Pathological demand avoidance in a population-based cohort of children with epilepsy: four case studies

Reilly, C., Atkinson, P., Menlove, L., Gillberg, C. , O’Nions, E., Happé, F. and Neville, B. G.R. (2014) Pathological demand avoidance in a population-based cohort of children with epilepsy: four case studies. Research in Developmental Disabilities, 35(12), pp. 3236-3244. (doi: 10.1016/j.ridd.2014.08.005) (PMID:25178706)

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Abstract

Childhood epilepsy is associated with a range of neurobehavioural comorbidities including Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), motor impairments and emotional problems. These difficulties frequently have a greater impact on quality of life than seizures. Pathological Demand Avoidance (PDA) is a term increasingly in use in the UK and Europe to describe behaviours associated with an extreme resistance to demands and requests and the need to be in control in social interactions. In a population-based group of 85 children with epilepsy, four (5%) were identified as displaying significant symptoms of PDA, were assessed using the Extreme Demand Avoidance Questionnaire (EDA-Q) and are described in detail. As well as significant symptoms of PDA, the four children met criteria for a range of neurobehavioural disorders; all four had cognitive impairment (IQ < 85) and met DSM-IV-TR criteria for ADHD. Three, in addition, met criteria for ASD and Developmental Coordination Disorder (DCD) and two for Oppositional Defiant Disorder (ODD). All four experienced their first seizure before 5 years of age. School and parent reports indicated very significant functional impairment and management concerns, particularly with respect to complying with everyday demands. Symptoms of PDA should be considered when evaluating neurobehavioural comorbidity in childhood epilepsy.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gillberg, Professor Christopher
Authors: Reilly, C., Atkinson, P., Menlove, L., Gillberg, C., O’Nions, E., Happé, F., and Neville, B. G.R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Research in Developmental Disabilities
Publisher:Elsevier
ISSN:0891-4222
ISSN (Online):1873-3379
Published Online:30 August 2014

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