Do you assess and diagnose Pathological Demand Avoidance(PDA)?
Pathological Demand Avoidance (PDA) is a term used to describe a profile of Autism Spectrum Disorder (ASD) that is characterized by an extreme resistance to everyday demands. Additionally, a need for control.
It is considered a subtype of ASD and was first described by Elizabeth Newson in the 1980s. PDA is not officially recognized as a distinct diagnostic category in the DSM-5, so it is not possible to give a formal diagnosis of this.
Pathological Demand Avoidance Diagnosis in Children
Children with demand avoidant profiles frequently experience a high level of anxiety. Furthermore, they find it extremely challenging to cope with everyday tasks or requests. Even if it is something that they might enjoy.
They may engage in avoidance strategies e.g.
- distraction
- negotiation
- defiance
to resist or escape demands placed upon them. Demand avoidant profiles can be accompanied by an apparent ‘surface sociability’ and a strong desire for social interaction. In other words, these children do not always present with more ‘classic’ autism traits.
Difficulties for Children with Demand Avoidant Profiles
Children with demand avoidant profiles often have difficulties with:
- flexibility
- social imagination
- sensory processing
All the above may contribute to their avoidance behaviours. Similarly, they may show a strong need for control and struggle with transitions or changes in routine. These difficulties can have a significant impact on the child’s ability to engage in:
- everyday life
- learning
- relationships
- wellbeing
Supporting Childing with Pathological Demand Avoidant Profiles
Understanding and supporting children with demand avoidant profiles requires a creative and flexible approach. This approach needs to take into account their need for control, reduces demands, and allows for negotiation and choice-making.
In other words, the following strategies can be helpful in managing demands and reducing anxiety.
- offering alternative options
- using indirect language
- providing clear visual cues
PDA Assessment
Whilst it is not possible to assess and diagnose PDA in its own right, if our assessment identifies extreme demand avoidance as a behaviour profile, we will write about this in our report. In addition we will signpost to more information and resources for those supporting children and young people with a demand avoidant presentation.
If you have any questions, or would like to request an assessment please fill in our Contact Form . If you have any immediate questions, you may find them on or FAQ page. Please do connect with us on Facebook too.