Autism Spectrum and PDA
We take a neurodivergent affirming stance when it comes to discussing the treatment of autism. We see autism as reflecting a brain type that is hardly “less than.” Rather, we recognize that autistic individuals are disproportinately responsible for some of the most important innovations that our society enjoys. Autistic individuals bring a capacity to perceive elements that “neurotypicals” might miss, whether related to social justice, patterns in the environment, creativity, or sensory experiences. At the same time, autism is associated with relatively high rates of seeking mental health services. Autism is linked to genuine mental health vulnerabilities. Autistic individuals are suspectible to anxiety, depression, emotion dysregulation, and behavior dysregulation. There are aspects to our environment than can create undue stress for persons with autism.*
As with most issues that we work with at CATS, we value parent/ caregiver involvement when it comes to building mental health resilience. It’s also common for us to need to address supports at school so that the child or teen is better understood by their education team and can certain accommodations. Many of our evidence-based approaches for addressing issues such as emotion dysregulation and behavior issues have been shown to be applicable and effective when autism is in the picture.
*We intentionally use both identity-first and person-first language because we recognize that people within the autism community vary in their preference of which type of language suits them best.
Common challenges associate with autism that may warrent mental health support:
Transitions
Inflexibility
Friendship development
Emotion dysregulation
Meltdowns
Sensory overwhelm
Interpersonal conflict
Overreliance on screens to self-regulate
We get a lot of questions about Pathological Demand Avoidance (PDA). PDA is not a recognized diagnosis in the United States, and it has not yet been validated as a construct in the scientific literature. However, many families find the framework to be helpful to understanding their child’s needs.
What is PDA?
A theoretical concept and framework, not a diagnosis
Considered, in theory, to be a part of the autism spectrum
An anxiety-driven need to be in control and avoid other people’s demands and expectations
Children with PDA have difficulty seeing boundaries and understanding their social obligations
How is PDA expressed?
Making excuses
Off-task behavior
Negotiation
Defiance
Meltdowns
Physical outbursts, explosive behavior, or aggression
What do we do about PDA?
Personalized learning experience (to accommodate areas of special interest)
Continual adjusting of expectations
Flexibility and accommodations
Explicitly evaluate and rank priorities (high, medium, low)
Use planned ignoring for low-ranking priorities
Reduce anxiety
Build self-awareness
Avoid unnecessary confrontation
Support the needs of adults working with the child with PDA