{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:26:27Z","timestamp":1768415187586,"version":"3.49.0"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Adoles Ment Health"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>\n                    Pathological demand avoidance (\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    ), a term first used by Elizabeth Newson in the 1980s, refers to a collection of behaviours that children will demonstrate to avoid instructions (and tasks) that they perceive as demands. These children are postulated to be averse to anything that is perceived as a demand placed on them.\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    features are commonly encountered in children with autism but\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    is not a subtype of autism nor a separately diagnosed mental, behavioural or developmental disorder in any of the major classification systems (\n                    <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\n                    \u201010 or\n                    <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\n                    \u20105). Such behaviours are not confined to children with autism and debate continues regarding its existence as a distinct phenomenon and if such a phenotype exists whether it is merely a part of autism or a separate condition. We comment on O'Nions and colleagues\u2019 study that explores common themes\/behavioural traits in children with autism spectrum disorder (\n                    <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content>\n                    ) who also fit the phenotypic description of\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    . We explore how the current classification systems capture features of\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    in autism with diagnoses of common comorbidities in\n                    <jats:styled-content style=\"fixed-case\">ASD<\/jats:styled-content>\n                    (such as disruptive behaviour\/conduct disorders,\n                    <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                    and anxiety), but to many clinicians and parents this seems an inadequate description. What remains to be explored are the trans\u2010diagnostic temperamental and cognitive traits of children with\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    features, such as cognitive rigidity and intolerance of uncertainty. It is important to understand why some children are demand avoidant and identification of these factors (individual and systemic) helps in management much more than classifying them with an additional label. O'Nions et\u00a0al. have helpfully provided further insight into several underpinning traits\/dimensions of children with\n                    <jats:styled-content style=\"fixed-case\">PDA<\/jats:styled-content>\n                    features; understanding these will help develop effective strategies for parenting demand\u2010avoidant children.\n                  <\/jats:p>","DOI":"10.1111\/camh.12273","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T14:59:25Z","timestamp":1539788365000},"page":"387-388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Commentary:\n                    <scp>PDA<\/scp>\n                    \u2010 what's in a name? Dimensions of difficulty in children reported to have an\n                    <scp>ASD<\/scp>\n                    and features of extreme\/pathological demand avoidance: a commentary on O'Nions et\u00a0al. (2017)"],"prefix":"10.1111","volume":"23","author":[{"given":"Osman","family":"Malik","sequence":"first","affiliation":[{"name":"Department of Children's Neuroscience King's Health Partners Academic Health Science Centre Evelina London\/St. Thomas\u2019 Hospital London UK"},{"name":"Children's Psychological Medicine at St. Thomas' Hospital South London and Maudsley NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Baird","sequence":"additional","affiliation":[{"name":"Department of Children's Neuroscience King's Health Partners Academic Health Science Centre Evelina London\/St. Thomas\u2019 Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,17]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-014-0647-3"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:JADD.0000022613.41399.14"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-013-9778-0"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.7.595"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-015-0740-2"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12242"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361313481861"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e318179964f"}],"container-title":["Child and Adolescent Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcamh.12273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/camh.12273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T12:42:01Z","timestamp":1761741721000},"score":1,"resource":{"primary":{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/10.1111\/camh.12273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,17]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/camh.12273"],"URL":"https:\/\/doi.org\/10.1111\/camh.12273","archive":["Portico"],"relation":{},"ISSN":["1475-357X","1475-3588"],"issn-type":[{"value":"1475-357X","type":"print"},{"value":"1475-3588","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,17]]},"assertion":[{"value":"2018-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}