When 11-year-old Milly and her mum Jenny arrived at the school principal’s office, Jenny’s heart sank.

There were more people there this time than usual — and she knew this would be a problem for her daughter.

They were there for Milly’s re-entry into school after yet another suspension.

And it didn’t take long.

Within half an hour, Jenny had sustained punches, the office was trashed, and the police were on the way.

Milly stood, amid the chaos, on the principal’s desk.

Jenny would later discover she was dealing with Pathological Demand Avoidance (PDA).

PDA is described as an atypical profile of autism.

It’s defined in the Australian government’s National Autism Strategy, released earlier this year, as:

“An extreme need for control and autonomy driven by high levels of anxiety or an automatic nervous system threat response, which results in demand avoidance, emotional regulation difficulties and a heightened reaction to stress”.

Put simply, it means that asking, requiring or expecting a person with PDA to do something is likely to trigger resistance.

For children, it can affect everything from cleaning teeth to attending school.

‘She’d be throwing chairs or kicking teachers’

When Milly was two, her paediatrician told Jenny her daughter “danced to a different tune”.

In the ensuing years, Milly was diagnosed with sensory processing disorder, anxiety, selective mutism and, eventually, autism.

But none of these diagnoses fully explained Milly’s complex presentation.

“She masked in the school environment probably until about year five,” Jenny said.

But she couldn’t keep it up.

“I guess it started with a lot of hiding under the desk, hiding in the toilet,” Jenny said.

“But it ended up with a lot of aggression.

“She’d be throwing chairs or kicking teachers.”

Milly began running onto the road and was routinely suspended from school.

“They told me every parent in her class had complained.”

Traditional parenting strategies don’t work, psychologist says

Clinical psychologist Theresa Kidd and her staff support children with a PDA profile at clinics in Perth and Melbourne.

She said typical parent and teacher strategies — rules, consequences, even praise — often backfired, leading to “meltdowns, shutdowns and prolonged conflict”.

“Especially when schools or professionals view the child’s behaviour as simply defiant or oppositional.”

Dr Kidd said if children with PDA weren’t identified and supported appropriately, they had a greater chance of experiencing anxiety, depression and social exclusion.

“One child who went undiagnosed for years was repeatedly labelled as difficult and defiant,” Dr Kidd said, “leading to escalating conflict at school and at home, as well as a significant decline in mental health”.

Which brings us back to Milly.

Jenny isn’t sure when she realised life at home couldn’t continue in the way it had been.

While dysregulation at school was a newer problem, explosive and prolonged meltdowns had been happening at home for years, leaving Milly’s siblings fearful and anxious.

Jenny said the final tipping point might have been when Milly’s brother, who she describes as kind and passive, physically attacked his sister in a bid to stop a loud and violent meltdown that had lasted hours.

Or, it might have been when Milly, clutching a knife and cornered by police on the verandah at home, charged at one of the officers.

Then there were the countless times Milly ran onto the street, leaving Jenny with the impossible choice of abandoning her other children to chase Milly — or letting her go.

Eventually, Jenny followed professional advice and relinquished her daughter’s care.

Months later, a psychiatrist diagnosed Milly with PDA.

First Australian PDA conference to be held in November

This year, Perth Stadium will host the inaugural PDA Conference Australia, to be opened by WA’s Chief Psychiatrist, Dr Nathan Gibson.

Organiser Heidi Brandis said she stumbled across PDA after nine years of “floundering and overwhelm” when it came to finding support for her eldest child.

She travelled to the UK, which has long recognised the PDA profile of autism, to learn more about it.

Three years ago, she set up the PDA Perth WA Parent Community and Support Page. It now has nearly 3,000 members.

Ms Brandis said the past few years had seen a groundswell of interest in PDA in Australia.

“I emailed a couple of dozen people around the country announcing the conference and inviting them to speak,” she said.

“Our committee has worked absolutely flat out to deliver an engaging, informative and neuro-affirming event for hundreds of neurodivergent and neurotypical families and professionals.”

More than 650 tickets have sold, with only a handful left for professionals. There’s also the opportunity to buy digital passes.

Speakers include those with lived experience of PDA, teachers, researchers and medical specialists.

Dr Kidd is one of them.

She said, although there were common themes, children with PDA could present in a variety of ways.

“I’ve worked with children who appear articulate and capable, but shut down or panic when faced with even simple expectations no matter which setting they are in,” Dr Kidd said.

“Importantly, capacity can fluctuate — a child might manage a task one day and find it completely unmanageable the next. The common thread is that demands, even ordinary ones, can feel threatening.”

She said people with PDA often developed clever avoidance strategies, using distraction, negotiation or role play to regain control.

“For instance, a child might pretend to be a dog who ‘doesn’t have hands’ when asked to tidy up or eat dinner at the table, or spin an elaborate story to redirect adult attention.”

Dr Kidd said research and observation had highlighted distinct strengths in people with PDA, including above-average intelligence, creativity and wit.

“Our clinicians often comment on the humour our PDAers bring into the therapy room.”

Also heading to the conference in November will be Milly’s mum, Jenny.

It’s been nearly a decade since she relinquished her daughter’s care, which was only short-term.

After a couple of months in residential care, Milly had begun a gradual return home; a night a week at first, then increasing over time.

Jenny said her daughter’s diagnosis provided clarity and that becoming a PDA-affirming parent changed everything at home.

This included abandoning traditional parenting techniques such as offering rewards and being firm.

“It honestly was such a light-bulb moment,” she said.

Jenny said abandoning the “parent-child” hierarchy and knowing when to pull back was key.

“I learned to approach things in an upside-down kind of way.

“The more I wanted something to occur, the more important it was to reduce the pressure. Milly was more likely to be able to ‘do the thing’ if she knew she didn’t have to.

Jenny hopes with more awareness and professional training around PDA, other families will be spared similar trauma.