Aspergers v Pathological Demand Avoidance – is there a difference?

There is much debate about whether PDA needs a separate diagnoses from autism or whether indeed there is any difference between it and other subtypes of autism. If you are not sure of exactly what PDA is then please click the link to the list of traits from the PDA society: What is PDA?

As I said in an earlier post I am just a Mum so don’t expect huge amounts of medical evidence and research, this post is based on conversations with my autistic brother who is diagnosed as Aspergers and my son who is diagnosed as ASD using PDA diagnostic criteria. It is intended as a starting point for debate rather than ‘proof’ of PDA as a separate subgroup under the autism umbrella.

The differences our conversations uncovered were;

  • Difference in interests and play. My son chooses to play out human relationships, film sequences and parrot conversations with his people shaped toys where as my brother was never interested in this type of play and preferred instead logical problem solving, taking things apart, and technology (anything he could do that had no direct link to human relationships).
  • Meltdowns and aggression. My brother did have meltdown but even as an undiagnosed child they had clear triggers on the whole – we may not of understood why certain things upset him but we knew the ones that did, it made it easy for other kids to press his buttons and make him react. I have seen similar patterns in Aspergers children as a TA when children in the class would know trigger points and push them to get he child into trouble. My son on the other hand has much more subtle triggers and he is able more readily to suppress the urge to react if the environment is not a safe one (such as at school) until things build up and come out in a more prolonged and aggressive meltdown usually in a place of safety. Conversely he can seemly a hair trigger when he goes from 0-100 with no warning at all.
  • Fears and Anxiety. My brother describes feeling anxious and having panic attacks when he is out of his comfort zone ie in a supermarket or a group of people but being able to decompress when he returns home. His fears are rarely irrational although he has used logic to come to wrong conclusions which created anxiety. He fears doing hints that trigger his anxiety. My son on the other hand describes being afraid all of he time, even in a place of safety he is on high alert. He often has imagined fears similarly to those of a much younger child and for example spent years at our last house believing someone was living in the attic and waiting to do harm. My son can have a panic attack with no other trigger than his mind working over time. Another example of this is when he meets someone he tells me his first thought is they are likely a murderer and so they have to prove to him they are not until he can get to a neutral point and then and only then can he begin to build trust with them. My brother on he other hand would come from a far more neutral and disinterested starting point.
  • Creativity and imagination. Both my brother and my son are creative people. My brother practices and refines his technics, is extremely focused and will repeat tasks over and over to get things right, he is an accomplished graphic artist and 3D modeller as a result. To him recognition of his talents is a bonus not a necessity, he would do it anyway. My son is a perfectionist, he wants to be able to do something well from the start. He likes to sit back and watch something done over and over until he has learnt the method completely before he will try. Only when he has done something to his own satisfaction will he present it for someone else to see. He plays guitar and draws in secret, I find the evidence in his waste paper bin. At the point of presenting something if I am either to eager or if he detects a hint of criticism he will not do that activity again for or a long time or even at all.
  • Need for personal support. Where is my brother is very much self contained (although he does of course appreciate understanding and friendships in moderation), my son has always been very reliant on special human relationships to see him through life, usually one person in each environment. He can become almost obsessional about that person whether it is me, his best friend or a loved TA or teacher. He suffers greatly with separation anxiety and can have a real need to be physically close with that person where as my brother would find this intensely uncomfortable.
  • Saying Yes and No. My brother is able to say yes to things he wants to do but has issues sometimes knowing how to say no in some circumstances and will ignore or avoid the situation or person instead where as for my son no is the go to response and he can not say yes to even things he wants to do very often.

These are just the main areas of different I have observed and most distinct, I would be very interested to know if other PDAers or their parents recognise these traits and he differences between other subgroups of autism. Obviously this is not an extensive study, it is just two autistic people of very different ages (although I have used my memory of my brother at the same age and asked him how he felt then). However I do think there is evidence, at least in my mind, that there are enough strong differences to consider the two as distinctively different. What about you?

For more on my views on PDA clink on the link to my related blog post below:

One Mum,s view on Pathological Demand Avoidance

This blog was published with the kind permission of both my brother and my son.

23 thoughts on “Aspergers v Pathological Demand Avoidance – is there a difference?

  1. Totally relate to these in terms of our PDA girl, particularly the perfectionist bit and the need for personal support x

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    1. Thanks for commenting Steph, it is good to know that these are things other parents can relate to.

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  2. Our Autistic, PDA subtype son experiences the world exactly how you describe your PDA son does – especially how you describe how his fears effect him… he obsessively needs to keep all doors shut . If left open, he is constantly fearful of what/who might walk through or be behind.

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    1. It must be so stressful for them to feel that way all the time. I find reducing everyday stresses helps keep the general anxiety levels down to a more manageable point.

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  3. This is very interesting. My son is how you describe the PDA profile. He was diagnosed with Aspergers with subtype PDA by a private psychologist. However, following this diagnosis my son had a Multi-disciplinary clinical assessment by Elizabeth Newson centre (founders of PDA) and they confirm that he did NOT have PDA. He was diagnosed with Aspergers and anxiety disorder instead 🤔

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    1. That is really interesting. I guess it is much about the subtle differences as the major ones. I hope your sons diagnoses has been the right one in terms of being understood and getting the right support, that’s the main thing.

