Distinguishing Between Pathological Demand Avoidance of Autism (PDA) and Other Types of Demand Avoidance: A Guide for Parents
What is Demand Avoidance?
Demand avoidance is a concept that many parents encounter in their children's behavior. It's important to understand that demand avoidance, in general, is a normal part of human behavior. We all have moments when we resist doing something we're asked to do, whether it's a mundane task or a more challenging request. However, when demand avoidance becomes persistent and significantly impacts a child's functioning, it may be worth exploring further.
Normal Demand Avoidance in Children
Normal demand avoidance in children and adults can manifest in various ways, often as a natural response to stress, discomfort, or personal preferences. In children, examples of normal demand avoidance include procrastination, where they may delay or avoid starting tasks they find uninteresting or challenging, such as homework or chores. Additionally, children may exhibit selective compliance, choosing to comply with some demands while avoiding others based on their personal preferences or perceived importance. Negotiation is another common behavior, where children may attempt to bargain with caregivers to modify or avoid certain demands, such as extending bedtime or reducing the amount of vegetables they have to eat. Similarly, children may redirect their attention or engage in unrelated activities to avoid engaging with demands they find unappealing. Finally, seeking alternatives is another strategy children may use, such as finding shortcuts or workarounds to complete tasks more quickly or easily.
Normal Demand Avoidance in Adults
Similarly, in adults, demand avoidance behaviors are also prevalent. Adults may exhibit procrastination, where they delay or avoid tasks they find overwhelming or uninteresting, such as completing paperwork or organizing household chores. They may also engage in avoidance behaviors, avoiding situations or responsibilities that trigger feelings of discomfort, anxiety, or stress, such as social events or confrontational conversations. Setting boundaries is another common behavior, where adults assert their autonomy by saying no to demands that exceed their capacity or interfere with their personal priorities or well-being. Seeking support is also common, where adults may seek assistance from others or delegate tasks to avoid becoming overwhelmed by demands they perceive as excessive or unmanageable. Finally, prioritizing self-care is essential, with adults often choosing to prioritize self-care activities or leisure pursuits over demands they perceive as less urgent or important, such as taking time for relaxation or pursuing hobbies.
Pathological Demand Avoidance (PDA)
One profile of demand avoidance that parents may come across is Pathological Demand Avoidance (PDA), which is considered a subtype of autism. PDA is characterized by a heightened fight/flight/freeze response to demands, leading individuals to actively avoid or resist requests, even if they are enjoyable activities. Children with PDA often have an overwhelming need for control and may respond positively to having choices and feeling in control of their environment.
In PDA, demand avoidance manifests as a pervasive and extreme response to perceived demands, significantly impacting daily functioning and social interactions. Unlike typical demand avoidance behaviors, which may stem from personal preferences or occasional resistance, demand avoidance in PDA is characterized by a compulsive need to resist and evade demands, regardless of their nature or context. Here are some signs that you may see in individuals with PDA:
Signs of Pathological Demand Avoidance
Intense avoidance: Individuals with PDA exhibit an intense aversion to demands, often responding with extreme anxiety, defiance, or meltdowns when faced with requests or expectations, even those related to enjoyable activities or routines.
Strategic non-compliance: Unlike typical defiance or non-compliance, which may be motivated by a desire to exert autonomy or assert control, individuals with PDA often employ strategic tactics to avoid demands, such as distraction, negotiation, or manipulation of situations to evade compliance.
Excessive negotiation: Individuals with PDA may engage in persistent and elaborate negotiations or bargaining strategies to modify or delay demands, often resorting to extreme measures to avoid compliance.
Inflexibility: Individuals with PDA may exhibit rigid and inflexible behaviors, resisting any attempts to accommodate or adapt demands, even when offered alternatives or compromises.
Masking: While individuals with PDA may mask their difficulties in certain situations, especially in social contexts or unfamiliar environments, the underlying demand avoidance tendencies remain pervasive and may surface when they feel overwhelmed or threatened.
Control issues: Individuals with PDA often struggle with a deep-seated need for control over their environment and interactions, leading to heightened anxiety or distress when they perceive a loss of control or autonomy.
Social difficulties: Demand avoidance in PDA can significantly impact social relationships and interactions, as individuals may struggle to navigate social expectations, maintain friendships, or participate in group activities due to their aversion to demands and unpredictability of responses.
It's important to differentiate demand avoidance in PDA from normal avoidance behaviors, as the intensity, inflexibility, and pervasive nature of demand avoidance in PDA significantly impact the individual's ability to function and engage in daily life. While occasional avoidance or resistance to demands may be typical in children and adults, particularly when faced with challenging or unpleasant tasks, demand avoidance in PDA is characterized by its extreme and disproportionate nature, causing significant distress and impairment in multiple areas of functioning.
Demand Avoidance and ADHD
Another condition to consider is Attention Deficit Hyperactivity Disorder (ADHD), which can also involve demand avoidance behaviors. In ADHD, demand avoidance is typically related to tasks involving executive functioning skills, such as organization, planning, impulse control, and attention. Children with ADHD may struggle with tasks they find uninteresting or challenging, but they may respond well to additional structure and support in managing these tasks.
Demand Avoidance in Anxiety and Depression
Anxiety and depression are also common contributors to demand avoidance behaviors. Children with anxiety or depression may avoid demands because they perceive them as difficult or fear that they won't be able to meet expectations. These behaviors can be driven by negative beliefs about themselves, such as feelings of inadequacy or fear of making mistakes. Providing praise, creating low-stress environments, and focusing on the process rather than the outcome can be helpful strategies for supporting children with anxiety or depression.
Demand Avoidance and ODD
Oppositional Defiant Disorder (ODD) is another condition characterized by defiance and resistance to authority figures. Children with ODD may avoid demands as a way of asserting their independence and challenging authority.
Learned Demand Avoidance
Additionally, some neurotypical children may exhibit learned demand avoidance behaviors, where they have learned that they can avoid tasks by engaging in certain behaviors, such as throwing tantrums or refusing to comply. This pattern of behavior can be reinforced if parents inadvertently give in to their child's demands or take over tasks for them.
Testing for Pathological Demand Avoidance
Overall, understanding the different profiles of demand avoidance and their underlying causes is crucial for parents seeking to support their children effectively. By recognizing the specific factors contributing to demand avoidance behaviors, parents can implement strategies tailored to their child's needs and promote positive outcomes in managing these challenges.
If your child has been experiencing demand avoidance, testing can help clarify the source. Whether it is autism, autism with PDA profile, ADHD, anxiety, depression, ODD, or another cause, we can help clear that up for you. Zephyr Care specializes in neurodiversity-affirming evaluations. Our testing is comprehensive and doesn’t just look at one thing. We are able to assess for all of the possibilities of demand avoidance behaviors and provide a diagnosis, strategies for helping, and referrals to specialists for continued treatment. We provide testing services in Nashville for those who live locally, but also virtually for families in most states. For more info, Contact us today!
Author: Heather Joppich, PhD
Dr. Joppich is a Licensed Psychologist and owner of Zephyr Care Mental Health. She specializes in neurodiversity-affirming assessments for autism, ADHD, and mental health concerns.
