Adult or child, neurodivergent or neurotypical, we can all benefit from strategies and tools to support nervous system regulation. Avoiding meltdowns and panic attacks is an accomplishment for even the most self aware adult. But for neurodivergent individuals, particularly autistic kids with pathological demand avoidance (PDA), it becomes even harder. Young children’s brains are not fully developed yet, especially the prefrontal cortex that is often recruited to analyze situations and think logically. Understanding which tools work for nervous system regulation can be pivotal in supporting your child through their dysregulation.
Pathological Demand Avoidance (PDA) And Autism
PDA is a theorized profile that is seen in a subset of autistic children. Because it is not well-studied (yet!), estimates of how many autistic children have PDA are unknown. Referred to as a persistent or pervasive drive for autonomy by the autistic community, individuals with this profile often experience fight or flight or intense anxiety in response to any demand or a perceived loss of autonomy. These behaviors can appear oppositional or defiant, but are actually a behavioral response to extreme nervous system dysregulation to the extent that it can be conceptualized as a nervous system disability. PDA children are not intentionally this way, their nervous system’s are simply more easily activated and stressed than neurotypical humans.
PDA generally shows up as avoidance, aggression, or arguing in response to a perceived loss of autonomy. Parents of children who demonstrate symptoms of PDA often describe they feel like they are walking on eggshells around their children. Symptoms of selective mutism or very intense anxiety to the point of avoidance or refusal can also be common with PDA.
Navigating PDA
Navigating PDA can feel overwhelming, both for the neurodivergent individual and their caregiver; it is not uncommon for your child’s dysregulated nervous system to trigger your own anxiety response, or a response where you are trying so hard to get them to calm down that it actually makes the situation worse.
As a caregiver, it is important to recognize when your loved one starts to go into distress. Different from a tantrum, this distress is characterized by complete overwhelm and dysregulation often known as a meltdown or neurocrash. Your child’s regulation systems are usually completely offline at this point. Knowing what tools and practices to use to help guide them through this intense fight or flight response is paramount for the individual’s safety and for their overall wellbeing.
Actionable Steps To Support Someone Who Experiences Intense Tantrums or PDA
Intervention approaches should focus on helping the child to regulate their nervous system, rather than trying to “stop” the episode. Simply be with them. Reduce the amount of words you are using. Take some deep breaths yourself but do not prompt your child to do anything at that moment. Four things are known to help calm the nervous system proactively:
- Screen time: Yes, you read that right! Screen time for autistic children, in moderation, can be a useful tool for bringing a nervous system back into regulation through calming online activities.
- Another safe, regulated person: This is why your nervous system regulation matters, too!
- Special interest activities: This may look like creating a marble run for hours on end or reading or sharing all their favorite facts about a topic they love.
- Dopamine: Sensory seeking activities such as lots of big body movements like crashing into something, jumping on a mini trampoline, or transforming things with Kinetic sand or similar materials.
Setting Boundaries Are Important
It will be important to determine which of these are most effective for each kid.
Where possible, demands should be reduced. It is important to note that this can be a mindset shift and may feel counterintuitive to many mainstream parenting approaches. Boundaries are still important, particularly around safety, but it can be beneficial to explore where they are essential vs. preferred.
A low-demand lifestyle also includes, when possible, making suggestions vs. explicitly asking your child to do something. This can look like using declarative language:
- “I have set your clothes out” vs “I need you to get dressed.”
- Making suggestions, asking in a playful manner, or making mundane tasks a game can also be effective:
- Providing many options for the child to choose from, or modeling what you want them to do. Often with PDAers, they are more likely to do things when it feels like a choice rather than a requirement.
Additional Resources To Learn More about PDA and Nervous System Regulation
- The PDA Resource
- PDA North America
- PDA Society
- At Peace Parents Podcast
- The PANDA Approach from the PDA Society summarizes helpful approaches for PDA children and further explains many of the strategies I elaborate on below!
- Although not written explicitly with PDA in mind, the approaches introduced in the Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children by Dr. Ross Greene are ideal for navigating and supporting PDA. Other books and resources are also listed on the websites above.
Social Media Accounts to Follow
@the.dr.tay on Instagram and TikTok
@atpeaceparents on Instagram and TikTok
@pda.project on Instagram
@stephstwogirls on Instagram and Facebook
When to Seek a Professional
Ask your child’s pediatrician for a referral to a professional that can provide a diagnostic evaluation. However, don’t be shocked if your doctor has never heard of PDA, as this has not made its way into mainstream medicine yet because it is new and not well-studied. If your child is not yet diagnosed with autism, find a child psychologist, developmental behavioral pediatrician, or other provider that specializes in autism.
If your child has been identified as autistic, there is no additional diagnosis for PDA. Instead, find a child psychologist or mental health provider that can support your family using a PDA lens and you can discuss with them if your child presents symptoms that align with the PDA profile. As a whole, focus on finding providers that provide neurodivergent affirming care, as they are more likely to be familiar with PDA.
If you’re interested in learning more about PDA, autism diagnosis, and neurodivergent affirming care, or simply want to chat, feel free to book a consultation call with Dr. Tay, here.
