All families will have some struggles when raising children, but does your child's behaviour leave you feeling frustrated and exhausted? You might be searching for answers because traditional parenting and discipline methods do not work, and may even make things worse. You may have come across the term Pathological Demand Avoidance, or PDA. This guide is a foundational explanation of PDD, how it relates to autism, and how you can help your child.
It is important to understand that PDA is not not a sign of bad parenting, or is it your child being deliberately naughty or problematic. The behaviours associated with PDA come from a psychological need to avoid everyday expectations.
What is the Core of PDA?
Pathological Demand Avoidance is widely accepted as a profile on the autism spectrum. Its central characteristic is an anxiety-driven need to remain in control and avoid the demands of others.
For a child with PDA, even seemingly simple requests like "can you please put your shoes on" or "time for dinner" can feel like a threat. This triggers anxiety and a panicked response to resist the demand. These are not conscious choices to be difficult; it is an automatic system that produces an overwhelming response.
Key features of the PDA profile often include:
- Resisting ordinary demands: This goes far beyond typical childhood resistance. The avoidance can feel all consuming.
- Finding strategies for avoidance: Children with PDA are often highly social and can use distraction, negotiation, giving excuses, or claiming to be unable to do something to avoid a demand.
- Sociability: As is common in autism, those with PDA can appear charming and socially capable, but often have a flawed understanding of social boundaries.
- Sudden mood swings: Behaviour can be erratic and unpredictable, driven by the constant effort of managing anxiety and perceived threats.
PDA or ODD?
Children with a PDA profile are often misdiagnosed with ODD. ODD is also associated with neurodiversity. The strategies used to manage these conditions are quite different, and using the wrong one can make the situation worse.
- Motivation: PDA is an anxiety-based need to feel safe through control. ODD is defined as being based in anger and hostility usually directed at authority figures.
- Social Strategies: Children with PDA often use elaborate excuses, charm, or distractions to avoid demands. ODD is more directly confrontational and argumentative.
- Target: In PDA, the avoidance is pervasive and can apply to anyone, even enjoyable activities or internal feelings like hunger. For ODD, the defiance is usually aimed at authority figures such as parents and teachers.
- Response to Strategies: This is the most important difference. The low-demand, collaborative strategies needed for PDA do not work for ODD. In the same way, the firm boundaries and consequences recommended for ODD are damaging for a child with PDA, increasing their anxiety.
Some Professionals Call It ‘Pervasive Drive for Autonomy’
The term "Pathological Demand Avoidance" can feel negative. To avoid this, many professionals and some parents are now using the term ‘Pervasive Drive for Autonomy’. This name tries to remove PDA’s implication of blame and reframe it more positively and accurately. It focuses on the core trait: wanting to be in charge of their actions and choices.
Not an official diagnosis
PDA is not currently listed as its own diagnosis in the clinical manuals such as the DSM-5 and ICD-11, which are used in the UK. This is why many doctors or local authorities may say they cannot give a PDA diagnosis.
PDA is a specific profile of Autism Spectrum Disorder (ASD). This means a person first is diagnosed with autism, but their behaviour is shaped by PDA. Awareness of PDA is growing in the UK, but the knowledge is inconsistent. Some identify a "PDA profile" within an autism diagnosis, while others don’t.
Understanding is the First Step
Realising that your child's behaviour is a form of extreme anxiety and a need for control, rather than trying to cause trouble or disruption, is important in removing blame from the situation. It helps you to see the flare ups empathetically, even if they are just as challenging.
Support begins when we see a child who is refusing, and see someone who is trying to feel safe.
