The PDA diagnostic criteria.

This is taken from the PDA contact group webpage. A link can be found on my blog. I have edited a bit. Those of you who have visited the PDA contact group will know that  next to this on the web page is a comparison to Autistic/Asperger children

PDA CHILDREN		Katie
1. Passive Early History in first year
Often doesn’t reach, drops toys, ‘just watches’; often delayed milestones. As more is expected of him/her, child becomes ‘actively passive’, ie strongly objects to normal demands, resists. A few actively resist from the start, everything is on own terms. Parents tend to adapt so completely that they are unprepared for the extent of failure once child is subjected to ordinary group demands of nursery or school; they realise child needs ‘velvet gloves’ but don’t perceive as abnormal. Professionals too see child as puzzling but normal at first.		Katie – She resisted from the start, she was a little slower with her milestones compared to Emma. Potty training was a nightmare, she didn’t talk properly till she was about 3.
2. Continues to resist and avoid ordinary demands of life
Seems to feel under intolerable pressure from normal expectations of young children; devotes self to actively avoiding these. Demand avoidance may seem the greatest social and cognitive skill, and most obsessional preoccupation. As language develops, strategies of avoidance are essentially socially manipulative, often adapted to adult involved; they may include: Distracting adult: ‘Look out of the window!’, ‘I’ve got you a flower!’, ‘I love your necklace!’, ‘I’m going to be sick’, ‘Bollocks! – I said bollocks!’ Acknowledging demand but excusing self: ‘I’m sorry, but I can’t’, ‘I’m afraid I’ve got to do this first’, ‘I’d rather do this’, ‘I don’t have to, you can’t make me’, ‘you do it, and I’ll …….’, ‘Mummy wouldn’t like me to’. Physically incapacitating self: hides under table, curls up in corner, goes limp, dissolves in tears, drops everything, seems unable to look in direction of task (though retains eye contact), removes clothes or glasses, ‘I’m too hot’, ‘I’m too tired’, ‘It’s too late now’, ‘I’m handicapped’, ‘I’m going blind/deaf/spastic’, ‘my hands have gone flat’. Withdrawing into fantasy, doll play, animal play: talks only to doll or to inanimate objects; appeals to doll, ‘My girls won’t let me do that’, ‘My teddy doesn’t like this game’; ‘But I’m a tractor, tractors don’t have hands’; growls, bites. Reducing meaningful conversation: bombards adult with speech (or other noises, eg humming) to drown out demands; mimics purposefully; refuses to speak. (As last resort) Outbursts, screaming, hitting, kicking; best construed as panic attack.		Well Katie went from Screeching and screaming about things to the stage she is at now, Her conversation technic and distracting adults is something many politicians would admire. She can turn a conversation around and talk non stop until you have forgotten what it is that she was supposed to be doing. If you don’t listen she gets very cross. Recently she has told me “mummy your been very very very very naughty” after she misbehaved. She often pulls the “my legs don’t work” My arms are broken. routine and I’m too tired is her favourite sentence. The other day whilst visiting my step dad to give him his Birthday present, when asked to give him his present Katie placed it on the floor, got on her hands and knees crawled round the house chanting I’m a squeaky mouse eek eek eek. Then the tantrums, they are amazing. I did take to recording them but that made Katie more mad.
3. Surface sociability, but apparent lack of sense of social identity, pride or shame
At first sight normally sociable (has enough empathy to manipulate adults as shown in 2); but ambiguous (see 4) and without depth. No negotiation with other children, doesn’t identify with children as a category: the question ‘Does she know she’s a child?’ makes sense to parents, who recognise this as a major problem. Wants other children to admire, but usually shocks them by complete lack of boundaries. No sense of responsibility, not concerned with what is ‘fitting to her age’ (might pick fight with toddler). Despite social awareness, behaviour is uninhibited, eg unprovoked aggression, extreme giggling/inappropriate laughter or kicking/screaming in shop or classroom. Prefers adults but doesn’t recognise their status. Seems very naughty, but parents say ‘not naughty but confused’ and ‘it’s not that she can’t or won’t, but she can’t help won’t’ – parents at a loss, as are others. Praise, reward, reproof and punishment ineffective; behavioural approaches fail.		Katie always likes to play the teacher, She loves it when everyone will do as she tells her. She will flip when it doesn’t go her way. Ahhh the giggling and insane manic laughing. Katies favourite. At the most inappropriate of times. Adults and children are all the same to Katie. Have tried star charts sweets rewards and punishment, no go. She would spend half her life on the naughty step and still do exactly the same thing 2 minutes later. One of my favourite Katie moments was telling her NOT to touch the wall that had just been painted, we made her repeat back what we had just said. 10 seconds passed and then big Katie hand print on the wall.
