Are you deliberately defying me? Experts say it may be PDA

Are you finding that a family member regularly resists your demands, and often just ignores you? Do you feel it is deliberate? I’ve been dealing with what I thought was deliberate defiance behavior from my spouse of 32 years, only to learn he unknowingly is struggling with pathological demand avoidance (PDA), a functional impairment understood as a profile on the autism spectrum.

We all sometimes evade tasks we are asked to do, but for some people, like my husband (who is on the autism spectrum), requests or demands can seem overwhelming. Those with PDA traits often exhibit heightened social sensitivity, which they may use to manipulate or distract others to avoid their requests. That is why many misidentify PDA as deliberate defiance.

Elizabeth Newson, a British developmental psychologist, first identified PDA in the 1980s, to describe people who do not want to cooperate with instructions even when it would be in their own interest. She identified this trait in a group of children who would avoid everyday demands and expectations to an extreme extent. According to her extensive research, she determined PDA was a distinct profile of autism.

Today, some 40 years after Dr. Newson’s discovery, PDA still is not a formal diagnosis. Researchers continue to investigate its distinct features and how it fits under the autism spectrum umbrella.

It is estimated that about one in five autistic individuals present with a PDA profile, also known as Persistent Demand for Autonomy.

How can we identify PDA? Just like autism spectrum disorder, it can look different from person to person and manifest in many ways including:

  • Obsessive behavior toward others
  • Strong need for control over their environment, often anxiety related
  • Excessive mood swings such as loss of control, going into fight or flight mode or withdrawing
  • Impulsive behavior
  • The use of elaborate social strategies to avoid tasks (eg, distraction, negotiation, excuses)
  • Resistance to, and avoidance of, ordinary life demands to an extreme extent – demands are avoided, not because they are unpleasant or difficult to accomplish, but because these individuals perceive them as threatening, causing great distress. They tend to avoid all demands, even those that don’t produce negative outcomes.
  • A tendency not to respond to conventional parenting, teaching, or support strategies

Individuals displaying PDA traits also may resist demands involving time restrictions and expectations, specific plans you make, questions that require a response, decision-making and transitions. These demands can cause sensory overload.

What can we do to accommodate individuals exhibiting PDA tendencies?

  • Start by adjusting the way we present demands to reduce anxiety and resistance. If we push too hard, we only increase anxiety, which can lead to a meltdown.
  • Use suggestive techniques or offer choices instead of direct demands. Here is an example: instead of saying, “do your homework now,” try asking, “would you like to start your homework now or after lunch?”
  • Incorporate flexibility in your requests. If they are not ready to respond to you, give them some time and revisit your request later.
  • Involve them in decision-making, which helps them feel empowered instead of pressured.
  • Create an environment that feels safe and gives them a sense of control and autonomy.
  • Find a quiet space for them to retreat when they feel overwhelmed.
  • Reframe tasks as fun challenges.
  • Use supportive language. Rephrase demands into softer questions to reduce resistance.

PDA presents unique challenges, but with the right accommodations, and some patience and understanding, we can help these individuals thrive. Flexibility, choice, and reducing pressure are critical strategies for success. It is up to us to create a supportive environment where these individuals can feel empowered and safe.