal with the presentations!   Some insight on to what is really going on and HOW TO DEAL WITH IT!  In the UK, where the PDA syndrome diagnosis is widely accepted, there are actually schools to deal solely with children with PDA.  (But on the flip side, these kids may never get the real help for the root cause of their issues).

I am currently reading Understanding Pathological Demand Avoidance Syndrome in Children by Phil Christie, et al.

Anyway, I just thought I would share . .  sorry about the weird spaces and punctuations but I am doing this without my glasses on, which really isn't the best idea.


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