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Adopting a PDA-friendly mindset

For autistic people with a PDA profile, traditional support approaches can often cause more harm than good. Things like firm routines and hierarchical relationships can increase anxiety and reduce trust. 

For professionals, the right mindset is an important first step in helping manage the anxiety and resistance demands can create. Focusing on understanding, compassion and co-regulation rather than control or compliance is important. It’s about more than tactics; it’s a philosophy that will help you choose the right approach at the right time. Understanding that stress caused by demands can impact on every area of a PDAers life is a good start. As is knowing that this anxiety gets in the way of being able to do things to keep themselves safe and happy – and that this is not a choice.

As a professional working within a system, there may be limitations in the changes you can influence about how your service runs. But anyone can work to build values into the relationships they have with people they support.

These are three fundamental values that will help you work effectively with PDAers:

1. Trust

Consistency, warmth, and honesty are key. Treating anxious behaviour as communication (rather than defiance) builds security. When PDAers trust that they’re safe, anxiety subsides, and daily tasks become more manageable.

2. Equity

Relationships grounded in shared power reduce anxiety. It’s about letting go of control, listening deeply, and negotiating decisions. This approach reassures individuals that you respect their autonomy, reducing tension and the urge to avoid.

3. Compassion

Recognize distressed behaviour as an anxiety response. This mindset shift can be difficult, but viewing meltdowns or refusal through a compassionate lens fosters more effective engagement.

This approach aligns with evidence that anxiety-not opposition-is the driver of avoidance in PDA (Cage & Troxell-Whitman, 2019).

PDA Society’s PANDA mnemonic was originally created as a memory aid – a way to introduce the kinds of flexible approaches that tend to help. These aren’t separate strategies to apply one by one but overlapping ideas that support each other. 

The letters stand for: 

  • P – Prioritise and compromise  
  • A – Anxiety management 
  • N – Negotiation and collaboration 
  • D – Disguise and manage demands 
  • A – Adaptation 

It’s helpful to think of PANDA not as a checklist, but as a gentle guide – especially helpful if you’re new to PDA support. The real work happens through connection, curiosity and trial and error.

“Having a big toolkit means you can be more adaptable in the moment.”

You can find our guide to PDA approaches for everyone here. It covers the fundamentals that will help you support PDAers you come across. The rest of the information in this guide is healthcare specific.

Mindset change – challenges & responses

Moving away from traditional methods-where confidence and authority is normally a perceived advantage-can be hard in health and social care. Staff shortages, strict protocols, and the pressure that comes with managing high levels of risk and legal compliance can make this particularly difficult. However its really important in building trustful relationships with individuals with PDA, who feel high anxiety about demands.

Reasons mindset change could be difficult include:

  • Pressures of time & delivery:
    In many social care settings, resource constraints and protocol-driven practice shape how support is delivered. For instance, a team may be expected to complete statutory child in need reviews within a fixed timeframe, using structured forms and tightly timed home visits. In cases involving PDA, this rigidity can backfire. If a young person is highly anxious or overwhelmed, a standard checklist interview may trigger shutdown, withdrawal, or defensive behaviour. Spending time to build rapport first-perhaps by allowing the young person to choose where the conversation happens or by spacing assessments over multiple short sessions-might initially seem inefficient. However, this flexibility often prevents escalation, improves engagement, and ultimately leads to more meaningful outcomes.
  • Assumed Compliance:
    There is also a common assumption in social care processes that individuals will comply with plans or expectations-and that parents or carers will reinforce this compliance. For PDAers, this assumption can be especially damaging. For example, if a parent is pressured to enforce a strict morning routine involving school attendance, hygiene, and household tasks, the child may experience this as overwhelming and unsafe, leading to conflict or refusal. Similarly, expecting a teenager to attend a multi-agency review without first offering choice about the setting or who will be present can result in them disengaging entirely. In such cases, rigid enforcement of expectations can increase distress and undermine relationships.
Instead, social workers will see improved outcomes if they approach refusal not as a sign of defiance but as a potential expression of anxiety or fear. Offering choices, using non-authoritarian language, and adapting the process to the individual’s communication style can go a long way in building trust. Especially in contexts like safeguarding or family support, where power dynamics are already heightened, relational flexibility can mean the difference between collaboration and crisis.
  • Shifting perspectives on parenting.
    Families of PDAers are often blamed for being “lax” or “permissive” when they choose gentle, cooperative approaches. But Luke Clements warns that parent-blame can hide problems in the system. He points out that professionals sometimes underestimate how hard things are for families. As a result, they judge parents and weaken the partnership needed for effective support. With a PDA profile, less rigid and more inventive parenting is not just a choice; it helps lower anxiety and keep connections strong.
“Where services fail to meet the needs of disabled people and their families, the families are often blamed for this failure.” (Clements, L. (2017). Disabled Children: A Legal handbook)

For PDAers, “good parenting” might look very different from the usual. Parents may use unusual routines, negotiate boundaries, and offer a lot of freedom. While this can clash with older ideas about “firm authority,” it often reduces stress and supports the child’s wellbeing.

Practical suggestions for changing mindsets include:

  • Reflecting on authority.
    Encouraging team discussions about who holds power and why. Ask if your protocols can allow more flexibility.
  • Acknowledging pressures.
    Recognising that staff and resources are limited. Brainstorm creative ways-like shorter appointment slots or remote options-to meet PDAers’ needs.
  • Promoting empathy.
    See anxiety, not defiance. Collaborative approaches reduce stress for both individuals and systems.
  • Respect parental expertise.
    Parents adjusting their style for a PDA child’s needs are not “failing.” Invite their insights to shape support plans instead of blaming them.
Moving to a mindset which centers a respect for each person’s anxiety, autonomy, and lived experience can take time. Yet this shift fosters true engagement, lessens stress for everyone, and honours shared decision-making in social care.