What is pathological demand avoidance?

Pathological demand avoidance (PDA) is increasingly, but not universally, accepted as a behaviour profile that is seen in some individuals on the autism spectrum.

People with a demand avoidant profile share difficulties with others on the autism spectrum in social communication, social interaction and restricted and repetitive patterns of behaviours, activities or interests.

However, those who present with this particular diagnostic profile are driven to avoid everyday demands and expectations to an extreme extent. This demand avoidant behaviour is rooted in an anxiety-based need to be in control.

While the demand avoidant profile has been found to be relatively uncommon, it’s important to recognise and understand the distinct behaviour profile as it has implications for the way a person is best supported.

Features of a demand avoidant profile

Autism is dimensional and the different profiles affect people in varying ways and to different degrees.

People with a demand avoidant profile can appear to have better social understanding and communication skills than others on the autism spectrum, and are often able to use this to their advantage. However, they might not really have as good an understanding of social matters as it seems.

The distinctive features of a demand avoidant profile include:

People with this profile can appear controlling and dominating, especially when they feel anxious. However, they can also be enigmatic and charming when they feel secure and in control. It’s important to acknowledge that these people have a hidden disability.

People with a demand avoidant profile are likely to need a lot of support. The earlier the recognition of PDA, the sooner appropriate support can be put in place.   (www.pdasociety.org.uk )

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