According to Autism UK, Pathological Demand Avoidance syndrome (PDA) is a profile that describes children and adults whose main characteristic is to avoid everyday demands and expectations to an extreme exten. 

Many parents and teachers find that some of the recommended strategies used with autistic children are not effective for a child with a PDA profile. So here are some tips specifically for children with PDA to help with toileting.

Children with PDA find certain situations, such as toileting, extremely stressful and will often do whatever they can to avoid them. Behaviours may include hiding under tables or in cupboards, going limp, crying, verbal withdrawal, and hitting, kicking and screaming.

Compliance difficulties may arise because your child simply doesn’t understand what to do, or the task is too complicated. Or perhaps in a world where adults control everything like how and when to pee is something a child can control.

To avoid your toilet becoming a battleground:

• Try to ignore negative behaviours and see them as signs of distress. Respond calmly and matter-of-factly. Even better, with humour!
• Break the toileting process into more manageable steps your child.
• Choose your battles – don’t sweat the small stuff.
• Don’t demand compliance – be prepared to negotiate.
• Provide options – being able to choose between one activity or item empowers children and reduces their anxiety.
• Be creative, and flexible in your approach – use role play and bring your child’s favourite toys into the mix. Keep it fun.
• If your child is very anxious, let them withdraw to a safe place until they’re calmer. 

Often children with PDA learn to be more compliant at school – don’t take it personally, this more likely indicates they can express their anxiety where they feel safe and secure - at home.

Top tips to remember:

• Your child may take longer to master the toileting process – so be patient and positive and don’t try to rush it.
• Never force your child to go to the toilet – physically or verbally.
• Even if you are feeling frustrated, don’t let your child know. Remember, they are doing their best.
• Focus on one stage at a time and be enthusiastic about the process - celebrate flushing a poo down the toilet, for example.
• Make sure your child has everything they need to feel comfortable and happy sitting on the toilet. 

For more books on getting your child toilet-trained, contact the IHC Library on 0800 442 442, or email: librarian@ihc.org.nz.