The distinctive clinical and educational needs of children with Pathological Demand Avoidance syndrome: guidelines for good practice

Phil Christie is currently the Director of Children's Services within the Nottinghamshire Regional Society for Children and Adults with Autism (NoRSACA) and has been Principal of a specialist school for children with autism for over 25 years. This paper, The distinctive clinical and educational needs of children with Pathological Demand Avoidance syndrome: guidelines for good practice, was first presented at the World Autism Congress held in Cape Town, South Africa in 2006. It describes a syndrome that was identified over a long period of time by Professor Elizabeth Newson, often during work done jointly with this author, Phil Christie. In the many diagnostic assessments conducted at the Child Development Research Unit based at the University of Nottingham, she found there were children referred with a possible diagnosis of autism who did not seem typical in that they shared some of the features but displayed other very different behaviours and characteristics. There were also more girls affected than boys. After several years of careful note-taking and interviews with parents, Professor Newson felt that there was sufficient evidence to create a new syndrome or diagnostic description within the category of Pervasive Developmental Disorders. She named this Pathological Demand Avoidance syndrome and first brought it to public attention in 1980s. Since that time, there has been much debate between professionals as to whether this is indeed a separate condition or whether the behaviours found in PDA can be explained within other disorders such as attachment disorder or personality disorder or a female form of autism. Readers of this paper can send their thoughts and personal experiences to the author or the Editors of GAP to add to the debate.