What is PDA?
The term PDA stands for Pathological Demand Avoidance. This is widely understood to be a profile found within some autistic people. The most obvious characteristic of PDA is a determined avoidance of so-called ‘common’ demands of life, including expectations and things the person enjoys doing. It is important to be aware that PDA is not just about demand avoidance.
When the term PDA was first coined by Elizabeth Newson she created some criteria for recognising it in children. While these criteria are helpful in recognising a PDAer (someone with PDA) and are still used by clinicians today, they are not phrased in a very positive way. The characteristics we’ve used below were published in a 2003 academic paper and uses language many people with this profile, and those who care about them may find challenging. Out of respect for that we’ve included them underneath how some PDAers have chosen to describe those characteristics themselves:
“On a daily basis I can’t do things that are expected or routine as a result of my stress response to demands. Demands cause me lots of anxiety.”
This is described in academic literature as an obsessive resistance to everyday demands.
“I often get round demands by changing the subject, distracting people with humour, flattery, avoiding situations where demands come up, zoning out (freezing) or becoming angry, or something similar.”
Described by Newson as using a range of apparently ‘socially manipulative’ strategies of avoidance. Clinicians agree that the word ‘manipulative’ suggests a deliberate attempt to mislead, which isn’t the case, even if it seems so. These days clinicians talk about ‘social strategies’ instead.
“I can talk with people and be charming, but sustained deep friendships are rarer for me”
Or – A superficial ability to manage social interaction, but with little evidence of a normal sense of social identity (e.g. believing themselves to be on a par with or superior to adults), and a lack of pride or shame.
“I experience extreme emotions and can be very impulsive.”
“I have ‘safe people’ to whom I am very attached, and who I do almost everything with. I have deep interests, often in people or characters which I invest lots [of my energy] in.”
“I enjoy, or have enjoyed, role play and pretend, can be very creative and imaginative, and may ‘mask’ in character.”
Additional characteristics Newson noted in early childhood were language delay in a significant proportion of PDAers, and a passive early history and neurological involvement (e.g. delayed milestones, clumsiness, seizures or absences in a minority) in 60% of the children she studied. The term “passive early history” describes a lack of active exploration or engagement during infancy or early childhood.
These, combined with the effort spent on masking or overcompensation for difficulties, can make everyday life anxiety provoking and exhausting.
PDA as a profile of autism. What does that mean?
As PDA is a profile for some autistic people but not all, it can mean that someone with this profile may need very different support to another autistic person without it. Even when people share the same profile, the way these characteristics show up can differ greatly-each person’s personality, experiences, and environment shape how characteristics are expressed in daily life.
All sorts of things can impact on people’s ability to cope, so looking at a person as a whole is important. Good support will consider all these things and will be flexible, because things change and what is manageable at one time may be overwhelming at another.
There is more detailed information about PDA characteristics here
Is PDA a diagnosis?
PDA isn’t a diagnosis, but during an autism assessment a person can be identified as having a PDA profile. This may be described in paperwork by saying a person ‘has a PDA profile’, or that they have ‘demand avoidance traits’.
Clinicians are increasingly identifying this and there is greater awareness that it is important to give people knowledge of their PDA profile. It can give someone the words to explain to friends or partners why some things are difficult, which can have a big impact on relationships.
However, not all clinicians and professionals recognise PDA, and overall awareness is not as high as we would like it to be. This can make access to identification inconsistent. While research suggests that PDA is experienced by autistic people, we know from community research that not everyone who self-identifies as PDA considers themselves to be autistic. We fully respect people’s right to self-identify.
PDA can have a profound impact on people’s lives. It can make everyday tasks impossible and lead to conflict that a person doesn’t want but finds impossible to avoid. Things improve with understanding and the right support, and there are many PDAers who thrive as a result.
More useful information
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