PDA101 - what is Pathological Demand Avoidance?
I have SO much to say about PDA - and no, I don’t mean Public Displays of Affection. Why am I so passionate about it? Because my son is an AuDHD PDAer. And learning about PDA completely changed our parenting approach and his ability to thrive.
First things first. PDA is Pathological Demand Avoidance (or Persistent Drive for Autonomy). Today I am going to give you PDA101:
PDA is a nervous system disability defined by an overwhelming drive for personal control and autonomy.
It is an anxiety-based condition due to a deep intolerance of uncertainty regarding personal autonomy and control.
Controlling and demand avoidant behaviours are the result of trying to increase the tolerability of intolerable situations.
PDA does not hold diagnostic status. Current research* suggests that it is a profile of Autism and most Autistic PDA’ers also have ADHD.
What do you see with a PDAer?
Inability to compromise, apparent refusal to comply with even simple requests or instructions (even things they may want to do)
Attempt to control the actions of others
High frequency of nervous system activation - fight, flight, freeze, fawn
Highly social (but struggles with challenging social dynamics)
High levels of role play (especially pretending to be much older or younger)
Internal demands are part of PDA – hunger/thirst, need to sleep, toileting, feeling hot or cold - can all feel like an intolerable demand.
Unsuprisingly, PDA is often misdiagnosed as Oppositional Defiance Disorder (ODD) - our son included. This is due to the frequency of 'fight' response, and the high level of social skills and role play which many feel do not represent a 'typical' Autism profile (yes, I recognise the irony of the word typical). As such, PDAers are often considered 'atypically Autistic'.
But ODD behavioural techniques can be damaging to PDAers - and this, I suppose, is why I am so passionate about this. Because undoing the cumulative nervous system trauma of the incorrect approach is the last thing a parent of a neurodivergent child needs to add to their plate.
This is definitely a ‘Part One’ in the News Hub - stay tuned for more on PDA!
*Professor Tony Attwood and Dr Michelle Garnett