A list of general questions and answers regarding PDA
What does PDA stand for?
Pathological Demand Avoidance
Is PDA part of the Autism spectrum?
Yes. PDA is a type of Autism.
There is a bit of debate as to whether it is on the Spectrum but seperate to Autism or whether it is a form of Autism. Autism, Aspergers, PDD-NOS, and many others were recently all placed under ASD (autism spectrum disorders). Some believe these are all actually the same while others believe there are actually differences between the different diagnosis. Since PDA is linked to Autism in some way then it should come under ASD, but it is debated exactly how. Some feel it is a comorbid and so you could have Aspergers and PDA, while others believe PDA is Autism so all PDAers are autistic.
However you wish to see it, PDA is under the ASD umbrella so it’s best to say it is a type of Autism Spectrum Disorder.
Can you get PDA or is it there from birth? Does it ever go away?
PDA is a type of neurology, it is genetic and there from birth, it cannot be changed. You can’t grow out of it or treat it, but you can learn coping strategies that help you manage to live with it as best as possible.
Are PDA and ODD the same? Can someone have PDA and ODD?
No and yes.
They are very different conditions, although the behaviours displayed appear very similar. There are key differences which distinguish the two. For example, PDAers will avoid everything while those with ODD will only avoid certain things.
It is possible to have both PDA and ODD, PDA is a type of neurology while ODD is developed due to averse environment.
Can you have PDA and (ADHD, OCD, Bipolar, BPD, HAD, ect)?
Yes. PDA doesn’t rule out any other type of neurological difference or mental illness. It is possible to have one or more comorbid, and many do. ADHD is a common comorbid to ADD in general and PDA is no exception.
I’ve been told someone can’t have PDA if they have a low IQ or a learning disability, is this true?
No. PDA is a genetic neurological difference but it cannot affect a person’s intelligence or ability to learn in this way.
Some professionals struggle to see PDA traits in those with a low IQ and/or learning disability, this is because their ability to avoid demands may not be as varied as those without. This doesn’t mean PDA should be ruled out, it just means the professional diagnosing needs to take the person’s IQ/learning disability into account.
Can PDAers be fine at school but not at home?
Yes, this is known as masking. It’s quite common for Autistics and PDAers to hold everything in while in one environment (usually school) and then let it all out in another (usually home). This is called the coke bottle effect.
I was told my son cannot be PDA because they can do somethings, is this right?
No. Demand avoidance varies day to day, an individual may be able to do something fine one day but not the next.
Why do rewards not work for my PDA child?
Rewards are a demand. The expectation to perform, the anxiety around whether or not they will be able to comply, the desire to get the reward, the fear of failure, the feeling of a loss of control. It’s often just too much for a PDA child to cope with.
School said my child doesn’t appear anxious, they are too loud, bossy and aggressive while anxious kids are quiet, shy and nervous. I don’t understand!
Anxiety presents in many different ways, sadly most only recognise the quiet, shy and nervous behaviours as being anxiety. Actually anxiety can present by being loud, overly talkative, attention seeking, bossy, boisterous, aggressive, violent, sarcastic, laughter, energetic, touchy feely, and many other behaviours.
It’s important that professionals get to know each unique individual and learn their different behaviours and what they mean, rather than using an outdated, one-size-fits-all behaviour guide.
What medications work best for PDA?
There is no medication that treats PDA, however many have found anti-anxiety meds to be helpful.
My child doesn’t understand boundaries, what can I do to make them understand?
Often it’s not so much that they don’t understand the boundary, but that they cannot comply with it. A boundary is just another demand.
Sometimes a child doesn’t understand something because they can’t see why it’s important or it doesn’t make sense to them, they may lack the skills to grasp the point or it might be something that has little basis to it. Ensure the boundary you are placing is realistic and makes sense, explain it in a way they can understand and try using PDA strategies to enforce it. You may need to accept that this is a boundary they just cannot comply with.
How do I teach my child to control their emotions?
You cannot teach a person to control their emotions, what you can teach is how to control their response to their emotions. This is doubly hard due to demand avoidance as anything you teach may be met with resistance. Modelling behaviour often works best but may be harder to grasp for those who struggle to apply what they see to their own behaviours.
My daughter is obsessed with this one child and won’t leave them alone, is this typical of PDA?
Yes, it’s quite common. Some become fixated on a specific individual and feel the need to know everything about them, be with them all the time and control everything they do. It depends on the individual’s and their relationship as to whether it becomes an unhealthy dynamic that requires intervention or not. Some PDAers flit from one person to the next while others keep to the same person.
This is the unique way many PDAers manage relationships as it can be overwhelming to be close to more than one person at a time and they may need the comfort and safety that person presents.
Some PDAers however negatively target the individual, likely due to a need to feel in control and in power. It’s important to monitor relationships like this for the safety and well-being of all involved.
Will my child ever live an independent life?
A large number of adult PDAers are living independent lives so it is possible. We are unsure of the percentages of those living independently vs those living in assisted accomodations (care homes, hospitals, with parents, ect). Having PDA doesn’t automatically rule out independent living, many PDAers own their own homes, work, are married, have children, have travelled, been successful in one way or another, and/or live happy lives.
Riko's blog: PDA and more. 