Pathological demand avoidance: hype or hard graft?

Dr Jenny Curran1, Julie Hibell2, Michelle Miller2, Micheline Clark2, Kerry Rye1

1Health Education Interface, South Australia, Australia, 2Ascot Park Primary School, Ascot Park, Australia

Pathological Demand Avoidance or PDA is a recent addition to the discussion of Autism Spectrum Conditions. It describes a constellation of behaviours in a person living with autism that include refusal to follow direction and defiance when requested to do something to the point that there is extreme difficulty for the person in tolerating everyday demands. Children with PDA often also display impulsivity, severe anxiety and obsessive behaviour and socially “manipulative” responses, leaving the parents and teachers exhausted, frustrated and overwhelmed (Christie, 2012). Many such children are excluded from school. This Symposium aims to introduce the audience to PDA, then to present a successful approach to re-engagement in education which has been developed in one South Australian Primary School using a case example. The Symposium will end with a description of the Health Education Interface (HEI) Service and its role in supporting the educators in responding this most challenging of educational profiles.

Introduction to the new label of PDA, where it fits with in the many co-existing behaviour and mental health co-morbidities occurring for young people living with autism spectrum conditions
Dr Jenny Curran, Intellectual Disability Psychiatrist HEI

Description of the specific program they have developed and the outcome so far
Michelle Miller, Julie Hibell, Micheline Clark, Ascot Park Primary School

Description of a new service, the Health Education Interface (HEI) service
Kerry Rye, Nurse Consultant HEI


Dr Jenny Curran is a Senior Consultant Psychiatrist in Developmental Disability Psychiatry. Jenny comes from England where she did her medical training. Her psychiatry training was at St Georges Hospital in London in the late 80s to the early 90s. In 1996 Jenny migrated to Australia with her family Jenny has a specialist training in the mental health care of people with intellectual disability and  a strong interest in autism. She is passionate about working together in partnership with the client, their family and other professionals to achieve positive and meaningful outcomes for the people who seek her help.

Michelle Miller is a Special Education and Health teacher at Ascot Park Primary School. She has qualifications in JP/P Teaching and Special Education. Since 1999 she has taught in regional SA, the NT, Sydney, Regional NSW and the SA School for Vision Impaired. Michelle is an innovative educator who loves building positive relationships with her students. In 2016 Michelle began working to re-engage a student whose complex special needs profile included vision impairment, ASD and Pathological Demand Avoidance (PDA). Michelle has since helped to implement a successful educational program for a student with PDA at Ascot Park Primary School.

Kerry Rye is a Registered Nurse with a Graduate Diploma in Mental Health Nursing.  Kerry has worked in the area of Intellectual Disability; physical and emotional health for many years.  Her experience and training in  developmental disability has been gained by working with some very experienced colleagues in this area over the years.  Working  with both adults and children with developmental disability and their parents and care providers have  proven to be her best teachers.

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