Demand Avoidance and PDA
Both children and adults with autism can experience significant levels of stress and anxiety through trying to negotiate their way in a world that does not always make sense to them. Some deal with these feelings of anxiety by seeking to impose and maintain control, and this means that they will go to increasing lengths in order to avoid demands placed upon them by others. Children and adults with this particular profile of autism are sometimes referred to as having ‘PDA’ or ‘Pathological Demand Avoidance.’
Despite this, many parents of children with a demand-avoidant profile struggle to have this recognised and acknowledged because there has been controversy over the very existence of PDA as a distinct diagnosis. Whilst it is true to say that PDA does not appear in the standard diagnostic manuals (for example, DSM-V and ICD-10), it has now been formally recognised by the NAS as a subtype of autism spectrum conditions.
For people with a profile of PDA, it cannot be assumed that ‘traditional’ strategies designed to help with autism will be effective. In fact, in our experience, some of these strategies may only serve to heighten the person’s anxiety to a point that they eventually come to react with a fundamental ‘fight or flight’ response.
We can help identify where a pattern of demand avoidance exists as part of a wider assessment for autism by profiling the person’s behaviour – and this can be identified clearly in our assessment report in the hope that it can assist those working or living with the person to develop a better understanding of their needs.