Welcome back to Turn the Paige! I hope you all had a wonderful holiday season and are staying warm! I tend to become a home body during this time of year because Chicago winters are brutal. I spend a ton of time online- learning and going down rabbit holes in research to ensure I am up to date on anything and everything that connects to ADHD & executive function.
Recently, I learned about a diagnosis called PDA—no, not the PDA you’re thinking of, but PDA as in Pathological Demand Avoidance. Research shows it’s most commonly seen in those diagnosed with ADHD (Attention Deficit Hyperactivity Disorder) or ASD (Autism Spectrum Disorder), often alongside other co-existing diagnoses, so I felt compelled to share some insights.
PDA is defined by the overwhelming need to avoid, reject, or resist requests or directions due to a lack of autonomy or control in a situation. This avoidance can extend to any expectation, even routine activities like taking off your shoes when you get home, or participating in highly desired activities like going out for ice cream with a friend. These seemingly simple requests can trigger a meltdown or even a panic attack in someone with PDA.
A Deeper Dive Into PDA
Ok, Paige, back up. You just said my child could have a panic attack from being asked to go get ice cream…? What do you mean?
I know. It sounds a bit surprising, but for a person with PDA, being asked to go get ice cream might translate to something like:
“Stop doing what you’re doing, and come do what I am asking you to do.”
“If I leave right now, I will lose control of my environment.”
“If I leave right now, I will no longer be able to pick what I want to do.”
While your intention is a kind gesture, the person with PDA often processes the request as a loss of control over themselves or their environment. This dynamic can be challenging not only for the person with PDA but also for their loved ones, who may struggle to understand why such reactions occur. This perception can trigger their fight-or-flight response, leading to significant overwhelm.
Key Features of PDA
After diving deeper into the research, here’s what I found interesting:
PDA presents differently in everyone. It’s a spectrum within a spectrum.
What does PDA behavior look like?
Using humor or cleverness to navigate social situations but struggling to maintain deeper connections.
Appearing oppositional or defiant on purpose.
Engaging in manipulative behaviors, negotiation, or distraction to avoid demands.
Ignoring requests outright.
PDA is often mistaken for Oppositional Defiance Disorder (ODD).
For some, even highly desired requests can be refused if they perceive the ask as too assertive, which could trigger their fight-or-flight response.
Some professionals refer to PDA as a “persistent drive for autonomy.”
While many providers suggest offering choices to someone with PDA, this can sometimes exacerbate their anxiety rather than alleviate it.
The Nervous System Connection
Here’s how it often plays out:
Processing assertiveness in a request can lead to a dysregulated nervous system.
This dysregulation triggers a fight-or-flight response, leaving the person anxious, on high alert, and prone to impulsive behavior.
Accommodations for Students with PDA
Working with students with PDA requires a thoughtful approach tailored to their needs. Here are some strategies:
Provide visual schedules and routines. Use tools like picture schedules or written lists to give students a sense of predictability.
Use indirect language. Instead of making demands, frame statements as observations or questions, such as, “I wonder what we should do next?”
Allow flexible pacing. Let students take breaks or engage in self-directed tasks if they feel overwhelmed.
Offer limited and low-pressure choices. For example, “Would you like to use markers or crayons?” instead of “What do you want to do?”
Establish a safe space. Provide a designated area where the student can go to self-regulate when they feel anxious.
Collaborate on problem-solving. Involve the student in creating solutions to challenges to give them a sense of ownership and control.
Minimize surprises. Give advance notice for transitions or changes in routine to help reduce anxiety.
Scale back requests during times of high anxiety. Make sure to document specific examples of how the student presents anxiety and incorporate them into their support plan.
Incorporate their special interests into learning. This allows the student to feel more in control of their learning experience.
Model expected behaviors without expecting immediate imitation. For example, a teacher might demonstrate a behavior as a way to gently guide rather than demand.
Are you a parent and need help with your child's academic accommodations? LOOK NO FURTHER!
Communication Strategies for PDA
Using specific language can help disarm the fight-or-flight response. For instance:
Avoid direct commands.
Instead of saying, “Clean your room now,” try, “Let’s figure out how to make your room feel more comfortable together.”
Instead of saying, “Go get ready for school,” try, “Together, let’s get ready for school.”
“Together” conveys collaboration.
“Let’s” reassures the person that they are not alone.
Empathize with their feelings. Validate their emotions by saying things like, “I understand that this feels hard for you right now.”
Use humor and playfulness. Approaching requests in a lighthearted way can sometimes ease tension, such as turning tasks into games.
Break tasks into small, manageable steps. Instead of asking them to complete an entire activity, focus on one step at a time and praise your child after completing each step to building reinforcement.
Encourage collaboration. Say things like, “How can we tackle this together?” to give them a sense of shared control.
Reflect on what works. After a challenging situation, calmly discuss what strategies helped and how to approach similar moments in the future.
Regularly engage in activities that calm the nervous system, such as mindfulness exercises or sensory breaks.
Final Thoughts
PDA is a complex and nuanced profile that requires understanding, flexibility, and compassion. It’s important to remember that everyone’s journey is unique. By learning about it and adapting our approaches, we can help create environments that foster safety and autonomy for those who live with it. If this resonates with you or someone you know, let’s continue the conversation and explore how we can better support those navigating life with PDA.
All the best,
Coach Paige
Are you or your child struggling with ADHD or ADHD-like symptoms or something in between? I can help! Click below!
Coach Paige Krug is a Chicago-based ADHD coach, learning behavior specialist, and educational advocate. She is passionate about her clients having the appropriate support they need to be successful inside and outside the classroom. She spends her free time with her husband enjoying the best gluten free eats around Chicago, playing with their sweet pup Ollie, and claims the title of number fan of the Bravo Network especially the Real Housewives franchise.
Looking for more resources? Click the image below to take you to over 20 evidence based resources and visuals to download for free!
Comentarios