Autism and PDA is a hot topic right now. As we learn more and more about Pathological Demand Avoidance (PDA), we will be able to better support our students and children. A PDA child presents distinct characteristics and challenges. Let’s dive into the world of autism and PDA, exploring the key characteristics of autism PDA and a range of effective autism PDA strategies to better support autistic individuals with this specific profile. Much of this information was provided during a podcast interview with Casey Ehrlich, Ph.D. of At Peace Parents. Listen to episode 54 of The Autism Little Learners Podcast to hear the interview.
What Is Autism PDA?
To provide meaningful support to autistic individuals with PDA, it is crucial to understand the distinct characteristics that define this unique profile. While individuals on the autism spectrum may exhibit a wide range of traits, those with PDA may display the following defining autism PDA symptoms:
- Survival Drive For Autonomy Or Equality: This survival drive consistently overrides other survival instincts like eating, sleeping, hygiene, toileting, and safety. You might see it in the moment. Casey Ehrlich shared an example from her experience with her son. If she said “Be careful. Don’t go in the street”, it would accelerate him toward oncoming traffic. She said it was not elopement and wasn’t “not” listening, but more of fixating on what he was told not to do. This can be a survival drive for autonomy that overrides safety. The child may not even be aware of this because it’s a nervous system activation.
- Equalizing Behavior: A reflexive behavior to get back to that place of safety. The child may perceive they are “below” or don’t have autonomy. They want to “equalize” but sometimes they overshoot with controlling or defiant behavior. An example of a less extreme expression is when the child may comply, but then go destroy another child’s work. This is a nervous system response and it can feel manipulative or oppositional, but it is related to the nervous system.
- High Masking: They appear one way in the classroom and one way at home. For example, they may seem fine at school, but at home they are destructive.
- Cumulative And Fluctuating Nature Of The Disability: Sometimes they can appear typical for a period in their life, then they hit a tipping point where they can’t access the skills they have. It can look like an autistic regression. But, it isn’t really a loss of skills, rather their threat response is so activated that they can’t access the skills they have.
- Constant Need For Signals Of Safety And Undivided Attention: This often gets overlooked. It can also be paradoxical because they want freedom, choice, independence, and autonomy, shouldn’t they be able to go play independently and do their own thing? But even when given freedom they may go bother other kids, or they don’t require constant attention from their parent or teacher. If they don’t get that, they may lead to equalizing behavior or panic attacks.
Other PDA Traits
Some other traits of pathological demand avoidance (PDA) include:
- Excessive Avoidance of Demands: Autistic individuals with PDA have a pronounced tendency to actively resist and avoid demands placed upon them. Unlike some autistics who may establish specific routines or interests, those with PDA exhibit resistance even to simple requests, leading to heightened stress and anxiety.
- Anxiety and Control Issues: PDA individuals experience heightened anxiety, particularly in situations where they perceive a loss of control. They may resist even the most straightforward requests, driven by an overwhelming need to maintain their autonomy.
- Surface Sociability: Interestingly, autistic individuals with PDA may appear socially capable on the surface. However, their social interactions often stem from their desire to control the situation.
- Difficulty with Transitions: Transitioning from one activity to another can be particularly challenging for autistic individuals with PDA. Any alteration in routine or expectation can trigger resistance and anxiety.
- Intense Emotional Responses: Emotional reactions, including meltdowns, are frequently intense when autistic individuals with PDA are confronted with demands or unexpected changes. These emotional outbursts can be overwhelming for both the individual and those around them.
Autism PDA Strategies
Providing effective support to autistic individuals with PDA necessitates a unique approach that values their autonomy and emotional well-being. Here are some autism PDA strategies to consider when working with or caring for autistic individuals with PDA:
- Signal Safety Non-Verbally: Autistic individuals with PDA often interpret verbal communication as demanding. To establish a sense of safety, employ non-verbal cues such as a friendly facial expression, a gentle tone, and open body language.
- Declarative Language: Instead of issuing demands or asking questions, utilize declarative language that makes observational statements. This approach enables communication without provoking resistance or a demand avoidance reaction. An example of imperative language (given by PDA North America) is “Get your coat on”, whereas declarative language would be “It sure looks cold outside”.
- Provide Autonomy: Whenever possible, offer choices to autistic individuals with PDA, allowing them to feel in control of their decisions. This can significantly reduce anxiety and resistance.
- Strewing: This strategy consists of leaving things out so the child can naturally gravitate toward their interests. Instead of directing them toward the activities, let go of any expectations with the activities.
- Signals Of Safety: Sitting close by without initiating conversation. Presence without expectation.
- Communication Accommodation: Reducing spoken language and responding only when the child initiates.
- Avoid Overstimulation: Be mindful of sensory cues. Excessive sensory input, such as excessive talking or high-energy environments, can be overwhelming. Create calm and quiet spaces when necessary.
- Understand Special Interests: Autistic individuals with PDA often possess intense special interests. Utilize these interests as a framework for communication and motivation, as they can serve as powerful tools for engagement.
- Embrace Flexibility: Recognize that rigid routines may not be effective for autistic individuals with PDA. Instead of adhering to strict schedules, consider flexible rhythms that allow for spontaneity while maintaining a sense of predictability.
- Avoid Co-Regulation Techniques: Be cautious when employing co-regulation techniques like deep breathing or physical touch, as they may be perceived as directives. Focus on self-regulation to indirectly support the individual’s emotional regulation. We need to regulate ourselves as adults and give off calm vibes vs being obvious that we are trying to get the child to copy what we are doing.
- Use Humor: Using humor is a great way to make everyone feel more relaxed and to help reduce the perception of demands.
Where To Start With Autism PDA
1. Pause: Take a step back and observe.
2. Experiment With Other Ways Of Doing Things: Try strewing, waiting until they ask a question, or providing autonomy.
3. Signaling Safety Without Words: Pay attention to your tone of voice, think about your facial expressions, and get low at their level. Sometimes it can help to use a sing-songy voice. This indicates to the subconscious survival brain that they are safe. Sit on the floor when talking because the PDA child will perceive himself as equal to or above the adult and this preempts the threat response.
4. Declarative Language: The Declarative Language Handbook can help caregivers move from using imperative language or asking questions to using declarative language. Observational statements can be more helpful for PDA kids.
The 4 S’s Framework For Autism And PDA
In podcast episode #54, Casey shares the 4 S’s mini-framework, which she describes as the 4 regulatory states for a PDA child. The 4 S’s consist of:
Safe nervous system: Provide 1:1 engagement consistently as much as possible.
Screens: If they are not on a screen, they are going to need one of the other 3 S’s.
Sensory intense, novel, or dopamine-provoking activities: Using novel or new activities, along with sensory activities. Both of these can provide dopamine hits for the child.
Special interest: Using characters or activities that the child is passionate about.
Autism And PDA: Learn More
Casey Ehrlich, Ph.D. has a website called At Peace Parents. She shares more information about autism and PDA on her website, in her free masterclass, and on social media.
Links to adult PDAer accounts recommended by Casey:
@rabbishoshana – Shoshana Meira Friedman
@demi.not.lovato – Demi Burnett
@kendahldamashek – Kendahl Damashek
@in.play.we.trust – Katherine Aurora Callahan
Sally Cat on Facebook
Navigating the unique challenges associated with the combination of autism and Pathological Demand Avoidance (PDA) can be challenging. By prioritizing autonomy, providing non-verbal signals of safety, and embracing flexibility, we can offer effective support to autistic individuals with PDA and address autism PDA symptoms. Through compassion and tailored approaches. I encourage you to seek more information about autism and PDA by following Casey Ehrlich!