Last updated at 11:03 PM on 17th December 2011
All parents will be familiar with the frustration of trying to pacify a disobedient toddler from time to time.
However, doctors have discovered some children have a condition which means they are unable to cope with any sort of demand.
Little is know about Pathological Demand Avoidance Syndrome (PDA) at present, but experts believe the reported numbers of sufferers is just the tip of the iceberg, in a report by The Times.
Have a naughty toddler? It may not be their fault as they may suffer from PDA
‘There are so many children out there with PDA who are not getting the right help,’ says psychologist Phil Christie, Director of Children’s Services at the Elizabeth Newson Centre, where the condition was first defined.
‘It is severely under-diagnosed. We know that around one in 100 children is on the autistic spectrum, but we don’t know yet how many of them have PDA. It is a small but significant proportion.’
What might be considered plain naughtiness by most parents, children with PDA essentially have an in-built need to be in control and to avoid other people’s demands and expectations, which raises their anxiety levels to an extreme extent.
Putting a child on the naughty step when they misbehave might not help if they are suffering from PDA
Christie’s colleagues noted the striking similarity between a growing number of children deemed to have ‘atypical autism’.
They all shared an unusual resistance to everyday demands, even when related to things they would enjoy.
The children were superficially sociable but were often manipulative and lacked awareness of unwritten social rules. Their moods could switch very suddenly and they often confused reality with fantasy.
Some demand avoidance is part of normal development in young children. But PDA is marked by the degree of the behaviour, and whether it continues beyond toddler years.
For most children the demand avoidance phase will pass, or can be greatly improved through strategies such as rewards or sanctions, reasoning, praise for good behaviour, peer pressure and routine.
But these techniques do not work for children with PDA. Instead parents need to reduce anxiety by avoiding or disguising demands.
A major conference on PDA, run by the National Autistic Society, was held recently and a book on the condition, written by Christie and other parents of children with PDA, was published this autumn.