Pathological Demand Avoidance (PDA)

PDA (Pathological Demand Avoidance) is a diagnosis which may be given to an individual on the autism spectrum, though we are still at an early stage in our understanding and PDA research is in its infancy. The PDA profile of autism means that individuals share autistic characteristics such as:

• Difficulties with social communication and interactions.
  
  
• Restrictive and repetitive patterns of behaviours.
  
  
• Sensory difficulties in relation to sight, smell, taste, touch, hearing, vestibular, proprioception and/ or interoception.

Many of these strategies will with for individuals with PDA, others will not. Flexibility and imagination are key to supporting a young person with PDA.

An individual with PDA will often try to avoid every day activities, demands and expectations to an extreme extent. Some key characteristics of a PDA child at school, diagnosed or otherwise, may be:

• A desire to be in control. A child with PDA may see themselves as equal to adults and do not confer to automatic respect of someone’s job title.
  
  
• A poor sense of self-esteem
  
  
• Significant difficulties with emotional regulation; extreme/sudden ‘mood swings’
  
  
• An ambivalence about success, typified by a child who destroys his/her work on completion especially if praised
  
  
• A lack of permanence and transfer of learning and experience; sudden/dramatic setbacks after periods of settled behaviour and progress
  
  
• ​A desire for friendships, often inadvertently sabotaged through a need for control
  
  
• ​Extensive involvement in fantasy/role play
  
  
• Meltdowns/shutdowns/behaviour that challenges – or equally a child may mask and internalise whilst at a Scouting event

When supporting a young person, it is important to remember that the demand, even to respond to a greeting, is physically impossible for the young person. and it is not 'chosen behaviour'.