Understanding Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance, often referred to as PDA, is used to describe a profile of autism spectrum disorder (ASD). It was first described by psychologist Elizabeth Newson in the 1980s, and it is characterised by a specific set of behavioural traits that are separate from ASD, however, people with PDA generally meet the diagnostic criteria by having difficulties in social interaction and communication.

Key Characteristics:

1. Resistance to Demands Individuals with PDA typically exhibit an extreme and pervasive resistance to everyday demands and requests, including things they enjoy. These demands may include tasks, activities, or social expectations, and the resistance goes beyond what is considered typical for individuals with autism.
   

2. Overwhelming Need to be in Control The loss of autonomy is perceived as a threat that activates the fight-flight or freeze response in individuals with PDA. Individuals may feel overwhelmed or anxious when faced with outsider expectations, leading them to resist or find ways to avoid the demands placed upon them.
   

3. Use of ‘Masking’ in Social Interactions While individuals with PDA can appear socially motivated and enjoy interaction, those with PDA may excel at 'masking' difficulties, especially with specific people or in certain situations. For instance, they might employ various tactics like distraction, making excuses, outright refusal, or engaging in role-playing to avoid demands. Children with PDA may find it challenging to establish their position within the social hierarchy, insisting on being treated as adults and often disregarding the traditional role of parents as authority figures.
   

4. Excessive Mood Swings and Impulsivity Individuals with PDA experience extreme emotional reactions. Their responses are outward representations of the brain and body's instinctual response to physiological stress.
   

5. Obsessive Behaviour Individuals with PDA frequently display 'obsessive' tendencies, often directed towards other people, accompanied by the development of intense and focused interests. Obsessive behaviour can extend to 'social' or 'performance-based' demands, driven by acute anxiety or a compelling desire to assert independence and avoid dependency.

Management and Support:

1. Recognizing PDA While PDA is predominantly recognised in the UK, it is not yet formally recognised in Australia. Therefore, individuals with PDA often encounter misunderstanding and misdiagnosis. PDA has the ability to mask or influence the manifestation of autistic traits, creating confusion and making it challenging to identify autism accurately. Moreover, PDA frequently goes unnoticed and is commonly misdiagnosed as behavioural disorders such as Oppositional Defiant Disorder (ODD) and conduct disorder.
   

2. Build Trust Creating environments that minimize demands and provide flexibility can be beneficial. It is essential for children to experience a sense of safety and security in their surroundings, encountering consistent responses that foster trust in their caregivers. Actively being present and practising attentive listening can further cultivate a sense of trust and connectedness.
   

3. Depersonalise Requests To enhance communication with individuals with PDA, particularly children, avoid the use of direct demand words such as "need," "must," or "now." Instead, employ indirect requests framed as questions or exploratory statements. For instance, phrases like "Is it okay if we...," "How do you feel about...," or "I wonder if we can..." create a more collaborative and engaging tone. Using written requests, visual prompts, or attributing requests to factors like health and safety can further depersonalise demands. Introducing puppets or toys as 'third persons' in communication can also provide a playful and non-threatening way to suggest ideas and foster cooperation.

PDA is a unique profile within the autism spectrum. By recognizing the distinctive characteristics and providing appropriate support, individuals with PDA can navigate daily life more successfully, contributing to their overall well-being and quality of life.

Contact us at (03) 5996 6006, admin@dyslexability.com.au or www.dyslexability.com.au to see how DyslexAbility can best support you and your family.

From The ACT Group. Source: https://theactgroup.com.au/pathological-demand-avoidance/

From Neurodivergent Insights. Source: https://neurodivergentinsights.com/autism-infographics/autism-pda-explained