Navigating Sensory Processing Challenges in Children with PDA and Autism
- Michelle Davis
- Mar 9
- 8 min read
Updated: Apr 12
Understanding Sensory Processing Difficulties in Our Uniquely Wired Kids
As I watched my daughter struggle with trying on what seemed like a million outfits this morning, I was reminded yet again how differently her brain processes everyday sensations. What feels like a minor inconvenience to many of us can be genuinely distressing for children with PDA (Pathological Demand Avoidance) and autism. The way fabric feels against skin, the sound of the dishwasher running, even the brightness of natural light—these seemingly ordinary experiences can be overwhelming for our extraordinary kids.
Like many of you reading this, I've spent countless hours trying to decode my child's reactions to the world around her. Today, I want to share what I've learned about sensory processing challenges and how they specifically affect children with PDA and autism. My hope is that by sharing our journey, yours might become a little easier to navigate.
When the World Feels Too Much: Sensory Processing Explained
Imagine wearing a scratchy wool sweater while sitting under flickering fluorescent lights as someone scratches their nails on a chalkboard—all while trying to focus on a complicated task. For many children with PDA and autism, this approximates how everyday life can feel. Their brains process sensory information differently, often more intensely than neurotypical brains do.
Sensory processing involves how our nervous system receives messages from our senses and turns them into appropriate responses. For children with autism and PDA, this system can be irregular, causing them to be over-responsive to some stimuli and under-responsive to others.
"Think of sensory processing like a neurological traffic jam," a therapist once told me. "The information gets in, but it has trouble getting to the right places in the brain to be interpreted correctly."
Dr. Lucy Jane Miller, a leading researcher in sensory processing, estimates that more than 75% of children with autism experience significant symptoms of Sensory Processing Disorder. For children who also have PDA, these sensory challenges can intensify demand avoidance behaviors, creating a complex interplay that affects everyday functioning.
How Sensory Challenges Present in Children with PDA and Autism
Every child is unique, but there are common patterns in how sensory processing difficulties manifest. My daughter, for example, has always been hypersensitive to sounds—even the hum of the refrigerator can distract and distress her. Meanwhile, my friend's son seeks out deep pressure, constantly crashing into furniture and people to satisfy his sensory needs.
Here are some common sensory processing patterns in children with PDA and autism:
Hypersensitivity (Over-responsivity)
Children might cover their ears at normal sounds, refuse certain food textures, or become distressed by light touch. A friend's son once had a meltdown in a department store because the overhead lighting was "screaming" at him—a powerful reminder of how differently these children experience the world.
Hyposensitivity (Under-responsivity)
Some children seem unaffected by pain, extreme temperatures, or loud noises. They might seek out intense sensory experiences, like spinning, crashing into things, or watching flickering lights. These behaviors aren't misbehavior—they're the child's attempt to meet their sensory needs.
Sensory Seeking
Children actively pursue sensory stimulation, perhaps by making loud noises, chewing on objects, or spinning in circles. My daughter loves jumping on her trampoline for hours—it's not just fun for her, it's a sensory necessity.
Sensory Avoiding
The opposite of seeking, these children try to minimize sensations by covering their ears, avoiding certain textures, or retreating from busy environments. School assemblies were impossible for my daughter until we developed strategies to make them more manageable.
According to research by Green and colleagues, these sensory challenges strongly correlate with anxiety levels in children with autism, creating a cycle where sensory overload triggers anxiety, which in turn amplifies sensory sensitivity.
The PDA Connection: How Demand Avoidance Intersects with Sensory Challenges
For children with both PDA and autism, sensory processing difficulties add another layer of complexity. PDA is characterized by an anxiety-driven need to avoid demands and expectations, and sensory challenges can effectively function as "hidden demands" that the child can't easily communicate or control (O'Nions et al., 2018).
A simple request like "please put on your shoes" becomes multi-layered when:
The texture of socks feels unbearable
The pressure of shoes feels constraining
The child already feels overwhelmed by other sensory input
The verbal instruction itself acts as another form of sensory input
No wonder getting out the door can take an hour!
Dr. Phil Christie, a specialist in PDA, explains that the anxiety triggered by sensory overload can significantly increase demand avoidance behaviors. It's a protective response—the child's system is already overwhelmed, so additional demands feel impossible to meet.
I've noticed with my daughter that sensory overload often precedes her most challenging moments of demand avoidance. Understanding this connection has been key to preventing meltdowns and supporting her more effectively.
Daily Challenges and Practical Solutions
Let me share some common scenarios we've faced and strategies that have helped us:
Clothing Sensitivities
My daughter used to have meltdowns every morning over clothing. We've learned to:
Remove all tags from clothing
Buy seamless socks and underwear
Prioritize soft, stretchy fabrics
Allow her to wear the same comfortable clothes repeatedly
Let her feel fabrics before purchasing
Food Challenges
Many children with PDA and autism have restricted diets due to sensory sensitivities. Some approaches that have worked for families I know include:
Introducing new foods alongside familiar ones without pressure
Respecting food preferences while gently expanding options
Focusing on nutritional content rather than variety
Experimenting with different temperatures and presentations
Using food chaining (gradually modifying accepted foods)
School and Social Environments
Educational settings can be sensory minefields. Working with my daughter's school, we've implemented:
Noise-canceling headphones for assemblies and noisy periods
A quiet space she can retreat to when overwhelmed
A visual schedule to reduce the anxiety of transitions
Sensory breaks throughout the day
Reduced homework demands after a sensory-demanding school day
Home Organization
Creating a sensory-friendly home environment has been transformative:
Designated quiet spaces with minimal visual stimulation
Dimmer switches on lights
White noise machines to mask disturbing sounds
Heavy blankets for deep pressure input
Organizing toys in clear bins to reduce visual chaos
Understanding Regulation: The Sensory Connection to Behavior
One of the most important insights I've gained is understanding that what looks like "bad behavior" is often a response to sensory dysregulation. When my daughter has a meltdown in a crowded store, she's not being difficult—her nervous system is in fight-or-flight mode due to sensory overload.
