Pathological Demand Avoidance (PDA) is rapidly emerging in paediatric practice, with increasing numbers of children being described with this profile despite the absence of clear diagnostic criteria or established clinical guidelines. Occupational therapists are often left navigating complex presentations involving anxiety, autonomy, sensory needs and functional participation, while families and schools seek practical support. The growing visibility of PDA raises important questions about assessment and whether our current intervention approaches are evidence-informed.
This course responds to a clear need for critical understanding and clinical direction. It introduces the evolving literature, acknowledges the debates and uncertainty, and grounds the discussion in real-world OT practice. With demand rising and confidence often low, this session offers space to make sense of the topic, learn from experienced clinical insight, and engage in discussion about how best to support this complex and increasingly recognised profile.
Dr Sisikelelwe Gwanya-Mdletye is a psychiatrist, medical practitioner, and mental health advocate with a strong interdisciplinary background spanning occupational medicine, clinical epidemiology, and psychiatry. She qualified as a medical doctor in 2004 through Walter Sisulu University and has since completed postgraduate training in occupational medicine, management, clinical epidemiology, and mental health, before specialising in psychiatry and qualifying as a Fellow of the College of Psychiatrists of South Africa (FC Psych SA).
Her clinical interests were shaped by years working in industry, where she witnessed firsthand the impact of mental health on functioning, participation, and work ability. This experience informs her practical, systems-aware approach to topics such as pathological demand avoidance and neurodiversity in real-world contexts.
Now in private practice and active as a healthcare entrepreneur, she is also involved in mental health advocacy through organisations including SASOP and the Africa Global Mental Health Institute.
Beyond her professional roles, she is a wife and mother of two teenagers, and draws strength and perspective from her faith and family life. She enjoys reading, music, and cooking for loved ones — experiences that ground her work and deepen her understanding of the everyday realities faced by the families she serves.
Elize Janse van Rensburg [Occ. Ther. (UFS), M. Occ. Ther. (UFS)] is an experienced occupational therapist with a keen interest in the fields of sensory integration, peadiatric occupational therapy and neurodevelopmental conditions. Elize holds bachelor’s and master’s degrees in occupational therapy from the University of the Free State, both with distinction. She completed her sensory integration training through the South African Institute for Sensory Integration (SAISI), and has also received training in DIR Floortime and the Early Start Denver Model (ESDM), both early intervention models for autistic children.
Elize believes strongly in the power of early intervention, and a holistic, child- and family centred, strengths-based approach. Elize co-owns a private occupational therapy practice in Bloemfontein. She is a former lecturer in occupational therapy at the University of the Free State and serves on the executive board and lecturing team of SAISI. She regularly presents at conferences and has authored several peer-reviewed articles and book chapters.
At home, Elize is a wife and a mom of two beautiful children. She loves camping, good coffee, her husband’s cooking, her children’s energy and reading a good book.
