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What Is Pathological Demand Avoidance?

12/07/2017 11:19 BST | Updated 12/07/2017 11:19 BST

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Pathological Demand Avoidance (PDA) is a sub-type of autism. Autism is a difference of neurology marked by difficulty in communication, social understanding, literal thinking and heightened sensory processes. PDA, in relation to autism, is a heightened anxious state coupled with an overactive fight, flight, freeze response.

PDA is something a person is born with, it's the way their brain and body are and is not something that can be changed. There are ways to manage behaviours and difficulties but the overall neurology won't change. PDA children will become PDA adults.

The main traits of PDA (as listed by Pr. Elizabeth Newson, who discovered PDA) are:

- Resists and avoids the ordinary demands of life

- Appearing sociable, but lacking depth in understanding

- Excessive moods swings and impulsivity

- Comfortable in role play and pretend, sometimes to an extreme extent

- Language delay, often with a good degree of catch-up

- Obsessive behaviour, often focussed on people

Not everyone will have every trait but the percentage of PDAers who have the first trait is 100%, as resisting/avoiding demands is the hallmark of PDA.

Other traits include:

lack of preference for routine

need for change/novelty

tendency towards perfectionism

prolonged eye contact

Jekyll and Hyde behaviour

meltdowns/shutdowns

masking, especially in an educational setting

There is currently only one test for PDA, the Extreme Demand Avoidant test - EDA test, which is available on The PDA Society website. This is not a diagnosis but can be helpful during a diagnosis assessment.

Using PDA specific strategies for parenting a PDAer will help as traditional parenting and autism parenting strategies don't tend to work and may in fact make it harder for the child to cope, which will cause an increase in negative/unwanted behaviours. Some find home education to be more successful for PDAers although some children do manage in mainstream or specialist settings.

PDA adults do tend to struggle in all aspects of life yet many have been able to get high levels of qualifications, have jobs, get married, have kids, live alone and lead happy lives. It seems most PDAers struggle to cope until their late 20's when some form of self-awareness kicks in allowing greater ability to control their anxiety-led behaviours and adult coping strategies are developed. All PDAers will struggle to some degree throughout their lives. It is thought the greater freedom and control given to adults helps alleviate some anxiety, although there are more expectations placed on PDAers by society too which for some can increase anxiety.

PDAers tend to experience ups and downs in terms of behaviour, some go for weeks without any major issues then experience a week of constant struggles. This is because they only have a limited amount of energy for coping, once it's depleted then any masking stops and the person becomes unable to control their behaviour any longer, the body then uses whatever it can to escape the danger it believes itself to be in. The more demands placed on a PDAer, the quicker their energy will run out. This is why it sometimes seems like the person is reacting badly over nothing or something small, it is the straw that broke the camel's back. Masking at school is another example of this - the child holds their emotions in all day then finally lets loose at home once they feel safe, the demands of the day have sapped their energy. Sometimes a person wakes up with an already nearly depleted energy bar, this means the person starts off unable to tolerate many demands so it won't take much for them to fully run out and for negative behaviours to surface.

PDAers can be very perceptive to things like tone of voice, body language, emotional states etc, so parenting a PDAer can be difficult if they have a negative reaction to the way a person is communicating. These things can cause anxiety in the PDAer which they may not be able to ignore or rationalise away. Many PDAers are also empaths so they instinctively pick up on the emotional states of others even when they are hiding their emotions.

Living in a PDA world, either as one or with one, might not always be easy, but there are Positives to PDA and these are worth bearing in mind when things seem most difficult.

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