Deconstructing Pathological Demand Avoidance and Oppositional Defiant Disorder

This month, we are going to discuss Pathological demand avoidance (PDA) and Oppositional defiant disorder (ODD). Both are becoming more recognised in society and educational settings and can be tricky disorders to navigate. We are now seeing many schools come forward in search for staff who have an understanding of both disorders. At Five Education we support many children who have increasingly complex profiles. Identifying and working alongside children with PDA and ODD can be challenging and requires skill and careful observations. I hope this blog helps you identify the difference between both disorders and equips you with new strategies and skills.  

What is PDA?

Pathological demand avoidance can link with children who are on the Autistic spectrum. It can be perceived as a complex pattern of behaviour where a child will experience feelings of anxiety around everyday demands and tasks set by others. Sometimes very ordinary expectations like being asked to put shoes on can cause extreme reactions. The anxiety stems from the child having feelings of uncertainty and intolerance to new requirements and expectations. Children with PDA usually have a strong desire to be in control and struggle with authority, relationships and boundaries.

What is ODD?

Oppositional Defiant Disorder is a behavioural disorder and is defined by continuous patterns of irritable, angry behaviour and responses towards authority. Although ODD has some similar characteristics of PDA, the main difference is that it’s less about anxiety of the unknown, but more about consistently having oppositional behaviours. ODD is also not normally linked to Autism and can be seen in children who have an SEMH profile, (social, emotional and mental health needs).

Signs of PDA in children:

• Becoming anxious when normal routine is changed
• Very specific attachments to only certain adults
• Highly emotional reactions to certain demands/ expectations
• Using refusal and distraction techniques when asked to do something
• Needing to control interactions, routines and types of play
• Having good intellectual skills, but struggling to build friendships and more emotional connections
• Escaping into a fantasy world and pretending to be a different character to avoid a task

Signs of ODD in children:

• Lots of arguing with adults or authority figures
• Deliberate attempts to upset other people
• Frequent patterns of anger and irritability
• Being defiant and ignoring instructions or requests from authority figures
• Blaming other people for their own mistakes
• Social problems because of the inability to co operate or stick to rules

As you can see, both PDA and ODD have similarities on the surface, but are quite different when you unpick the characteristics of each. Both disorders are resistant to authority, instructions and demands but require different strategies and approaches. PDA is more typically associated with children on the Autism spectrum and stems from high anxiety and the fear of expectations and everyday activities. In contrast ODD is characterised by strong minded and persistent angry/defiant behaviour towards authority figures. Below are some targeted strategies that can help support children with PDA and ODD.

Classroom strategies for children with PDA

• Create a calm and low anxiety environment
• Reduce demands and instructions by using in-direct language such as “Perhaps we could” or “I wonder if” Instead of saying “You need to do this”
• Give a child choices instead of a direct instruction
• Try to incorporate the child’s interest into their learning
• Use a calm and open-ended tone of voice
• Try to be use predictable behaviour
• Give the child lots of warnings before transitions
• Think about emotional regulation strategies to reduce anxieties such as: having a quiet area for the child, sensory activities and movement breaks

Classroom strategies for children with ODD

• Really work on building positive relationships with the child
• Try not to be reactive to any angry or aggressive behaviour from the child
• Think about emotional regulation strategies to reduce anxieties such as:  having a quiet area for the child, sensory activities and movement breaks
• Try to avoid power struggles with the child and avoid emotional responses to the defiance
• Give the child lots of warnings before transitions
• Validate the child’s feelings if they’re upset

Working with children who have PDA and ODD requires patience, practised skills and strategies. Children with these disorders can be complex and it takes time and practice to build relationships and successful and effective routines for them. Remember to validate feelings for children with PDA and ODD, as it helps them feel heard and understood. This will also help reduce defiance and anxiety as you progress with supporting them. Try to be consistent with the techniques and strategies you use. Consistency and patience are key when working with children with PDA and ODD.

Support for Educators and Caregivers

We understand that supporting children with SEND has its challenges and can, at times, take a toll on your well-being. If you are struggling in a particular placement and need some support and advice, we are always here to help you. Please reach out to Karla Tondel at Five Education and arrange weekly check-ins for advice, support, and guidance to help you with your work and provide you with a safe space to talk. Please call 07978983657 or email karla@fiveeducation.co.uk to schedule a chat. If you're looking for a role in September supporting children with SEND you can take a look at our website or jobs page. We will support you every step of the way during your time with Five Education.