COMMENTARY ON DAP AND NEUROCEPTION: A RESPONSE TO CHANGING THE NARRATIVE ABOUT AUTISM BLOG POST 25TH OF JUNE 2019.
Harry Thompson asked for my thoughts on a recent blog post about Demand Avoidance Phenomena (DAP, aka Pathological Demand Avoidance) and neuroception. I figured that if I am going to type up my thoughts on the topic, I may as well produce a blog post. The specific blog post is called “Highly Sensitive Neuroception May Be At The Heart of PDA”, by Changing The Narrative About Autism and dated the 25th of June 2019. I will provide a list of comments I made to a word document of the blog (copy and pasted over).
Retrieved from: https://pathologicaldemandavoidanceaprofileofautism.com/2019/06/25/pda-neuroception-the-five-fs/ Accessed 04 July 2019).
The author also welcomes to their Facebook page below:
- Incorrect, Newson proposed DAP in 1980, not 1990; see Gillberg (2014) and Stuart et al (2019).
- This is a misrepresentation, there is growing disagreement with the main interpretations that DAP is a form of autism, see Green et al (2018) and Woods (2019a).
- Avoiding any demands also common in conditions such as depression, see Woods (2019b).
- Some research suggests sensory issues cause anxiety in autism. This makes sense a monotropsm and predictive coding perspective. As the more hyper aroused we are, the more alert we are prone to having larger prediction errors from the environment.
- This can be explained by monotropism, as the person frequently experiencing such situations, the response gets internalised over time and becomes part of the person to be disposed towards such stimuli.
- High anxiety levels can be experienced in some autistic persons; I would not say they are associated with autism as anxiety is not an autism symptom. Although, high anxiety levels is the core DAP symptom as it drives the need for control and the demand avoidance. In fact the high anxiety makes DAP a non-autism comorbid (Woods 2019b).
- Brain scan research into autism is problematic and has not led to a great leap in our understanding of autism. For instance see Runswick-Cole et al (2016). The author is placing too much faith into this theory.
- The author is reifying DAP when there is insufficient evidence to do so, for example see Green et al (2018), Milton (2017) and Woods (2019a).
- I challenge this, autistic persons can often shut down like this and automatically say *yes* to things on autopilot. This is a potentially dangerous assumption as ignores how easily autistic persons can enter this state. It would negligent to not recognise that, as it can lead to inaccurately recognising the nature of some persons actions. It is a high stress response though, my issue is specifically with the prolonged stress response.
- “Can’t help won’t” lack of control in a person’s behaviours is also explained by monotropism theory and autistic inertia (Milton 2017; 2018; Woods 2019).
- Again explained by monotropism, in this case the discussion of the “flight response”. A person enters a flow state of fantasy roleplay pretend as reduces their anxiety and is a fixed point.
- The 5 fs responses author says should be reduced in a predictable environment. It can be described as a way of reducing prediction error.
- Raelene Dundon is not the only person exploring DAP as a trauma response. Damian Milton has talking about DAP as a trauma response since 2013.Woods is also exploring DAP as a trauma response, see Milton (2017), Woods (2018; 2019a).
- I have corresponded with clinicians who say DAP is found in non-autistic persons. Research suggests DAP behaviours can be caused by trauma; for practitioners discussing DAP and trauma, see Fieldman (2018), Flackhill et al (2017) and McElroy (2016).
Latest DAP Research.
I have delivered 2 talks on Demand Avoidance Phenomena at recent Critical Disability Studies events:
- An Updated Interest Based Account (Monotropism theory) & a Demand Avoidance Phenomenon discussion.
- Demand Avoidance Phenomena (Pathological Demand Avoidance): an ethical challenge to its orthodoxy.
Two of these talks supplement the DAP deconstruction Critical Reflections on the Pathological Demand Avoidance debate: A response to The Practice MK blog and discussion, which can be accessed here:
Besides book reviews, I have 2 new articles published in the journal, Autonomy, the Critical Journal of Interdisciplinary Autism Studies. The first is a DAP one that was submitted 2 years ago. The second is co-authored with Dr Mitzi Waltz and was written last summer. These are:
- Pathological Demand Avoidance: Is it time to move beyond the pathological need to not to develop more inclusive pedagogical practices?
- The strength of autistic expertise and its implications for autism knowledge production: A response to Damian Milton.
Fieldman, R. (2018). Reflections on the Psychopathology of Demand Rejection and Avoidance (Online Blog). Retrieved from: https://libertyofthinking.wordpress.com/2018/10/29/reflections-on-the-psychopathology-of-demand-rejection-and-avoidance/ (Accessed 08 March 2019).
Flackhill, C., James, S., Soppitt, R., & Milton, K. (2017). The Coventry Grid Interview (CGI): exploring autism and attachment difficulties. Good Autism Practice, 18(1), 62-80.
Gillberg, C. (2014). Commentary: PDA – public display of affection or pathological demand avoidance? – reflections on O’Nions et al. (2014). Journal of Child Psychology and Psychiatry, 55: 769–770.
Green, J., Absoud, M., Grahame, V., Malik, O., Simonoff, E., Le Couteur, A., & Baird, G. (2018). Pathological Demand Avoidance: symptoms but not a syndrome. Lancet Child & Adolescent Health, 2(6), 455–464.
McElroy, R. (2015). PDA – is there another explanation? (Online Magazine). Retrieved from: https://thepsychologist.bps.org.uk/volume-29/january-2016/pda-there-another-explanation (Accessed 08 March 2019).
Milton, D. (2017). ‘Natures answer to over-conformity’: deconstructing Pathological Demand Avoidance (Online book chapter). Retrieved from: https://kar.kent.ac.uk/62694/431/Natures%20answer%20to%20over%20conformity.pdf (Accessed 04 July 2019).
Milton, D. (2018). Pathological Demand Avoidance (PDA) and alternative explanations: a critical overview (Conference Paper). Retrieved from: https://kar.kent.ac.uk/67064/1/PDA%20and%20alternative%20explanations.pdf (Accessed 07 November 2018).
Runswick-Cole, K., Mallett, R., & Timimi, S. (2016). Re-Thinking Autism: Diagnosis Identity and Equality. London: Jessica Kingsley Publishers.
Stuart, L., Grahame, V., Honey, E., and Freeston, M. (2019). Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents. Child and Adolescent Mental Health, DOI: 10.1111/camh.12336
Woods, R. (2018). PDA by PDAers, from anxiety to avoidance and masking to meltdowns. Disability & Society, 33(9), 1547-1549.
Woods, R. (2019). An Updated Interest Based Account (Monotropism theory) & a Demand Avoidance Phenomenon discussion (Conference paper). Retrieved from: https://www.researchgate.net/publication/332727790_An_Updated_Interest_Based_Account_Monotropism_theory_a_Demand_Avoidance_Phenomenon_discussion (Accessed 08 June 2019).
Woods, R. (2019b). Demand Avoidance Phenomena (Pathological Demand Avoidance): an ethical challenge to its orthodoxy (Conference paper). Retrieved from: https://www.researchgate.net/publication/333682762_Demand_Avoidance_Phenomena_Pathological_Demand_Avoidance_an_ethical_challenge_to_its_orthodoxy (Accessed 04 July 2019).