Pathological Demand Avoidance (or PDA for short) is a newly discovered developmental disorder. This term was coined by the late Professor Elizabeth Newson in 2003 and to this day it remains largely misunderstood. While it is true that PDA falls under the general Autism Disorder Spectrum, it is not, in fact, directly linked to autism.
PDA is a challenging condition to deal with, and so is its diagnosis. The vast majority of autism detection tools will fail to recognize if an individual is suffering from PDA and most professionals aren’t even aware of its existence.
Let’s examine Pathological Demand Avoidance closer and understand what it is, how to identify it, and what people can do in order to help individuals who are suffering from this disorder.
What is Pathological Demand Avoidance and What Are The Symptoms?
As the name suggests, an individual who suffers from PDA feels a strong urge to not carry out tasks given to them by others. These tasks may not always be difficult or cause considerable stress. It could be something as simple as a parent asking their child to put a toy away.
People with PDA will not comply with orders and will often come up with excuses as to why they cannot complete a task. They may use plausible excuses, such as a hurt leg or a headache, or excuses originating from their imagination, such as “I’m a cat, cats don’t talk to humans” etc. Children with PDA will often role-play as another object or person and retreat into this fantasy to protect themselves and not comply with orders.
If the demands are not met and enough stress has accumulated, the individual will suddenly switch moods, often without warning. Happiness can turn into anger in the blink of an eye. Certain methods used to calm autistic children can be adapted to children with PDA, like e.g. the Low Arousal Approach, where parents and teachers will issue commands in a friendly, indirect manner to avoid this phenomenon.
Unlike other people suffering from autism, people with PDA will initially be perceived as having good social skills, but in reality, they don’t have a good grasp of how to react to other peoples’ feelings and how to behave in front of an or even identify an authority figure. People suffering from Pathological Demand Avoidance are also inherently obsessive, often socially. They could become fixed to another person, either loving or hating him/her in excessive amounts.
Another thing to note is that PDA (as professor Newson has claimed) is a defense mechanism for dealing with anxiety and it will follow a child well into his/her adult years.
Can You Have PDA Without Autism?
While some Pathological Demand Avoidance symptoms have a few things in common with autism symptoms, these two disorders are largely different. In fact, there is a debate in the scientific community about whether or not PDA truly falls under the autism disorder spectrum.
Like autism, PDA is something an individual is born with (probably due to genetic factors). However, it takes a few years for a child to exhibit the behaviors that are linked to PDA. Autistic children and adults often have impaired speech, will show some unusual mannerisms and motions and aren’t socially graceful. In direct contrast, children with PDA will display an increased understanding of language early on and will learn how to be socially manipulative in order to avoid doing things.
PDA also affects men and women equally, unlike autism which, according to data, seems to affect boys and men disproportionately more than girls and women.
Can PDA be Cured or Treated With Medication?
Unfortunately, there is no known cure for PDA. Pathological Demand Avoidance is a relatively new discovery and there is much to learn about how it works. Furthermore, individuals suffering from PDA may be resistant to efforts to help them, as they perceive this help as orders that they will try to ignore or run away from.
If you suspect that you, your child, or a relative is suffering from this condition, then you should consult a medical expert who will be able to carry out a proper diagnosis. Therapists can help with alleviating the symptoms by using certain techniques in order to bypass the person’s defences and help them control their feelings and impulses.
Ava Wadaby is a contributing writer for Autism Parenting Magazine. She researches and writes about autism as she works to understand the challenges of her son who was diagnosed with Autism and ADHD. She also regularly conducts activities with children in her neighborhood, focusing on their learning and development.