4. Lability of Mood, impulsive, led by need to control
Switches from cuddling to thumping for no obvious reason; or both at once (‘I hate you’ while hugging, nipping while handholding). Very impetuous, has to follow impulse. Switching of mood may be response to perceived pressure; goes ‘over the top’ in protest or in fear reaction, or even in affection; emotions may seem like an ‘act’. Activity must be on child’s terms; can change mind in an instant if suspects someone else is exerting control. May apologise but re-offend at once, or totally deny the obvious. Teachers need great variety of strategies, not rule-based: novelty helps.		Katie is often very impulsive. She doesn’t think about what we have just said ie don’t go past the end of the road. She then walks up the road to knock on her friends door. She explained that she hadn’t gone past where we said she had gone to knock the door. Even if it was 3 times as far as we said she could go. Katie does get upset by perceived pressure. It normally can turn her into a very clingy mummy’s girl. Also when out in social situations you are much more likely to suffer a Katie Melt Down
5. Comfortable in role play and pretending
Some appear to lose touch with reality. May take over second-hand roles as a convenient ‘way of being’, ie coping strategy. Many behave to other children like the teacher (thus seem bossy); may mimic and extend styles to suit mood, or to control events or people. Parents often confused about ‘who he really is’. May take charge of assessment in role of psychologist, or using puppets, which helps co-operation; may adopt style of baby, or of video character. Role play of ‘good person’ may help in school, but may divert attention from underachievement. Enjoys dolls/toy animals/domestic play. Copes with normal conventions of shared pretending. Indirect instruction helps.		As mentioned before We have Katie the dog, Katie the cat, Katie the squeaky mouse eekk eeek, Katie the one legged flamingo (which is a new one) Katie snake, Also Katie talks in code for example, If my teddy shakes like this its Yes ? I spend my life waiting to hear if its yes or no. Also if I knock twice its yes, or it begins with y.
6. Language delay, seems result of passivity
Good degree of catch-up, often sudden. Pragmatics not deeply disordered, good eye-contact (sometimes over-strong); social timing fair except when interrupted by avoidance; facial expression usually normal or over-vivacious. However, speech content usually odd or bizarre, even discounting demand-avoidant speech. Social mimicry more common than video mimicry; brief echoing in some. Repetitive questions used for distraction, but may signal panic.		3 years old when she started talking then BAM she was off. We do have odd noises and when you ask her a question she will find a hundred different questions to ask about it, for example – Katie pick up that bit of paper, Katie – which bit of paper? Me – that one there the only bit there is. Katie – The yellow one? Me – Yes . Katie – what this one? Me – yes. Katie – that one by the door? Me – Yes (She is still looking at it ) – Katie – you want me to pick this one up. That is it Snap goes my sense of humour YES that one. It would of been easier and quicker to do it myself.
7. Obsessive behaviour
Much or most of the behaviour described is carried out in an obsessive way, especially demand avoidance: as a result, most children show very low level achievement in school because motivation to avoid demands is so sustained, and because the child knows no boundaries to avoidance. Other obsessions tend to be social, ie to do with people and their characteristics; some obsessionally blame or harass people they don’t like, or are overpowering in their liking for certain people; children may target other individual children.		Katie tends to swamp people with love. The only thing at school I have heard her say is – That is XX he is really naughty he does this and that and this. This was while we were stood next to him and his mother at the school gate.
8. Neurological Involvement
Soft neurological signs are seen in the form of clumsiness and physical awkwardness; crawling late or absent in more than half. Some have absences, fits or episodic dyscontrol. Not enough hard evidence as yet.		ERM