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Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance (PDA)

What is Pathological Demand Avoidance?

Pathological Demand Avoidance (PDA) is the avoidance of some of the everyday demands in life. For example, avoiding homework, a social situation, eating something in particular, doing chores or housework, or travel. The avoidance is grounded in anxiety, and therefore could be seen as an anxiety related behaviour.

Pathological Demand Avoidance (PDA) can form part of an autistic profile, or can be a standalone profile.

A PDA profile is normally held with someone with better social understanding and communication skills than some autistic people, and held by people that often mask their difficulties. It can be seen through people that:

· Resist and avoid the ordinary demands in life

· Use social strategies to avoid things such as giving excuses or the use of distraction

· Appears to be sociable but lacks some understanding of this

· Experiences excessive mood swings and impulsivity

· Appears to be comfortable with role play and pretence

· Can display obsessive behaviour that could be focussed on other people

NAS (2023)

PDA is not currently used as a diagnostic category, but it can be described as a profile that can be useful when seeking support from professionals.

PDA

What is the difference with Oppositional Defiant Disorder?

Oppositional Defiant Disorder (ODD) is a behaviour disorder often diagnosed in childhood. Children with ODD can appear to be defiant, hostile towards peers and adults in authoritative positions such as parents and teachers.

Behaviours associated with ODD are:

  • Having frequent temper tantrums

  • Arguing a lot with adults

  • Refusing to do what an adult asks

  • Always questioning rules and refusing to follow rules

  • Doing things to annoy or upset others, including adults

  • Blaming others for the child’s own misbehaviours or mistakes

  • Being easily annoyed by others

  • Often having an angry attitude

  • Speaking harshly or unkindly

  • Seeking revenge or being vindictive

As you can see, if anxiety is driving the avoidance of an activity, it could be seen in some of the above behaviours too, and at times there can be confusion with ODD and PDA.


How can someone with PDA be supported?

There are some excellent resources for parents and teachers in relation to supporting someone with a PDA profile. The PDA society discuss the PANDA approach:

P - picking battles

A – Anxiety management

N – Negotiation and collaboration

D – Disguising demands

A – Adaptation

The link to the PDA society is below.

If you work in Education, there is an excellent book by Clare Truman; The Teacher’s Introduction to Pathological Demand Avoidance; Essential Strategies for the Classroom. There is very detailed advice and guidance on supporting pupils with a PDA profile in this, and well worth purchasing.


Useful resources:

· National Autistic Society- PDA a Guide for Autistic Adults https://www.autism.org.uk/advice-and-guidance/topics/diagnosis/pda/autistic-adults

· Pathological Demand Avoidance Society https://www.pdasociety.org.uk/


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