Pathological demand avoidance (PDA) is a relatively new term in the world of mental health, but it can be the answer for families who are struggling to understand their loved ones with this particular type of autism.

Understanding Pathological Demand Avoidance (PDA)

PDA is a subtype of autism, so people with this condition must also meet the criteria for autism spectrum disorder. PDA is characterized by intense anxiety when faced with any type of demand. It was first studied in the UK in the 1980s and 1990s and is slowly becoming more well-known and understood in the United States.

To break it down a little, we can consider each part of the term Pathological Demand Avoidance.

Pathological:

This is out of the person’s control. People with this condition cannot help but to react in the ways they react. It is innate.

Demand:

Any type of expectation or request that is made of the person, either by other individuals (parents, teachers, bosses, roommates, etc.) or by themselves (an internal drive to finish a particular book, or excitement about taking a specific class).

Avoidance:

Individuals with this condition often have meltdowns, pretend to other people or even animals, or act in ways to avoid and escape situations where demands are present. Some people might feel that a PDA distinction is not important or necessary, because an Autism Spectrum Disorder diagnosis should be sufficient for an individual to access the help and services they need to be successful in school and other situations.

However, people with a PDA profile often need supports that are very different from those required by a typical autistic individual. Things like rewards, schedules, and consistent expectations work very well for many individuals with autism, but can backfire for people with PDA.

The Challenges of Recognizing PDA

On top of that, understanding the anxiety behind PDA can be incredibly important. Educators and providers who can see the anxiety and panic behind PDA and the sometimes extreme reactions and meltdowns are often more able to empathize and react in a much more helpful way than those who see opposition, defiance, and other “bad” behaviors. Unfortunately, many children with undiagnosed PDA tend to be homeschooled, since their needs are not being met in the public school system.

Getting a diagnosis of PDA is a problem right now because many providers are unfamiliar with PDA. Thanks to the advocacy efforts of a few people, including Diane Gould, this is slowly changing. For now, many parents are finding support from other parents and having to educate schools and providers. PDANorthAmerica.com is a great resource for those who are new to learning about PDA or want to learn more—I plan to feature Diane Gould in a guest blog post in the next few months!

Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.