Avoidance of daily tasks and anxiety-driven need to control define Pathological Demand Avoidance (PDA), a behaviour characteristic of the autism spectrum disorder (ASD). Although some diagnosis guides don’t formally recognise this profile, its unique behaviour and problems are getting more attention from clinicians and researchers. Parents, teachers and carers who want to support children who show these behaviours need to understand PDA.
Understanding Pathological Demand Avoidance
PDA is characterised by an ongoing avoidance of expectations and demands which could be from clear orders to subtle social pressures. Children with PDA will show techniques such as distraction, excuses, negotiation or direct avoidance of tasks. This avoidance is from a great sense of anxiety and a need to control their environment not from disobedience or laziness.
Children with PDA often show high levels of social awareness and can use this to control events to avoid requests. Their behaviour may seem deliberate or oppositional as a result which can lead to misinterpretation and inappropriate punishment. Although their interactions are the usual difficulties of autism, children with PDA may be more socially active and inventive than the more commonly known characteristics of ASD.
Difficulties Faced by Children with PDA
In individuals PDA, the anxiety-driven avoidance behaviour can cause major problems in daily life. Especially in schools the controlled environment and continuous expectations can be very stressful so can present big difficulties. Many traditional teaching methods and behaviour management techniques are inefficient and can exacerbate anxiety and avoidance.
Parents may find it hard at home to manage daily expectations and routines. The widespread impulse to avoid expectations can impact family dynamics and cause more stress for the child and their carers. Social relationships may also be strained as peers and adults may misunderstand the child’s behaviour and cause social isolation or arguments.
Techniques for Helping Children with PDA
Dealing with children with PDA requires a bespoke approach that puts empathy, understanding and flexibility first. These may be helpful:
- Establish a trusting relationship is key: Children with PDA need to feel understood and safe. Avoid confrontational approaches and substitute calm, persistent communication.
- Reduce Demands: Where one direct demand is placed on the child, try to reduce the overall load. Give them choices and control over some aspects of their daily life to help them relax.
- Use Indirect Language:
Use indirect language; suggestions and indirect requests can be more successful than direct instructions. Using indirect cues or phrasing questions as requests helps the child avoid their natural demand avoidance. - Flexible Routines: Use flexible routines that allow one to be independent will help reduce stress. Give the child feedback on activities for planning will help increase their willingness to participate.
- Emotional Support: Crucially the child needs validation of their feelings and emotional support. Understanding and managing their anxiety will help them feel safer and in control.
- Collaborative Problem Solving: Engage the child in collaborative problem solving conversations to find reasonable solutions. This will help the child develop agency and reduce their need to control by avoidance.
Positive Outcomes and Future Prospects
Although PDA presents special difficulties children with this profile can thrive with the right knowledge and support. These children are not being deliberately challenging; their behaviour is a result of deep seated anxiety and a need to control their environment. Carers and teachers can help children with PDA develop confidence and coping strategies by using a compassionate, flexible and tailored approach.
Children with PDA have bright futures as awareness of this profile grows. Better resources and support systems such as a pediatric occupational therapy are emerging as a result of growing research and activism. Children with PDA can negotiate their difficulties, use their strengths and have happy lives with the right support. In the end it’s all about creating a good supportive environment so we can all release human potential.