O'Nions, E;
Viding, E;
Floyd, C;
Quinlan, E;
Pidgeon, C;
Gould, J;
Happe, F;
(2018)
Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/"pathological' demand avoidance.
Child and Adolescent Mental Health
, 23
(3)
pp. 220-227.
10.1111/camh.12242.
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Abstract
Background: A subset of individuals with autism spectrum disorder (ASD) resemble descriptions of extreme/ ‘pathological’ demand avoidance, displaying obsessive avoidance of everyday demands and requests, strategic or ‘socially manipulative’ behaviour and sudden changes in mood. Investigating challenging presentations using dimensional description may prove preferable to identifying subgroups. However, there remains an imperative to explore which behavioural traits appear most problematic to inform quantitative investigation. This study provides an in-depth exploration of parent perspectives on maladaptive behaviour in children reported to have an autism spectrum diagnosis and features of extreme/‘pathological’ demand avoidance. Method: Parents completed a tailored semistructured interview about their child’s behaviour, focusing on difficulties relevant to descriptions of extreme/‘pathological’ demand avoidance. The 26 interviews rated as scoring above threshold for ‘substantial’ features of extreme/‘pathological’ demand avoidance on relevant indicators were analysed qualitatively using a general inductive approach. Results: New themes that emerged from these data included attempts by the child to control situations and others’ activities. Avoidance behaviours in this sample could be described as ‘strategic’ rather than ‘manipulative’. A range of factors, including a negative emotional response to demands, but also phobias, novelty, and uncertainty, were perceived to play a role in triggering extreme behaviour. Conclusions: These descriptions highlight the importance of systematically measuring noncompliance, attempts to control situations and others’ activities, and extreme mood variability in individuals with ASD. These dimensions represent important targets for intervention, given their considerable impact on daily life.
| Type: | Article |
|---|---|
| Title: | Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/"pathological' demand avoidance |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/camh.12242 |
| Publisher version: | http://doi.org/10.1111/camh.12242 |
| Language: | English |
| Additional information: | Copyright © 2017 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Autism spectrum disorder; extreme demand avoidance; pathological demand avoidance; noncompliance; mood variability; meltdowns |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10056124 |
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