Disabilities, Learning Challenges, and Educational Tips

Treatment and Management of PDA Autism

Recognizing and supporting individuals who consistently and noticeably avoid demands is crucial. Tailoring strategies and approaches based on their unique strengths and requirements is essential. Accessing appropriate support heavily relies on comprehending and accepting the concept of demand avoidance behavior, as indicated by research findings.

Here are a few strategies to make communicating (hopefully) a little easier for both of you.

1..Work on building a strong relationship rooted in trust. The individual should experience a sense of safety and stability in their surroundings. They must receive consistent and reliable responses from their loved ones and support team. Be fully present and actively listen to the PDA autistic individual. Foster trust and establish a strong bond with the individual. When people perceive their loved ones and support team members as trustworthy allies, they are more inclined to respond positively to them.

2. Avoid using ‘demand words’ (e.g., “need,” “now,” “must,” “urgently”). Where possible, try to make indirect requests instead of using demand words. For example:

  • “Is it alright if we…”
  • “How do you feel about….”
  • “I wonder if we might…”
  • “Could you please help me? I wonder if you could…”
  • “Let’s see if there’s a way to….”

You may also like to try using humor to make demands feel less oppressive to the PDA-er. For instance, “Wanna play a game? Let’s make a bet – I bet you can’t…”

3. Remain calm, and don’t take it personally. Try to view meltdowns or tantrums as intense panic attacks that require your assistance to handle rather than as acts of defiance. Attempt to refrain from imposing consequences as this frequently exacerbates the situation.

Employ the three R’s (Regulate, Relate, and Reason) to acknowledge their emotions and address meltdowns instead. The PDA-er requires reassurance and should not be made to feel ashamed of their behavior. They have no control over it.

4. Depersonalize requests. If requests are made too forcefully, queries and instructions may be misunderstood, resulting in a PDA-ers refusal to cooperate. Utilize written requests or visual cues to remove the personal aspect of the demand. Another effective approach is to attribute the need for a request to external factors such as health and safety.

For instance, you can explain to the person, “Brushing your teeth helps maintain the health of your teeth and gums, as well as keeping your breath fresh.” Additionally, employing puppets and toys as a ‘third person’ can depersonalize requests and suggest ideas, such as saying, “Lego Leah is curious if we can…”

5. Give indirect praise. People diagnosed with Pathological Demand Avoidance tend to avoid direct praise due to the potential increase in anxiety. Instead, it is more effective to acknowledge their involvement and contributions by offering affirmations and praising the results.

For instance, you can express your gratitude by saying, “I appreciate your assistance in tidying up the dishes” or “It’s wonderful to witness your successful completion of all of your projects.”

6. Be consistent. Decide on the non-negotiables, explain the reasons for doing and stick to them. Structure and consistency makes the world predictable, and therefore much less confusing, overwhelming or anxiety-inducing.

7. Be flexible (within reason). Allow the PDA-er a sense of control, and be prepared to negotiate. This might mean watching out for signs that they are getting overwhelmed. Then, you can adjust the demands before behaviors escalate.

The Importance of Empathy and Understanding

PDA meltdowns, shutdowns, and behavioral escalations can be silent, concealed yet profoundly impactful emergencies. Identifying these behaviors and triggers is imperative for anyone seeking to assist autistic individuals.

Exhibiting patience, comprehension, and compassion is arguably the best way to offer support without exacerbating their already heightened levels of stress.

Never shame them, blame them, or chastise them. Experiencing PDA is not a conscious choice, a flick of a switch, or an attempt to manipulate a situation with behavior. It is primarily out of the autistic person’s control. While they may sense it coming and sometimes may be able to self-soothe or co-regulate enough to stave off a behavioral shift, it is still not a conscious choice.

Empathy and well-informed support can truly have a profound impact on someone grappling with PDA.

It is crucial to bear in mind that the objective of comprehending and handling autistic PDA is not to “repair” the person. Create a world that is more inclusive and considerate of their requirements. This can only be achieved through raising awareness, providing education, and fostering empathy towards the diverse ways in which individuals perceive the world. 

Autistic individuals, like all individuals, possess a variety of experiences and reactions to the world surrounding them. By comprehending these diverse experiences, we can enhance our ability to provide support to autistic people in a way that acknowledges their unique neurological makeup and enhances their overall well-being.

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