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Confronting Avoidance

January 11, 2025
A child looks at her phone
Photo by Kaboompics.com from Pexels

 

By Anatta Zarchi

 

Avoidance is a pretty typical way of responding to things you don’t want to do, not just for children, but for adults too! But much like with defiance, which I discussed in last month’s issue, there may be a point where avoidance starts to interfere with daily life. Pathological demand avoidance disorder (PDA) describes a pattern of extremely resistant behaviors. It is currently a proposed subtype of autism and is not yet classified as an official diagnosis in the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5). 

 

However, it is important to note that not all avoidant behaviors are indicative of a deeper issue. New Counseling Service (NCS)’s founder and counselor Johanna de Koning says, “Kids can also avoid things out of shame, fear of failing, or simply not wanting to do it as part of their development (rebellion or power play). Age can also play a role in this, like the ‘terrible twos’, or when children start to develop an identity separate from their parents or caregivers.” This is an issue that many parents encounter to different degrees, so let’s dive into it!

 

When avoidance occurs

Avoidance isn’t just limited to special occasions or activities; children with PDA might also avoid everyday activities such as brushing their teeth, sometimes distracting, delaying, or claiming physical injury to avoid the activity in question. Some may also start to avoid things they usually like. Active avoidance of this nature is associated with high levels of fear and anxiety, often of losing control. Actively avoidant children might feel that whatever they’re trying to avoid is a demand or expectation that scares them in some way, and therefore it is better to stay away from it completely. 

 

Some might think of these behaviors as “manipulative”. It is extremely important to not throw words and accusations like that around. This invalidates the child’s fears and could increase their anxiety, causing them to become even more avoidant. As with most issues, it’s best to try to calmly and openly understand the underlying cause of their avoidance—perhaps they don’t want to do sports because they think they’re bad at it, or perhaps they’re struggling with anxiety or PDA. 

 

Understanding the underlying cause makes it easier for you to help them work through it—if they are scared of being bad at something, it could be effective to teach them that there is nothing wrong with not being good at something. If there seems to be a deeper mental health concern, you could take your child to see a psychologist. Certain issues might take a while to overcome, but understanding the cause means that you are able to tackle it at its root and help your child learn coping methods that will last them a lifetime. 

 

Why avoidance occurs

Avoidant behavior can also be correlated with rapid mood swings and meltdowns. This is a result of the fear and anxiety they are experiencing—it’s possible they want to do something while also experiencing fear. Or it’s possible that they were trying to hide their discomfort until they could no longer contain it. Children with PDA often appear to be happy at school, only to have a meltdown the moment they get home. This can be baffling to parents. You might ask yourself, what am I doing wrong? In many cases, this is because they suppress their emotions at school and only feel able to let them out when they get home. “In a way, this tells you that your child feels safe with you,” Johanna adds. 

 

As PDA is a proposed subtype of autism, the term used for this would be “masking”—trying to suppress any neurodivergent characteristics to fit in with others, which can be exhausting. For this reason, some avoidant and/or autistic children may appear to do well socially even though they don’t feel like they actually belong. Some may also be good at imitating others’ social cues even though they feel that they lack the same social understanding.

 

How avoidance may present itself

This brings us to our next point. Children with PDA often absorb and imitate other people’s behaviors. This is often accompanied by intense special interests or hyperfixations on other people, fictional characters, certain topics, and more. This can be an escape from the things they wish to avoid. For example, a person or piece of media that they are highly interested in might be someone or something that makes them feel safe. Johanna says, “As a parent or caregiver, we must observe whether this interrupts their daily functioning or development. Children around the age of four often have an imaginative figure or friend to play with or to take the blame, and in adolescence it can be normal to have an idol or ideal person that they try to imitate.”

 

When evaluating whether your child’s avoidance may be a sign of neurodivergence or a deeper mental health issue, it is important to take into account how strongly the child exhibits those behaviors, how often, and how much it interferes with their daily functioning. You can always see a professional for an assessment or opinion; this is always helpful regardless of whether your child needs external support, or if you simply need advice. 

 

What to do

It’s important to note that autism is a form of neurodivergence, and thinking of it as something to “fix” or “cure” can be very harmful. Every child has unique traits and capabilities, and an essential part of childhood is learning how to cope with things that make you scared or uncomfortable as best you can. Coping mechanisms may not be 100% foolproof, but they can help your child learn how to process things in a way that can improve their overall mental health and happiness. If your child often displays avoidant behavior that gets in the way of important tasks, here are some things you can do for them at home: 

 

  • Create a safe environment where they can express and regulate their emotions without judgment. 
  • Avoid demanding language, for example, words like “must”, “need”, or “have”. Children are more likely to try something if they feel some sense of control, especially in cases where they fear losing control. Try wording it in a way that takes their feelings into consideration, for example, “How do you feel about this?” or “Would you like to try this?”
  • Gently explain the importance of the task they’re avoiding and why it’s good for them. For example, brushing their teeth or washing their hands. 
  • Communicate with them through toys or other objects that bring them comfort if they respond better to this when they’re feeling anxious or avoidant. 
  • Offer them options to help them feel less overwhelmed and give them some sense of control. For example, instead of, “What do you want to eat?” you could ask, “Would you like oatmeal or a sandwich?” This is especially helpful for smaller children. 

 

Lastly, I want to emphasize that being caring and gentle can go a long way in helping your child. It can be frustrating to deal with avoidance sometimes, but explosive or cold anger can be a major setback for children. For more on anger management and the healthy way to respond to your child, you can read my articles from BAMBI’s June and July–August 2024 issues.

 

Further reading 

About the Author

Anna works for New Counseling Service (NCS), the first and only licensed mental health center in the heart of Bangkok. NCS has provided counseling services in Thailand and surrounding regions for over 20 years, with therapists specializing in a wide variety of issues such as anxiety, depression, work stress, relationships, and more. 

Contact: info@ncsbkk.com; Phone: +66-2-114-7556; ncsbkk.com; FB/IG: @ncsbkk.