Researcher Dr. Stephen Porges developed the Polyvagal Theory, which helps explain this connection between sensory processing and regulation. When children with sensory processing difficulties encounter overwhelming stimuli, their autonomic nervous system can trigger a stress response. They're not choosing to overreact—their bodies are responding automatically to perceived threats.
Learning about the "zones of regulation" concept developed by Leah Kuypers has helped our family tremendously. We now talk about being in the "green zone" (calm and ready to learn), "yellow zone" (heightened alertness), "red zone" (extreme emotions), or "blue zone" (low energy). This vocabulary helps my daughter identify and communicate her sensory state before reaching meltdown territory.
Advocating for Your Child: Working with Professionals
Getting proper support for sensory processing challenges often requires working with multiple professionals. In our journey, we've benefited from:
Occupational therapists with sensory integration training
Speech therapists who understand the sensory components of communication
Psychologists familiar with PDA and autism
Educators willing to implement sensory accommodations
When seeking professional help, I've found it crucial to look for providers who understand both sensory processing and PDA. Many professionals are familiar with autism but not the specific PDA profile, which requires different approaches.
Don't be afraid to ask potential providers about their experience with sensory processing challenges and PDA specifically. A good provider will be honest about their expertise and willing to learn more if needed.
Creating a Sensory Lifestyle: Beyond Individual Strategies
Over time, I've realized that one-off sensory strategies aren't enough—we needed to create what occupational therapist Carol Stock Kranowitz calls a "sensory lifestyle.". This means weaving sensory supports throughout our daily routines rather than only implementing them during difficulties.
For us, this includes:
Starting each day with "heavy work" activities (jumping, push-ups against the wall)
Scheduling regular movement breaks
Incorporating deep pressure throughout the day (tight hugs, weighted lap pad)
Being proactive about sensory needs before entering challenging environments
Having sensory tools readily available at home, school, and in the car
This proactive approach has reduced my daughter's anxiety and improved her ability to handle unexpected sensory challenges when they arise.
The Emotional Journey: Supporting Yourself As You Support Your Child
Parenting a child with sensory processing difficulties and PDA can be emotionally exhausting. There's the practical exhaustion of constant accommodation and advocacy, but also the heartache of watching your child struggle with experiences others take for granted.
I've found a few things essential for my own wellbeing:
Connecting with other parents who truly understand
Educating extended family to reduce judgment and increase support
Celebrating small victories that others might not recognize as significant
Being compassionate with myself on difficult days
Remembering that my daughter's challenges aren't a reflection of my parenting
As one mother in my support group wisely said, "You can't pour from an empty cup." Taking care of your own needs isn't selfish—it's necessary to sustain the energy needed to support your child.
Next Steps
Parenting a child with autism and PDA is both challenging and rewarding. If you're looking for more practical strategies and insights, I've compiled extensive research and personal experience in my book, "A Practical Parent's Guide to PDA and Autism." This resource provides concrete approaches tailored specifically to parents and caregivers of children who experience both autism and PDA.
As a parent juggling therapy appointments, IEP meetings, and the daily challenges of raising a child with PDA, I know you barely have time to sit down, let alone read a book. That's exactly why I've made "A Practical Parent's Guide to PDA and Autism" available as an audiobook you can listen to during school drop-offs, while making dinner, or during those precious few minutes alone in the car. Transform your "lost time" into learning time by grabbing the audiobook here: US, UK, Australia, Canada, France, and Germany.
I wrote this book because I needed it myself and couldn't find anything like it. It offers practical, parent-to-parent advice based on both research and my own real-life experience raising a child with PDA, with specific chapters dedicated to understanding and preventing burnout. The strategies I share have helped thousands of families reduce stress and build more harmonious relationships with their neurodivergent children. As parents walking this path, we need real solutions from someone who truly understands—not just theory, but practical approaches that work in everyday life with our wonderful, complex children.
Your Turn
Have you noticed specific sensory triggers that affect your child's demand avoidance? What sensory strategies have made the biggest difference in your daily routines? I'd love to hear about your experiences in the comments below.
References
Christie, P., Duncan, M., Fidler, R., & Healy, Z. (2019). Understanding Pathological Demand Avoidance Syndrome in Children: A Guide for Parents, Teachers and Other Professionals. Jessica Kingsley Publishers.
Eaton, J., Duncan, K., & Hesketh, E. (2018). PDA - Pathological Demand Avoidance Syndrome: My Daughter is Not Naughty. Jessica Kingsley Publishers.
Green, S. A., Hernandez, L., Tottenham, N., Krasileva, K., Bookheimer, S. Y., & Dapretto, M. (2020). Neurobiology of Sensory Overresponsivity in Youth With Autism Spectrum Disorders. JAMA Psychiatry, 72(8), 778-786.
Kranowitz, C. S. (2016). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder. Penguin.
Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2017). Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis. American Journal of Occupational Therapy, 61(2), 135-140.
O'Nions, E., Christie, P., Gould, J., Viding, E., & Happé, F. (2018). Development of the 'Extreme Demand Avoidance Questionnaire' (EDA-Q): Preliminary observations on a trait measure for Pathological Demand Avoidance. Journal of Child Psychology and Psychiatry, 55(7), 758-768.
Porges, S. W. (2021). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. W. W. Norton & Company.
Robertson, C. E., & Baron-Cohen, S. (2017). Sensory perception in autism. Nature Reviews Neuroscience, 18(11), 671-684.
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