What is Pathological Demand Avoidance (PDA)?
What is PDA?
Pathological Demand Avoidance is not an official diagnosis, but is widely recognized within the Autistic community as a profile of Autism. Alternatively, some researchers argue (e.g., Woods, 2019) that PDA is a profile that could be seen within other neurotypes such as ADHD. Some folx prefer to use the term Persistent Drive for Autonomy, which uses the same acronym but whose language is less pathologizing. All this being said, it is important to note that some neurodivergent individuals may exhibit traits associated with PDA but it's crucial not to pathologize them or label them based solely on these traits.
So, what does a PDA profile look like? PDA is often characterized by an intense need to resist and avoid demands or requests made by others. Folx with a PDA profile are “thought to have higher social fluency, engage in role play, and utilize socially strategic manipulative behavior” (White, et al., 2022). In regard to what is referred to as “socially strategic manipulative behavior,” this could mean things like distraction or targeted shocking behavior. This behavior can present differently in different folx. Also, it is important to note here that the word “manipulative” typically carries a negative connotation. In regard to PDA, the use of this term is not meant to be pathologizing but instead descriptive of the ways that folx with PDA profile may engage in certain behaviors to get their needs met. The intention behind these behaviors is not meant to be manipulative but may come across to others in this way. Of course, these behaviors can create obstacles for PDA-ers and their loved ones alike, but again the use of the term manipulative is not meant to be pathologizing.
More specifically, PDA characteristics include, but are not limited to, the following:
(Adapted from Eaton & Banting, 2012)
Desire to do everything on one’s own terms.
Avoidance strategies which can appear to be socially manipulative.
Major outbursts if frustration escalates.
Superficially sociable but apparent lack of social identity.
Lability of mood, typically led by need to control situations.
May copy others’ behavior as a coping/avoidance strategy.
May target people obsessionally.
May have “soft” neurological signs such as clumsiness/awkwardness.
May have sensory integration difficulties.
Understanding PDA in the Context of Autism
Now that we have covered some of the descriptors of PDA, let’s discuss how we can understand PDA in the context of Autism. Here are some important considerations when thinking of PDA in the context of Autism:
Individual Differences: Every Autistic person is unique, and their experiences with PDA will differ. It's essential not to make sweeping generalizations but instead focus on understanding the specific needs and preferences of each individual.
Communication Challenges: Autistic individuals may have difficulty expressing their feelings and needs verbally. PDA-related behaviors may serve as a form of communication, indicating discomfort or anxiety in response to demands.
Sensory Sensitivities: Sensory sensitivities are common in Autism, and they can play a significant role in PDA behaviors. For example, a demand might trigger sensory overload, leading to avoidance.
Anxiety and Emotional Regulation: Anxiety often coexists with Autism. PDA behaviors may be a coping mechanism to manage overwhelming emotions or anxiety triggered by demands.
Supportive Strategies
Why is it important to understand PDA? Well, PDA-ers often need to utilize creative strategies to get their needs met. This is crucial for loved ones and professionals alike to understand when interacting with folx with a PDA profile.
Instead of pathologizing PDA, let's focus on some supportive strategies that can benefit both Autistic individuals and their loved ones:
Communication: Encourage open and non-judgmental communication. Create an environment where the individual feels safe expressing their needs and concerns.
Sensory Considerations: Be mindful of sensory sensitivities and provide sensory-friendly spaces or tools to help regulate sensory experiences.
Flexibility: Recognize that demands can be sources of stress. Offer flexibility and negotiate when possible to reduce anxiety.
Wrapping up
In conclusion, understanding PDA within the context of Autism is essential for promoting acceptance and support. Instead of pathologizing neurodivergent individuals, let's adopt a more compassionate approach that focuses on individual needs and experiences. By doing so, we can create a more inclusive and empathetic society for all.
Remember, every Autistic individual is unique, and our goal should be to celebrate their strengths and support their challenges without judgment or pathologization.
References
Eaton, J. and Banting, R. (2012), "Adult diagnosis of pathological demand avoidance – subsequent care planning", Journal of Learning Disabilities and Offending Behaviour, Vol. 3 No. 3, pp. 150-157. https://doi.org/10.1108/20420921211305891
White, R., Livingston, L. A., Taylor, E. C., Close, S. A. D., Shah, P., & Callan, M. J. (2023). Understanding the Contributions of Trait Autism and Anxiety to Extreme Demand Avoidance in the Adult General Population. Journal of autism and developmental disorders, 53(7), 2680–2688. https://doi.org/10.1007/s10803-022-05469-3
Woods, R. (2019). Demand avoidance phenomena: Circularity, integrity and validity-a commentary on the 2018 National Autistic Society PDA Conference. Good Autism Practice, 20(2)