Pathological Demand Avoidance

The 'I can't response'

Pathological Demand Avoidance, PDA, is a subtype of autism and can be defined as a pervasive developmental disorder that falls under the autism spectrum.

PDA is categorized by people who resist or avoid demands of daily life because it surfaces an intense amount of pressure or anxiety. Typically, PDA can be considered high functioning in some ways, while also low functioning in other ways. Considering the autism spectrum, we see that the social communication skills of people with PDA are stronger and the person may act neurotypical, for example, making eye contact. However, when depth begins to develop during social interactions those with PDA retract and struggle to maintain the interaction. People with PDA also use social manipulation very well; lying, deceiving and making strong excuses, as compared to those who have Aspergers.

When a child with PDA is triggered it can lead to outrageous, impulsive meltdowns that are difficult to get control of. It is a complicated and often misunderstood condition triggered by the heightened anxiety response to demands being placed on them. Pathological Demand Avoidance is not universally recognized as a diagnosis, therefore, it is often misdiagnosed as mood disorders, such as bipolar disorder.

➤ Signs of Pathological Demand Avoidance: 

  • Avoids Ordinary Demands of Life
  • Social, but lacks understanding
  • Frequent mood swings and impulsivity
  • Uses social strategies, ex. Distraction and giving excuses
  • Withdrawing into Fantasy
  • Acknowledging demands, but excluding themselves

Pathological Demand Avoidance can also often be confused with Oppositional Defiant Disorder due to lack of awareness. Oppositional Defiant Disorder is diagnosed by seeing patterns of hostility, disobedience, and defiant behavior directed towards adults or other authority figures. Children with Oppositional Defiant Disorder will not comply to demands because of their behavior, however, children with PDA want to comply to demands but cannot due to the heightened anxiety they experience. Children with PDA are experiencing sensory overload; therefore, their bodies are being taken over and they cannot help it. 

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Pathological Demand Avoidance is commonly known for refraining. Rather than the person being faced with demands, they choose to isolate themselves and pretend that the demand does not exist. Another characteristic of PDA is high levels of anxiety, especially when demands are being placed on them. Below are other signs of PDA.

To offer the best help and support for your child who may have Pathological Demand Avoidance requires the parent or guardian to be patient and understanding. Not every strategy or approach may be effective for your child, it is important to remain open-minded while trying to distinguish a demand avoidant profile from other profiles. A great starting place is to create a series of lists for your child, and asking them what they can complete on the list. This opportunity to choose gives them a sense of power and control that can lead to reducing their anxiety.

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Due to our intensive parenting support process, in addition to individual weekly child sessions, weekly parenting sessions are expected at the beginning of therapy.  The duration of these sessions depends on the level of distress in the family and the level of parenting needs. With meeting weekly, many families meet their goals in 6-8 months!

Therapists in Charlotte who work with Children & Pre-teens

Below are our therapists who specialize in Pathological Demand Avoidance Treatment.

~ Treatment for Pathological Demand Avoidance in Charlotte, NC ~

Dandelion Family Counseling provides treatment for Pathological Demand Avoidance in the South Park area of Charlotte.

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