WHAT IS PATHOLOGICAL DEMAND AVOIDANCE (PDA)?

Pathological Demand Avoidance is an autism spectrum profile that is characterised by an anxiety driven need to avoid everyday demands and expectations, and maintain control. The key point being anxiety driven! Demand avoidance is often mistaken for defiance, oppositional behaviour, wilfulness or stubbornness but these descriptors are at best unhelpful and at worst detrimental to the individual. They lead us towards approaches like reward and consequence and imposing an adults will over the child, all of which are extremely unhelpful in helping and supporting someone with PDA. When we see demand avoidance as anxiety driven, it leads us to approaches that help reduce anxiety rather than focussing on the resultant behaviour.

As well as sharing many of the typical traits and challenges associated with autism (although they tend to present differently), PDAers experience extreme levels of anxiety around day to day life, in particular in relation to expectations and demands. The simple existence of a demand creates anxiety and any expectation and pressure to comply with it, or when demands pile up to high, they can push an individual towards panic mode and the Fight, Flight, Freeze, Fawn response. Quite often people only see the extreme behaviours associated with this response, which due to a lack of understanding appear to come out of nowhere and without any obvious trigger. When we understand what demands actually are, how many there are, and how they affect an individual with PDA it becomes clearer why an individual can easily reach the point of overwhelm and perhaps meltdown.

Many people when you say the word “demand” imagine someone forcefully and sternly making a request of someone. In fact the Cambridge Dictionary defines it as “to ask for something forcefully, in a way that shows that you do not expect to be refused”. However when thinking about demands and expectations in relation to PDA you have to delve much much deeper than that.

With PDA, pretty much EVERYTHING in life can be interpreted as a demand.

Demands also fall into different categories like direct demands, indirect demands and internal demands. They include both things an individual does want to do, as well as doesn’t want to do, and tolerance of demands is highly dependent on anxiety levels. One of the key ways to keep anxiety low, is to keep demands low, and in some cases it is necessary to drop all but the most essential expectations such as keeping themselves and others safe.

Below are some examples of everyday demands

WAKE UP : GET READY : EAT BREAKFAST : BRUSH TEETH : BRUSH HAIR : GET YOUR LUNCH : DON’T FORGET YOUR BAG : GET IN THE CAR : TIME : WRITING : TIMETABLES : ROUTINES : SCHOOLWORK : HOMEWORK : EATING: DRINKING : TOILETTING : SELF CARE : SLEEPING : SOCIAL OCCASIONS : ROUTINE REQUESTS : GOING TO THE PARK : GOING FOR A WALK : GOING SHOPPING : APPOINTMENTS

Demands can be reduced by eliminating them, changing our language around them, collaborating and negotiating, giving choice around how or when they do it, providing alternatives, and providing appropriate support to facilitate the individual coping with the demand.

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