Pathological Demand Avoidance (PDA) is a distinct profile within the autism spectrum characterised by an intense, pervasive drive for autonomy and an overwhelming need to resist or avoid everyday demands. This avoidance isn't simply being stubborn or defiant – it's driven by high levels of anxiety and a need for control that can feel like a panic attack.
Key Characteristics of PDA
People with PDA typically show these core features:
Resisting ordinary demands – Avoiding everyday tasks like brushing teeth or packing a school bag, even activities they normally enjoy
Using social strategies for avoidance – Making excuses, distracting, procrastinating, or creating elaborate reasons why they can't comply
Appearing sociable but lacking understanding – May seem more socially able than expected but still have underlying social communication difficulties
Experiencing intense emotions and mood swings – Can switch rapidly between being enthusiastic one minute and quiet the next
Comfort with role play and pretence – Often to an extreme extent
Obsessive behaviour – Sometimes focused on other people or performance demands due to anxiety
Strong need for control – Driven by anxiety and an automatic 'threat response' to demands
Understanding the PDA Experience
For individuals with PDA, demands aren't simply inconvenient – they're experienced as threatening. Many everyday demands are avoided simply because they're demands, creating a feeling of lack of control that increases anxiety and can trigger panic. This demand avoidance isn't a choice and is lifelong, appearing in infancy and continuing throughout life.
Supporting People with PDA
Supporting someone with PDA requires a different approach than traditional autism strategies.
Pick Your Battles:
Minimise non-essential rules and prioritise what's truly important
Allow for choice and control where possible
Provide clear explanations for necessary demands
Manage Anxiety:
Recognise signs of overwhelm and respond supportively
Reduce uncertainty in daily routines
Treat distressed behaviours as panic attacks and provide support throughout
Negotiate/Collaborate:
Stay calm during interactions
Use a collaborative approach that makes the person feel more in control
Focus on indirect communication rather than direct demands
Getting PDA Included in Your Assessment
Understanding Pathological Demand Avoidance can be life-changing for families struggling with a child who shows extreme demand avoidance. While PDA is generally considered a profile within the autism spectrum, getting it properly identified during assessments requires a PDA-aware psychologist who specialises in autism assessment including PDA profile.
The identification process is collaborative, involving parents, educators, and other professionals who know your child well. A comprehensive PDA assessment typically includes:
A parent-only appointment to explore developmental history and discuss concerns
Face-to-face appointments with your child
Questionnaires for parents and carers
Observation of your child in different settings
Why PDA Assessment Matters
Getting a PDA profile recognised is important because:
It helps distinguish PDA from other presentations of marked demand avoidance
It highlights the need for specific helpful approaches by professionals and families
Traditional autism strategies often don't work for children with PDA
It can explain why previous interventions may have been unsuccessful
Not all clinicians are familiar with pathological demand avoidance in children, which can make getting appropriate assessment challenging. When seeking assessment:
Ask potential providers about their experience with PDA specifically
Enquire whether they use PDA-specific assessment tools
Check if they're willing to include PDA profile descriptions in their reports
Take Action Today
If you're concerned your child may have a PDA profile, don't wait to seek professional support. Early identification leads to better understanding and more effective strategies.
Ready to understand your child better? Contact our clinic today to arrange a comprehensive autism assessment with PDA screening.
Book your assessment consultation today and take the first step toward transforming your family's understanding and approach to PDA. Your child's future starts with the right understanding today.
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Disclaimer
The information provided in this blog post about Pathological Demand Avoidance (PDA) is intended for general educational purposes only. This content does not constitute psychological advice, diagnosis, or treatment. Every individual is unique, and the information presented here may not apply to your specific situation. A proper assessment should always be conducted by a qualified healthcare professional registered with AHPRA. While we strive to provide accurate and up-to-date information, the field of autism research continues to evolve. This blog should not be used as a substitute for professional psychological services. If you have concerns about your child's development or behaviour, please consult with a registered healthcare professional. Our clinic provides assessment services as described, but outcomes and benefits may vary for each individual. No guarantee of specific results is implied or expressed in this educational content.
© Sunshine Psychology 2025 The clinical psychologist maintains current AHPRA registration and adheres to all professional standards and guidelines.
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