PDA Pathological Demand Avoidance

PDA Pathological Demand Avoidance according to the National Autistic Society is now considered part of the Autism Spectrum.  PDA Pathological Demand Avoidance

Caroline Ward Goldsmith

PDA Pathological Demand Avoidance is now considered to be part of the autism spectrum. Individuals with PDA share difficulties with others on the autism spectrum in social aspects of interaction, communication and imagination. However, the central difficulty for people with PDA is the way they are driven to avoid demands and expectations. This is because they have an anxiety based need to be in control.

People with PDA seem to have a better social understanding and communication skills than others on the spectrum and are able to use this to their advantage.

The main features of PDA Pathological Demand Avoidance are:

  • resists and avoids the ordinary demands of life
  • appearing sociable, but lacking depth in understanding
  • excessive mood swings and impulsivity
  • comfortable in role play and pretend, sometimes to an extreme extent
  • language delay, often with good degree of catch-up
  • obsessive behaviour, often focussed on people.

As the term spectrum suggests, individuals are affected in different ways and to varying degrees.

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Often in cases of PDA there will have been a passive early history, but this is not always the case. It is believed that there may be neurological involvement in some cases, with a higher than usual incidence of clumsiness and other soft neurological signs.

Other children and young people on the autism spectrum can display one or more of the features of PDA. When many occur together it is helpful to use the PDA diagnosis, as the strategies and interventions that help a person with PDA differ to those that benefit others on the autism spectrum.

People with PDA can be controlling and dominating, especially when they feel anxious. However, they can be enigmatic and charming when they feel secure and in control. Many parents describe their child with PDA as a ‘Jekyll and Hyde’ character. It is important to acknowledge that these children have a hidden disability. Many parents of children with PDA feel that they have been wrongly accused of poor parenting through lack of understanding about the condition. These parents will need a lot of support, as their children can often present severe behavioural challenges.

People with PDA are likely to need a lot of support into their adult life. Limited evidence so far suggests that the earlier the diagnosis and the better support that they have, the more able and independent they are likely to become.

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