For people with Pathological Demand Avoidance (PDA), completing an everyday task is a dance between determination and resistance. PDA is a rare effect of autism that can make one have an extreme avoidance of ordinary demands of life like operating on a timeline that is not their own.
In this blog, we will be discussing,
- What is Pathological Demand Avoidance in children?
- What are the symptoms of Pathological Demand Avoidance?
- What triggers Pathological Demand Avoidance?
- How to communicate with someone with Pathological Demand Avoidance.
- How do you discipline a child with PDA?
What is Pathological Demand Avoidance in Children?
Simple tasks like getting dressed, sitting down for dinner, brushing teeth, or naming everyday items are within the skill set of a young child. But children with PDA might only do these activities when they feel motivated to. This is referred to as “self-directed behavior,” as the child will not engage in any of these primary activities if asked to by another person–even if they are fully capable.
Adolescents and adults may struggle to complete basic school or work assignments, even if they are advanced in their abilities.
The Diagnostic and Statistic Manual of Mental Disorders hasn’t yet recognized this disorder separately from a subset of autism as it needs more evidence and clinical history. But, it’s considered to be in the category of persuasive developmental disorders.
What are the Symptoms of Pathological Demand Avoidance?
A PDA profile of autism can be shown through various symptoms. Overall, the PDA is most recognizable because it pushes against everyday demands.
Other symptoms include:
- Extreme mood swings and impulsivity
- Social, but lacks awareness and understanding of social interaction
- Resists and avoids the needs of ordinary life
- Using avoidance social strategies like creating a distraction or using excuses
- Panic attacks
- Comfortable in role play and pretending
- Deep/focused interests and behaviors
What Triggers Pathological Demand Avoidance?
Pathological Demand Avoidance is common among autistic children. Someone does not have to have autism to be diagnosed with PDA, and it’s believed that a high level of anxiety can trigger this disorder.
If an autistic child with PDA feels threatened by their environment–where they have no control–it might trigger a flight, fight, or freeze response. It is worth noting that 40% of autistic people struggle with anxiety, so such responses in your child are actually fairly common.
How to Communicate with Someone with Pathological Demand Avoidance?
Declarative statements are an excellent method of communicating with someone with PDA. An example is replacing statements such as “drink this now” or “pick that up” with “Here’s a drink” and “Would you like to pick this up now or later?” This can help the child feel less avoidant and in control of their actions because you’re providing them with options. Giving people with PDAs a choice, offering alternatives, and changing your terminology can make a world of difference.
Using indirect language, such as tapping a plate to communicate the need to eat or using visual props like a checklist, avoids verbal communication demands.
Additionally, depersonalization can diminish the blame of being the caretaker. For instance, you can say, “The manager is closing the restaurant at six,” which shows that a higher authority decided this demand and that rules must be prioritized.
Other effective methods include using humor, asking them to help “you,” modeling behaviors, distracting them, or making a game out of tasks. Learning together can be fun!
How Do You Discipline a Child with PDA?
Traditional discipline used for neurotypical children may not be the best option for children with PDA.
Some alternative methods include:
- Rewarding positive behaviors
- Avoiding punishment
- Offering alternatives
- Adapting expectations
- Educating yourself about PDA
Each child will respond differently to discipline efforts, so it’s best to use trial and error. Above all else, remember to be empathetic, patient, and involved during each step of the process!
