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Spire Bushey Hospital, Heathbourne Road, Bushey, Hertfordshire, WD23 1RD

020 8901 5505

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PDA

Pathological Demand Avoidance (PDA)

Pathological Demand Avoidance is a term very much talked about these days in relation to Autism although it is not a recognised medical term (in the Diagnostic and Statistical Manual 5 - DSM V).

We are able to profile your child as demand avoidant if there is clear evidence so that appropriate strategies can be used.

 

What Is PDA

Pathological demand avoidance (PDA) profile is increasingly being recognised as a behaviour profile in some children and young people diagnosed with Autism. 

Demand avoidance is a natural human trait but we all can manage this in our day to day life without any implications.

 

Children and young people with a demand avoidant profile tend to avoid everyday demands and expectations to an extreme extent. In addition they have difficulties in social communication, social interaction and restricted and repetitive interests like others with a diagnosis of autism.

Pathological Demand Avoidance is not a recognised distinct medical diagnosis in the DSM-V  however children and young people are increasingly recognised to have this profile of behaviours worldwide.

The UK governmant has included PDA in its recent announcement about the review of its autism strategy

Australia have included PDA in the latest guidelines on Autism Spectrum Disorder 

There is certainly an increase in the media coverage on this condition in addition to strengthening self advocates, development of PDA society and more and more availability of literature on this profile. 

More research in this area has created increased awareness among professionals too.

Cause

Demand avoidant behaviour is considered to be due to an anxiety-based need to be in control.​

It is important to recognise and understand the distinct behaviour profile as it has implications for the way a person can be best supported.

The survey of 1400 people, conducted by the PDA society, showed that the PDA profile of autism is being missed, misunderstood and misdiagnosed - usually due to lack of understanding of this profile among professionals.

PDA Profile

Children with Autism and a demand avoidant profile can appear to have better social understanding and communication skills than others on the Autism Spectrum. 

Some features of a demand avoidant profile include:

  •  Resistance to ordinary demands of life eg not brushing their teeth when asked

  •  Use of social strategies such as giving excuses or distracting as part of avoidance

  • Apparent sociable behaviours but lack a true understanding

  •  Excessive mood swings as if a switch has flipped etc.

  • These children are poorly understood and may find themselves at risk of school exclusion