The Drivers of PDA Anxiety in Children: A Naturopath’s Perspective
What are the major drivers of anxiety in children with PDA? This is the question I aim to answer, but first I’ll discuss what PDA is and my family’s experience with PDA.
What is PDA?
I am a Mum of a 9-year-old autistic boy who has the PDA profile. PDA stands for “Pathological Demand Avoidance”, however, many parents (including myself) prefer to say “Persistent Drive for Autonomy”.
In Australia, PDA comes under an ASD diagnosis recognised by paediatricians/psychologists and, therefore, is not a separate diagnosis. This makes PDA a little more difficult to analyse in population groups with only minimal studies on PDA to date.
Locally, there are OTs, psychologists and other children’s healthcare professionals trained in this area, however, PDA is only recently recognised in Australia and it can still be challenging to find adequate professional support.
Personal PDA Journey
On a personal level, at three years of age, my son was diagnosed with autism. His traits and health history differed slightly from many autistic children and I found some of the strategies that worked with other autistic families did not work for us.
PDA Traits in Children
Here are some of the traits that children with PDA are more likely to have compared to other autistic children:
High levels of anxiety (common in autism but the levels are generally higher in PDA)
The need to be in control and to control other people
There is an extreme avoidance of everyday tasks in life (such as going to bed or doing their homework)
Developmentally appropriate (or even advanced) communication skills
Developmentally appropriate emotional expression and facial expression
May appear to have age-appropriate social skills but when you look a little closer you see there are challenges
Enjoyment of imaginative play and make believe
Children with PDA in School
Many children with PDA struggle with school due to the rigid structure and the demands placed on children. In fact, many “school can’t” children have PDA.
Children with PDA generally need to be treated as equals and they struggle particularly where there is an authoritarian environment. This may explain why the PDA society (UK) state that 70% of children with PDA do not attend or have frequent absences from school.
PDA Parenting
Many parents of children with PDA express an exhaustion due to all these power struggles at home. There are many articles written about how to parent children with PDA and reducing those demands is paramount to supporting their nervous system and preventing triggers. However, this topic is covered at length in many articles and websites, so I will move on to the drivers of PDA behaviour.
Drivers of PDA Behaviour
Children with PDA have a high need for control in an environment to avoid triggering their anxiety. As a Mum of a child with PDA and, having treated a number of children with PDA in my clinic, I find there are two major drivers of this anxiety: histamine dysregulation and pyroluria.
It is well known that both of these issues cause anxiety and both are common in neurodivergent children.
Histamine dysregulation and pyroluria are not root causes of PDA, however, understanding which one (or both) is the major driver of your child’s PDA behaviour will determine how to lower your child’s anxiety (and associated symptoms/behaviour).
It’s also important to remember that some children have a combination of the two and hence, both drivers need to be addressed.
Histamine Dysregulation
Children with histamine dysregulation may show the typical signs of histamine issues such as runny eyes, sneezing, runny noses. However, there are lesser-known symptoms. Children with histamine dysregulation may have a history of food reactions, gut issues, sore throats/throat infections, ear infections, sinusitis, eczema and/or asthma.
The one behavioural trait I commonly see in children with PDA (where they have histamine dysregulation) is anger or extremely aggressive behaviour when triggered.
Quite often this is the most obvious sign a child has a significant histamine imbalance that needs to be addressed to lower their anxiety.
Histamine dysregulation may be the result of MCAS, allergies, food sensitivities/reactions, environmental sensitivities and/or histamine intolerance.
Finding the root cause is then a priority in treating their histamine dysregulation.
Pyroluria
Children with pyroluria are often sensitive children and may present with chronic constipation or encopresis, extreme picky eating, sleep issues and/or extreme moodiness. Children with PDA and pyroluria may also anger easily but the intensity is lower than with histamine dysregulation.
You can learn more about pyroluria in my article: Could Your Anxiety be Caused by Pyroluria.
Tip: It is common to have difficulties getting children with PDA to take their supplements (control issues). You may need to move from powders in liquid to capsules for children who are old enough to swallow them. The lack of taste can improve compliance.
Treating the histamine imbalance and/or pyroluria can result in dramatic improvements in children’s anxiety and associated behaviour and other symptoms.
I hope by sharing my professional and personal experience with everyone, other parents of children with PDA will see significant improvements in their children’s behaviour/symptoms also.
I now include children with PDA as part of my area of specialty. If you need individualised advice, book in with me by clicking on the “book now” link below.