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  4. Spot on as far as I’m concerned. I also think it is fascinating how specific PDA traits are. All I have spoken to who are diagnosed or identifying with PDA confirm the same and are very clear and tick all of those boxes.
    The perfectionist mind, the hiding of work until it is deemed good enough to show. I have a family member who practiced his work until he felt he was at a perfect level to stand on the big stage, whereas most would work their way up in the public eye, he had a master plan. He seemingly entered his profession as a top guy that came from no where, but behind the scenes he was perfecting his craft. My daughter is exactly the same, a talented artist in many forms, but hiding away until her day comes. She is scared of entering any work that might not be 100% authentic because she feel like that’s cheating.
    I can also agree that anxiety is much higher and consistent. There is a defined difference between Asperger’s and PDA but they do cross over and you have really explained the comparisons perfectly here. Do you mind if I re blog this onto mine and credit you? It’s very god and a great idea. With love. xx

    Liked by 1 person

    1. Thank you so much for your comments and I am so pleased you see similar too. I have another brother who is also diagnosed as AS and they have a common thread that is different to my sons (although there are common areas such as sensory and social anxiety between all three too) by all means re-blog, I would be honoured x

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  5. Wow my son has a PDA profile hand you just described him to a “T”. There is clearly a massive difference and the skill set just isn’t there to support PDAers

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    1. Thank you for sharing your experiences and you are so right about the lack of knowledge and understanding around PDA. The change in my son since using PDA strategies is amazing and had they been able to provide this at school he would likely still be able to attend instead of in Home ed.

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  6. Leslie Almberg Nov 10, 2018 — 8:31 am

    Your son sounds so incredibly much like my daughter. It was only when I randomly happened across a full description of PDA when I began investigating my own possible Asperger’s diagnosis did the pennies start to drop that my daughter might also be on the spectrum (although many friends and family had subtly hinted at this for years). Although she is not yet formally diagnosed with anything, she identifies very strongly with social stories/descriptions of Aspergirls, not the classic Asperger’s stereotype like your brother. Thankfully, we recognised the need to back off on demands as much as possible when she was 5, so we’re all getting better at working within this paradigm.

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    1. It sounds like your daughter is fortunate to have you and have her strengths and challenges understood. I am glad to hear that a low demand approach is working for your daughter.

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  7. Pity you compared your PDA autistic son with your male Asperger autistic brother. I’d be much more interested in comparing PDA to the “female” autistic profile and then the differences are much less. In fact I have yet to find anyone who can give me a definitive answer to “what’s the difference between PDA autistic and “female” autistic?” Especially if the female is demand avoidant.

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    1. I have noticed the similarities myself in the way autism presents in females is described and PDA especially around masking however I do not know enough to comment further. I have autistic brothers and my sister told me when she was dying she believed she was autistic but was ashamed of it and masked all her life so didn’t have any females left to compare with sadly (I am NT other than dyslexia). I think it is an area for research, I am very open minded about PDA, I fight for it as it currently stands because I know the approaches are much better suited to my son’s mental wellbeing and that is what matters to me.

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      1. I think the problem is that the approaches used for autistic people, no matter how you classify them, are generally not those designed by autistic people themselves. The “PDA approaches”, in my experience, work for some non-PDA autistics too. And the approaches that don’t work for PDA autistics don’t “work” for non-PDA autistics either. Especially if you use autistic definitions of what “works means.
        That is my issue with PDA – there is no clear cut-off. It’s why Aspergers was gotten rid of. These arbitrary divisions don’t do any good.

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      2. Yes agreed. If we lived in a perfect world where professionals who came into contact with autistic children had true expertise (ideally were autistic themselves) and also took the child as an individual then there would be no need for any divisions at all. However this is not the case and many children suffer as a result of the current thinking that autistic children and adults need imposed structure and routine for example, when that is often the opposite of what they want or need. Without the PDA profile description being out there my son would not even of been diagnosed despite a family history of neurodiversity and him being ‘classically’autistic as in things like speech delay, sensory sensitivity and sorting things and making lines, I have know since he was 2 but he was not diagnosed until 10. There needs to be so much more research, so much more autistic input and so much more desire to understand from professionals before things are anywhere near being ideal. In the meantime as parents we are just doing the best we can with what we have. Thanks so much for your comments.

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      3. “Imposed structure and routine”. Ugh. I hate that mantra so much. Yes some of us like routine. But only routines we devise ourselves. I’m glad you finally got your son diagnosed. Professionals are usually the last to see the obvious.

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      4. I literally had parents of autistic children assuming my son already was diagnosed without autism ever being mentioned by me that is how obvious it was. Yes I can only imagine how as an autistic person you must feel about the phrasing of some of these ‘strategies’ and the way it is assumed any list of ‘rules’ would fit every autistic person any more than any list of ‘rules’ would fit to make an NT feel comfortable! It’s all madness. My son suffered hugely at me trying to follow what I was told by professionals for too long, I am just relieved that I have found a way forward where he can be happy, accepted and himself and that was in large part down to advice I received from the PDA society initially, now my son is older and recovered from school, induced trauma he is able to recognise his own strengths and weaknesses and what best supports him to maintain that and he has plenty of older autistics in the family to help guide and support him too.

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  8. Just want to say, thank-you, so glad I found this blog

    Liked by 1 person

    1. Glad it helped. Thanks for reading x

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  9. Wow, I am so glad I came across this article. I have recently been diagnosed and I feel there is a defiantly a difference between the 2 but you don’t really want to go against the person who diagnosed you, also I have only been doing research for all of 2 months.

    There is absolutely no assistance with PDA here in South Africa, I am struggling and confused as I have my own opinion on my diagnosis and after reading your article I feel a bit of relief. Thanks.

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    1. As they are both on the autism spectrum as an adult or as a parent of a suspected PDA child you can as we have just accept a label in vaguely the right area and them research ways to be more PDA friendly in the approaches you take in life/with your child. You don’t necessarily need to spend all your time fighting for the exact diagnoses or not take steps to do the things that help while waiting for a Diagnoses. A PDA diagnoses is extremely hard to get even here in the UK so you may wish to just say I’m autistic and these are the things that help in the way that presents itself for me. Glad the article helped, thanks for reading.

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