PDA Diagnosis and Assessment

Detailed assessment to help us identify this lesser known profile of autism called Pathological Demand Avoidance

About demand avoidance

Autistic children and adults can experience great stress and anxiety when negotiating a world that doesn’t always make sense to them and it is usual for all people to seek more control when they are anxious.

However, some people have an intense need to seek control as part of their neurotype, going to great lengths to avoid demands placed on them by others. Those with this profile of autism are referred to as experiencing ‘PDA’ or ‘Pathological Demand Avoidance.’ This can also be known as pervasive drive for autonomy or a ‘demand avoidant profile.’

Many parents of children with a demand-avoidant profile struggle to have this recognised, as there’s some controversy over the very existence of PDA as a distinct diagnosis. PDA doesn’t appear in the standard diagnostic manuals, but it’s now been formally recognised by the National Autistic Society as a subtype of autism spectrum conditions.

How can we help?

We know that for people with a profile of PDA, it cannot be assumed that ‘traditional’ strategies designed to help with autism will be effective. In fact, in our experience, some of these strategies can heighten the anxiety to a point that the person will eventually react with an anxiety response, sometimes involving fight or flight, or freezing or fawning. We see this a lot where children are ‘no problem’ in school and then become overtly distressed as they leave the environment they find stressful.

We can identify where a pattern of demand avoidance exists as part of a wider assessment for autism. We profile the person’s behaviour and we are clear where there is a PDA-profile, as this helps the individual or those working or living with the individual to better understand their needs.

Mrs A, North West England

‘The process for assessment was smooth and the empathy and sensitivity that all staff showed to our daughter was simply magnificent. From the calming influence of Dr Taylor to the kindness showed to our daughter on the day of assessment when she was unable to make it up the stairs as she was so anxious. They literally met her on the stairs, put her at ease and gently guided her to bond with her over her passion for teddy bears (and chickens!).’ 

Mr and Mrs S, Yorkshire

‘Thank you so very much, you have helped more than anyone else so far. You are wonderful people and what you are doing is priceless, we cannot recommend you enough. We wish everyone could come to you, we are truly truly grateful.’  

Mrs A, Lancashire

‘We really can’t thank you enough for going the extra mile to provide us with some answers where others had previously failed. We are so glad we made the decision to have our daughter assessed by Spectrum.’  

Mrs K, Staffordshire

‘Thank you again for coming to see us, i felt so positive after your visit, and excited to try the strategies that you suggested. It was amazing to have that communication and feedback from our little boy after going so long with nothing from him. I really can’t thank you enough!’ 

Mrs S, Lancashire

‘I felt that my son was finally understood and appreciated for who he was. It was more than I could have ever expected.…The report was exceptional… valuable information about my son that I can’t stop reading. I finally understand everything I’ve wanted to understand for so long, and it’s in my hands to ponder and learn; I have the information to act on to help my son. I’ve never felt so enlightened.’ 

Mrs M, Liverpool

‘After years of feeling that our teen son had sensory issues and anxiety, we heard about PDA online and contacted Spectrum North West for assessment, and I’m so glad we did. As a family we have been treated with respect and understanding – something that is very hard to come by when you can’t explain your child’s behaviours to the people that feature in their everyday life. Until we sought help from Spectrum North West, we had been made to feel that we were ‘nice’ but ‘too soft’ and ‘ineffective.’ After the assessment was carried out, it was as though someone had released the pressure button. Until we contacted them, we had no idea that our son was autistic, because we were unaware at that time that PDA was a profile of autism. They have been professional, caring and understanding in the way that they interacted with all of us and guided us through the process. I would (and have) recommend to anyone looking to have these assessments done. Thank you.’