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Learn More about Pathological Demand Avoidance


PDA is a complex autism spectrum condition which is best described as an “Anxiety Based Need to be in control” Children with PDA still have significant difficulties associated with the Triad of Impairment, however, they are highly skilled at avoiding demands and masking their difficulties.  Children with PDA often behave very differently in different settings and it is often hard for parents to get a diagnosis as many professionals are unable to diagnosis it without clear autistic traits.


These are the characteristics of Behaviour Associated with PDA as described by Elizabeth Newson et al:  (Newson 1998, Revised 1995, Second Revision 2000, Third Revision 2001) 


         Resists and avoids the ordinary demands of life

         Appearing sociable, but lacking depth in understanding

         Excessive mood swings and impulsivity

         Comfortable in role play and pretend, sometimes to an extreme extent

         Language delay, often with good degree of catch-up

         Obsessive behaviour, often focussed on people, either loving or loathing them

         Can be domineering and overbearing

         Parents often describe a “Jekyll and Hyde” personality

         Bossy and controlling

         Often more comfortable with adults than children

         Often hypersensitive to other’s voices, facial expression etc

         Can be over familiar with adults and peers

         May take on the persona of others, i.e. teachers.

         May go into role in order to comply

         May have a panic attack or meltdown if highly anxious – these may result in aggression towards others

         Unaware of impact of behaviour on others

         Can behave very differently at school /college to home

         Unable to follow routines if set by others

         Often have sensory issues – noise, touch, brightness etc


Children with PDA are highly complex and often display behaviours which are very challenging to those around them.  There is also a significant impact on the rest of the family when a child has PDA.

 Although it is recognised by many as being an autism spectrum condition, individuals with PDA do not respond well to traditional autism strategies and far more flexible approach which allows the individual with PDA to believe they are in in control is far more effective.  The following strategies can be helpful when supporting children with PDA:

Remember that ANXIETY is what drives the behaviour of an individual with PDA.  If you always consider the anxiety rather than the behaviour you are more likely look for solutions and try to help.  Also remember that sometimes anxiety stops individuals with PDA doing the things they want to do as well as the things they don’t.


Use a flexible, non-directive approach.  Use phrases such as, “I wonder how we might……..”, “I wonder if anyone can do this?”


Be aware of your facial expressions.  Individuals with PDA can be hyper sensitive to tone of voice and facial clues, which can often cause them anxiety.


Offer choices.  This gives the illusion of control and lowers anxiety.  “Would you like to do X or Y first?”  “Would you like to sit here or here to do your work?”


Use challenges:  I bet you can’t finish this work before me!”


Praise indirectly: Let them hear you talking about them in a positive way.  Or send postcards home to celebrate success.


Use areas of interest to engage and motivate:  Look for ways to weave hobbies and interests into work.


Reduce pressures and pick your battles.  There will be days when anxiety is too high for an individual to comply with any demands.  This is fine.  You will have good and bad days.  Look for ways you can support so that work gets done, i.e. offer to scribe, or finish things for them.

·     Have a sense of humour!  Be prepared to take the mickey out of yourself too!!


·         Depersonalise Rules.  “I am afraid you can’t go outside as its slippery and our Health and Safety rules forbid it” or “It’s the law”


·         Show empathy and sympathy:  “I know you find maths really hard.  I do too. Shall we work on this together?”


·         Try to find a balance between routine and spontaneity. This will be dependent on the individual’s mood and anxiety levels.  But lots of individual’s with PDA like surprise and don’t like routine if too rigid or set by others.


·         Use Complex Language.  Sometimes it is possible to disguise a demand by wrapping it in complex language and making suggestions which allow the individual with PDA to think that they are in control.


·         Rewards need to be individualised, quick and personalised.  Often group rewards are ineffective and don’t motivate the individual with PDA.  You need to make sure they are motivational and change regularly.


·         Use surprise or spontaneous rewards.  “I love the fact you have worked hard, you can go on the computer now!


·         Most importantly!  Remember that everyone with PDA is different and should be treated with an individual approach!




“On behalf of Creative Support, I would like to thank you for the excellent training you provided.


There was nothing but positive feedback regarding the trainer’s ease of delivery and depth of knowledge on her subject. I feel I can say with confidence that each delegate will have left this training with regained confidence and new knowledge, regardless of what level of experience they have already.”



Brenda Moss, Creative Support



Very informative, lots of strategies I will try with both my own son and children in schoolJodie. Attended Autism Spectrum: Next Steps Level 3

emotional, enlightening and has made a huge difference to how I perceive Autism Mary. Attended Intensive Interaction

Fantastically delivered, a great informative day which will definitely inform my teaching and practice. Jo. Attended Positive Ways of Changing Behaviour

Really enjoyed the training session. Very useful and full of information. Great trainer!! Whitney. Attended Autism Spectrum: Next Steps Level 3

Great course, very informative, well presented by Claire Grace, learnt loads. Thank you.Anthony. Attended Autism Spectrum: Next Steps Level 3

I have found them to be a professional and highly effective training providerShelagh Mackey. Manager, Stevenage Educational Trust

Felt like I was sitting listening to a very wise womanJuanita Strange. National Autistic Society

A Fabulous warm funny, experienced realistic trainer, was a pleasure. Thank you Debbi. Attended Autism Spectrum: Next Steps Level 3

an afternoon that provided many insights and much practical adviceJames Harding. Deputy Head, The Purcell School For Young Musicians

Very Informative.Jo. Attended Understanding Attachment Disorders

Enjoyable, informative and very useful.Julie. Attended Understanding Behaviour as Communication

I regularly recommend the courses delivered by Concept Training to my colleaguesFran Clayton. Deputy Head, Pendle View Primary School

All of the commissions have been delivered to the highest standardJulie Curtis. Learning and Development Consultant, Warwickshire County Council

Excellent presentation – one of the best training courses I have been onChris. Attended Intensive Interaction

Excellent course, excellent tutor, excellent day.Andy. Attended Autism Spectrum: Next Steps Level 3

The day flew by! Very enjoyable. Lauren. Attended Positive Ways of Changing Behaviour

All members of our staff who have attended training organised by Concept have found it to be valuableSarah Melman. Deputy Head, Jack Tizard School

I have no hesitation in recommending them as trainers.David Aarons. Mapledown School

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