What exactly is Pathological Demand Avoidance (PDA)?
Pathological Demand Avoidance (PDA) is a subtype of Autism Spectrum Disorder (ASD) characterised by difficulties with social interactions, communication and a strong need to be in control of their environment. People with PDA may have an intense need to avoid everyday demands and expectations and may engage in behaviours such as refusal, manipulation and deceit in order to exert control over their environment.
PDA is considered to be a relatively rare subtype of ASD, and it is thought to occur in about 1-2% of the population with ASD. It is more commonly diagnosed in females than in males.
Symptoms of PDA typically become noticeable during childhood, with some children showing signs as early as 18 months old. Children with PDA may have difficulty following rules and routines and they may have a hard time understanding social cues and interacting with others.
They may also be highly sensitive to changes in their environment and have difficulty with transitions.
PDA is characterised by a strong need to control their environment and avoid demands. This can manifest in various ways, such as:
- Refusing to comply with requests or demands
- Manipulating or deceiving others to get their way
- Having an intense need for control and predictability in their environment
- Having a limited range of interests, which may be focused on control and manipulation
- Having difficulty understanding or following social rules and conventions
Diagnosis of PDA can be challenging because the criteria for PDA are not well-established and the symptoms may overlap with other disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). A diagnosis of PDA should be made by a qualified healthcare professional with expertise in autism, such as a developmental pediatrician or a clinical psychologist.
Treatment for PDA typically involves a combination of approaches, including behaviour therapy, social skills training and occupational therapy. Medication may also be used to manage specific symptoms such as anxiety or impulsivity.
Overall, PDA is a complex and unique subtype of autism, which affects individuals in a very diverse way. Individuals with PDA may need specialised support and understanding from their caregivers, educators and healthcare providers, in order to help them manage and cope with the demands of daily life. The best way of providing support for an individual with PDA is through understanding their perspective and tailoring interventions, therapy and support to their specific needs and abilities.