PATHOLOGICAL DEMAND AVOIDANCE (PDA)- DEBUNKED

Have you been hearing the term Pathological Demand Avoidance, or PDA lately? There’s been a surge in the discussions about PDA and autism spectrum disorder, so we wanted to take a minute to explain things a little further and give our readers some insight on a topic they may have seen popping up in recent times.


WHAT IS PDA?

Pathological Demand Avoidance (PDA) is a diverse and often misunderstood profile that can present within the Autism Spectrum.

It can be characterised as an extreme avoidance of every day demands and expectations, usually driven by an anxiety-based need to feel a sense of control. Parents and caregivers may often see this behaviour present with refusal, distraction and avoidance of requests and day to day tasks.

As a psychologist and behaviour support practitioner I have seen firsthand the challenges and strengths that can be associated with PDA. In my personal experience, parents and care givers often benefit from understanding the underpinnings of PDA. So, let’s delve a little deeper… Within our brain is a control centre for fear (aka fight or flight), called the amygdala. The amygdala plays a pivotal role in the anxiety-driven response which we often see in PDA. When demands are placed on someone who is experiencing PDA, their amygdala can trigger a fight or flight response, leading to the extreme avoidance behaviours we observe. At the same time, their decision-making and emotional regulation part of their brain may struggle to modulate this response, which can result in a heightened need to control their environment and to reduce perceived threats.

WHAT DOES PDA LOOK LIKE?

PDA may be observed through resistance to ordinary demands, use of social strategies such as charm or excuses to outstep demands, strong emotions, intense interest in others, and creative strategies to escape or avoid tasks. Individuals with PDA may also enjoy engaging in role plays and imaginative tasks which can allow them to explore scenarios on their own terms.


SUPPORTIVE STRATEGIES FOR SUPPORTING INDIVIDUALS WITH PDA

Supporting someone with PDA requires an approach that is specific to their individual needs, respects their need for control, and gently guides them towards greater flexibility and resilience. The following strategies may be useful when supporting someone with PDA;

  • Collaborative problem solving to create solutions to challenges together can help to foster their sense of agency.

  • Encouragement of flexible thinking by presenting choices and alternatives can also make demands feel less rigid.

  • Reduction of direct demands through reframing of tasks can have positive outcomes and significantly reduce anxiety. This can be done by making suggestions or invitations instead of direct demands.

  • Predictable routines can assist with consistency and predictability in daily routines. This will also help to foster a sense of safety and control for those experiencing PDA.


Pathological Demand Avoidance highlights the diverse ways in which individuals experience and respond to our very dynamic world. By embracing an open-minded, compassionate and client-centred approach, the complexities often associated with PDA can help to provide insight into others, and expand our understanding of life through another person’s eyes.

In the words of our wonderful director Myles Cherry, “lean towards curiosity, and away from judgment.”


Pathological Demand Avoidance (PDA)- Debunked

HAYLEY ARMSTRONG

Provisional Psychologist

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