Autism and Pathological Demand Avoidance
Pathological Demand Avoidance (PDA) is a behavioural profile of Autism that is starting to gain recognition around the world.
An ‘Autism profile’ is a pattern of common symptoms, characteristics, and likely behaviours that emerge within the Autism spectrum.
An example of an Autism profile is the Asperger’s profile of Autism, probably the most commonly known Autism profile.
Compared with other Autism profiles, PDA is considered quite rare, but it is prevalent enough that in the 1980’s British psychologist Elizabeth Newson recognised the PDA group of traits and created the term ‘Pathological Demand Avoidance’.
Can you have PDA without being Autistic?
‘Can you have Pathological Demand Avoidance without Autism?’ is a common question asked by people who have recently discovered PDA and are just starting to learn more about it.
As PDA is a profile of Autism, they must go hand in hand. It is impossible to have PDA and not be Autistic.
So the answer is clearly no.
To further explain, while the definition of Pathological Demand Avoidance focusses on the following unique traits:
- an anxiety-based need for control
- an extreme avoidance of seemingly everyday demands and expectations (including preferred activities)
- the use of social strategies to avoid demands
- a lack of response to conventional parenting, teaching or support approaches
These Autism traits (shared between all Autism behavioural profiles) must also be present:
- difficulties with social communication and social interaction
- restricted and repetitive patterns of behaviour, activities or interests
- sensory sensitivities and processing difficulties
These traits will have been present since early childhood and regularly limit and impair everyday functioning.
I know my child has PDA characteristics, but I’m not sure about Autism…
Before dismissing PDA due to the Autism component, I encourage you to learn more about Autism.
Autism research has come a long way since the ‘Rain Man’ days and we now know that every person with Autism is different and Autism can present in many different ways.
The Pathological Demand Avoidance profile of Autism differs from other Autism profiles and presents in a way that is very different from what a layperson might consider Autism to look like.
Here are some great resources to get you started:
- The PDA Society Website
- The Autism Discussion Page on Facebook
- The Cooperative Research Centre for Living with Autism (Autism CRC) Website
If you have an older child, I also suggest you think back to your child’s toddler years – especially with regards to anything that seemed odd at the time that they seem to have now ‘outgrown’.
- Did they have an extreme aversion to loud noises, smells or light?
- Were they clumsy or behind with any of their milestones?
- Did they have any quirky habits or relate to others in an unusual way?
You may think your child has outgrown these difficulties, but have they?
PDA children are excellent at masking their Autistic traits. This means they can learn to mimic others to fit in, or silently endure their sensory sensitivities (especially if they have been vilified for them in the past) and not let on that they are struggling.
If any Autistic traits were present in your child in the past, but they seem to have disappeared, ask yourself, have they really? Or are they being hidden or masked by an anxious child?
What else could it be?
Autism with a PDA profile is often misdiagnosed because it can share similarities with other non-Autism related conditions.
If you are still unsure whether your child fits the Autism component of PDA, then perhaps you should investigate these other conditions which share certain PDA behaviours:
- Oppositional Defiance Disorder (ODD)
- Conduct Disorder
- Reactive Attachment Disorder
- Personality Disorders
- Developmental Trauma
- Anxiety Disorder
You can read more about identifying PDA and common misdiagnoses on the PDA Society website.
What can I do in the meantime?
It can take time to obtain a proper diagnosis for your child. If your family is struggling in the meantime, then consider implementing some of the PDA PANDA support strategies and other recommendations for parenting a PDA child.
Final thoughts on PDA without Autism
Pathological Demand Avoidance is a behavioural profile of Autism and as such you can’t have PDA without being Autistic.
If you think your child might have PDA but are unsure whether they meet the criteria for Autism, then consider researching more about how Autistic traits are displayed in a PDA child.
Your child may be currently masking the Autistic traits they have, so reflect on whether your child has displayed any Autistic behaviours in the past.
You may also want to rule out any other conditions with similar traits – perhaps your child does not have PDA after all.
If you are struggling and need immediate help, then consider adapting helpful PDA strategies in your household. Their success would be another indicator that your child is indeed Autistic with a Pathological Demand Avoidance profile.
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