Autism and PDA

Autistic people with a PDA profile will often experience common autistic traits like sensory processing differences, a need for structure or predictability, and social and communication differences. In addition to this they experience PDA traits, the most well-known being marked demand avoidance.

With PDA, autistic traits are likely to differ from people’s expectations, for example not having any obvious difficulties with social situations or eye contact. And because PDA doesn’t reflect a mainstream understanding of autism, it can easily be overlooked or mis-diagnosed, especially at the screening stage of an assessment process.

Autistic people can also experience demand avoidance without having a PDA profile. It’s important to investigate the underlying reasons for demand avoidance because they might benefit from different support approaches. You can read more about this on our “What if it’s not PDA?” page.

Many neurodivergent people have a ‘spiky profile’, with high skills in one area (like verbal communication) and big challenges in another (like sensory processing or emotional regulation). PDAers often have this kind of spiky profile too, but it can be even harder to see because of the way demand avoidance interacts with their strengths and difficulties. For example:

• a PDAer might be incredibly articulate but unable to respond when asked a direct question.
• they may appear independent in some settings but be completely overwhelmed by everyday tasks.
• they can mask their anxiety so effectively that others don’t realise how distressed they really are.

This is why it’s so important to look beyond the surface. Just because someone can do something sometimes, doesn’t mean they can do it reliably – or without a huge cost to their wellbeing.

Masking is common for autistic people, and PDAers will often describe this as particularly intense or ingrained. Many say that they’ve learned to hide their stress until they reach a breaking point, while others explain that they can’t always tell how stressed they are until it’s too late.

These experiences need to be better understood, especially in settings like education, healthcare, or assessment where decisions are made based on what people appear to be coping with.

Currently, PDA is best understood as a profile of autism, and understanding it this way can make it easier for people to get the right support. But the field is evolving, and we know from community research that some PDAers don’t identify as autistic. We fully respect everyone’s right to self-identify when they find what works for them.

Some researchers have raised the possibility that PDA might also be connected to ADHD and/or trauma, and anecdotally there also seems to be an overlap with rejection sensitivity dysphoria. It’s thought that as many as two thirds of autistic people might also have ADHD traits, and this number is even higher with PDA. This means an ADHD assessment might also be helpful for someone with a PDA profile. 

These questions are important, and we welcome more research around PDA and will develop our understanding as the research base in this area grows.

• In PDA, the need to avoid everyday demands can mask or shape other autistic characteristics.
• Autistic people, including PDAers, can thrive in one area of their life whilst struggling in another.
• Masking can make it seem like someone is coping better than they are, especially in an environment they don’t feel safe.
• Assessments and support strategies need to account for the dimensional nature of PDA and the impact of demand avoidance across the different areas of a person’s life.

There’s always more to learn about PDA and it can be hard to keep up. Our newsletter brings updates, ideas and support straight to your inbox. It’s free, and easy to join.