Refusing Simple Demands – Understanding PDA in Autism

Here are some considerations to help our autistic children with pathological demand avoidance.

“No” is such a simple word, yet these two letters can stop even the most well-meaning parent in their tracks as they try to navigate the challenging world of parenting. In our ever more hurried society, our children refusing even simple requests stresses the entire family as we attempt to cross items off a growing list of tasks, chores, and responsibilities. Some days, it may seem that we may never dig ourselves out of this deepening blizzard to see the light of day and get ahead of our household duties.

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Autism Behavior Interventions

In the case of Pathological Demand Avoidance (PDA), the word “no” is characterized by children who may refuse to do what seems like simple everyday demands. Direct requests are often met with refusal, and indirect demands to do a school assignment or answer a question may be responded to similarly. As a result, these children may appear to be oppositional and defiant or are simply testing our patience.

When we take a deeper dive into PDA, we can better understand why our children may choose this strategy to address what looks like basic requests. It requires an understanding and working hand-in-hand to help shift answers towards leaping over the obstacle of the word “no” towards ultimate compliance. Our world is adult-driven and dominated; they often feel little control over their daily routines and lives.

Let’s look at some considerations when helping children through Pathological Demand Avoidance.

Demands in many forms

Keep in mind that demands come in many forms. 

Direct demands

These are verbal requests to do something.

Tasks and stressors

These would be items like school assignments or answering challenging questions.

Physical demands

These include physical feelings such as being sick, tired, or hungry.  

Remember that demands often dominate our lives and our children. Aside from the demands mentioned above, relationships, rules, social norms, requests from others, and wants and needs are also included in these potential triggers.

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Control

All children have control over relatively few aspects of their lives, namely:

• what they will or will not eat 
• what they will or will not wear
• when they will or will not use the bathroom
• when they will or will not try to sleep 
• when they will or will not behave   

When they feel less in control of other aspects of their lives, they will try to overcontrol these domains of their behavior. Giving our children limited choices that they can understand and we can accept is the key to tackling this.

Anger and frustration

As demands become more challenging, those with PDA become less able to cope due to frustration and anger. They often exhibit a fight or flight response in which their decision-making ability becomes extremely limited due to perceived anger and fear. Therefore, the best means of addressing demands are being calm, slow, and deliberate in your requests and assuring your child that the environment is safe and predictable.

When a child becomes frustrated, angry, and fully engulfed in fight or flight responses, it will generally take twenty minutes for their body to get back to a calm, balanced state in which they can comprehend requests or demands. This is because when we exhibit fight or flight, the chemicals of adrenaline and cortisol that dump into our system take about twenty minutes to deplete and permit functioning to return to normal.

Anxiety and anticipation

A great deal of demand avoidance has to do with anxiety and the inability to anticipate what is going to happen next. One optimal way to address this is to give your child as much information as possible about what will happen before they experience the scenario. 

Allowing time to be proactive and answer potential questions or concerns that could occur, as well as having a plan should things go awry, is also very beneficial.  

Finally, when possible, avoiding circumstances that may create sensory overload will help in demand avoidance.

Calm and concrete

When you give commands or demands, keep your voice calm and steady. Use as few words as possible. Avoid sarcasm and be concrete in your words. Instead of saying what you don’t want your child to do, be specific about what you want them to do.

Voice feelings

Recognize that your child may feel several emotions when refusing a request or a demand. Help them voice their feelings under the refusal, such as fear, frustration, and anger. Reassure them that discussing all these emotions is okay and they may have more than one emotion at a time.

Scale frustration and feelings

Remember that all of our perceptions are, in fact, our realities. When a demand is placed on your child, it may seem like the most difficult challenge. However, if we ask them to scale their frustration and anxiety from one (the least) to ten (the worst), we can help them realize that not every issue or problem is seemingly impossible.

“I” messages

Teach them assertiveness in expressing their emotions by using “I” messages. In this way, we explain to them that having feelings and concerns about someone’s request is okay. However, they must tell us how they feel, why that is so, and what might solve the issue.

Here is the format for an “I” message:

• I feel _____________ (What emotion you are feeling)
• Because ____________ (Why you are feeling that way)
• And I need _____________ (What others can do to help you with this feeling)

Understand and help

PDA is a coping strategy that can be frustrating to address and understand. Yet, for any of us who have procrastinated on some task we dreaded doing or felt ill-equipped to handle an upcoming situation, we can somewhat understand this defense mechanism.    

For a child with ASD, the mountains of challenge can seem too large and foreboding to climb. Instead, let’s help our children reach each summit one step at a time.