About Autism and PDA

PDA (Pathological Demand Avoidance) is widely understood to be a profile on the autism spectrum, though we are still at an early stage in our understanding and PDA research is in its infancy.

Whilst autism is a widely recognized term, our understanding of the full breadth and complexity of the autism spectrum is still evolving.

The National Autistic Society explains autism as “a lifelong developmental disability which affects how people communicate and interact with the world”. Many autistic advocates embrace the social model of disability and view a range of neurological differences as being part of a natural human variation (neurodiversity).

We know that autism is dimensional – it involves a complex and overlapping pattern of strengths, differences, and challenges that present differently from one individual to another and in the same individual over time or in different environments.

A cluster of traits can be called a presentation or a profile – in some cases, this can be quite different from what some people think autism ‘looks like’.

This can lead to presentations in some people – including autistic women and girls, and PDA individuals – being missed altogether, misunderstood, or misdiagnosed, which can in turn lead to poor outcomes.

All research points to early identification and tailored support being the best predictor of positive long-term outcomes. Recognizing these profiles signposts the approaches or support that will be most helpful for each individual.

A PDA profile of autism means that individuals share autistic characteristics …

• currently defined as “persistent difficulties with social communication and social interaction” and “restricted and repetitive patterns of behavior, activities or interests” present since early childhood to the extent that these “limit and impair everyday functioning” (according to the Diagnostic and Statistical Manual Fifth Edition (DSM-5))

• often including a different sensory experience in relation to sight, smell, taste, touch, hearing, vestibular, proprioception, and interoception.

… and in addition:

• have a need for control which is often anxiety-related

• are driven to avoid everyday demands and expectations (including things that they want to do or enjoy) to an extreme extent

• tend to use approaches that are social in nature in order to avoid demands

• present with many of the ‘key features’ of PDA rather than just one or two

• tend not to respond to conventional parenting, teaching, or support approaches

A PDA profile of autism is normally identified during an autism or holistic neuro-developmental, assessment – NexGenCounselling has produced practice guidance on identifying and assessing a PDA profile, collating the professional practice and experience of a multidisciplinary group of professionals working in the NHS and private practice.

In addition, we’d like to draw your attention to these additional sources of information, topics, or fields of study which we feel are helpful in furthering our understanding of PDA.