Do I have to do it now? The frustration is real when trying to get your child to do their chores, but it reaches a whole other level for children who suffer from pathological demand avoidance (PDA). Learn more about how PDA may affect your child.


What is PDA?

Many people who see children with autism spectrum disorder (ASD) refusing to do as they’re asked chalk it up to bad parenting or spoiled kids. The truth is that many children struggle because they are wired differently, requiring a shift in thinking and parenting to support them correctly. 

Pathological demand avoidance (PDA) is a common profile seen among individuals on the autism spectrum and involves avoiding everyday demands and using “social” strategies to do so. 

While PDA is a relatively new term, and there is still some debate as to its acceptance in the scientific community, it is slowly becoming more and more mainstream. Keep reading to delve deeper into its history.

History of PDA

PDA was initially described under a different moniker. Elizabeth Newson, a renowned psychologist and autism specialist believed that pervasive developmental disorder (PDD) is an umbrella term for a wide range of developmental disabilities, including PDA.

Recent advances in autism research, however, have led to the development of new diagnostic criteria. We now understand that what was previously known as pervasive developmental disorder is a spectrum – meaning a range of symptoms, experiences, and behaviors associated with autism. 

This made PDA increasingly recognized as a form of and sometimes a characteristic of autism. While not all people with autism have this profile, more and more researchers are coming to realize it is a valid component of the spectrum. 

This relationship was recently confirmed by a 2021 literature review concluding that five out of six people with PDA also had autism and confirmed that many symptoms were shared between pathological demand avoidance and ASD. 

Extreme demand avoidance (EDA) is an alternate term for pathological demand avoidance (PDA). Some individuals find the word ‘extreme’ more palatable than ‘pathological,’ so they have chosen this alternative. 


Features of a PDA profile

Autism is a complex and unique condition affecting each individual differently. Various aspects of a person’s strengths and difficulties combine to form an individual’s profile, making every person with autism unique in their own way. 

There are two key dimensions to examine when assessing  an autism profile:

  • The ability to relate socially
  • The need for sameness can initiate the creation of repetitive thoughts or behaviors

People with a PDA profile can seem quite socially savvy and have good communication skills, which can help them in many situations. However, this mask of social ability often hides the difficulty they experience when interpreting conversations or figuring out what is expected of them in different social contexts. 

We must remember this and recognize the challenges faced by those whose outwardly confident behavior may not reflect their inner experience. People with a demand-avoidant profile have particular traits that make them stand out, so let’s examine some of these defining symptoms.

Common characteristics of people with PDA

Children and adults on the spectrum who also struggle with PDA exhibit these similar symptoms:

  • Struggles with the everyday tasks of life, often using social tactics such as making excuses or trying to distract 
  • Appearing very sociable but sometimes lacking an understanding of certain concepts 
  • Quickly fluctuating moods and decisions
  • Feeling at ease when they act out scenarios or pretend to be someone else.
  • Displaying obsessive behavior – particularly when it comes to other individuals

Now that you know how to recognize signs of PDA, what now? We’re glad you asked; the next steps are to get your child assessed by an expert.

PDA and assessment

Getting an autism assessment for your child is important because it will help you understand what kind of help and support they need. PDA isn’t a diagnosis in itself, but an autism assessment can identify it. 

This usually requires a team of experts—like doctors, therapists, and psychologists—to look at the person’s behavior and other factors. They’ll work together to determine if PDA is part of the picture. At any given moment, you may have these people on your team:

  • Pediatricians
  • Clinical and educational psychologists
  • Psychiatrists
  • Speech and language therapists
  • Occupational therapists
  • Neurologist 
  • Special Education Teacher 
  • School administrators or educational advocate 
  • Physical therapist 
  • Social worker/Counselor

With all these experienced individuals on your team, you will surely get the answers you need for you and your child. The next step is learning how to manage PDA with different techniques.

Approaches and strategies

If you think your child might show signs of PDA, there are many things you can do to help connect with them and better manage the anxiety that drives their behaviors. Let’s take a look at strategies for you as a parent first.

Strategies for parents

It can be complicated when the strategies you may have heard work best with autistic children don’t seem to be having the same effect on your child, who also has pathological demand avoidance. It’s important to know that for kids with both diagnoses; these strategies may need adjusting to get the best results.

It can be challenging for parents of children with autism and PDA to fully understand why their child behaves the way they do. It’s important to remember that your child is not trying to oppose you deliberately – they are struggling with the need to have control over their environment. 

Proper support is essential for any parent raising a child with autism exhibiting signs of PDA. This kind of help and guidance can make a massive difference in helping your child build trust and self-confidence, enabling them to manage everyday demands better. Here are some practical suggestions:

Set clear boundaries and expectations. Parents need to develop consistent boundaries and expectations around behavior, as this can help children with PDA feel more secure in their environment. 

Use positive reinforcement. Positive reinforcement techniques such as praise, rewards, encouragement, or recognition can reinforce desired behaviors in children with PDA. 

Validate their feelings. Take your child’s feelings seriously but don’t give in to all of their demands. Show empathy and compassion for their struggles, but also set boundaries. 

Let them lead. Allow your child to take the lead as much as possible – this will help reduce anxiety caused by feeling overwhelmed or pressured by expectations they can’t meet. 

Work together.  Create a plan that meets everyone’s needs while still reducing stress on both sides – this could include flexible deadlines, breaks throughout tasks, and a clear understanding of what is expected from each party involved. 

Encourage independence. Autonomy should be encouraged but not forced upon a child with PDA; instead, it should be done gradually through activities that allow the child to experience a sense of accomplishment and success.

With proper assistance, your child can feel more secure in their abilities and develop the skills needed to tackle anything life throws at them. But what about school support? We’re glad you asked!

Strategies for education

By ensuring your child gets tailored help that considers their specific needs, you can set them up for success in school. As a parent to a child with PDA, this may not always feel easy or straightforward. 

However, by recognizing their challenges and working with teachers with specialized knowledge in this area, you can ensure that your child is provided with an individualized approach. 

For their part in your child’s educational task force, teachers need to realize these students will likely not respond well to structure and routine, which may present a challenge in the classroom. 

Because of this, teachers need to be open to learning new techniques and constantly adjust teaching methods to find the right one for your child.  While this may require some trial and error on the teacher’s part, the reward will be reduced frustration for both the student and educator.

In these cases, teachers may find it more beneficial to try indirect negotiations with their students. Hence, the learners feel more ownership of their learning experience and less anxious about the situation. 

Here are some practical examples of strategies teachers can apply in the classroom to support their kiddos with special needs:

  • Establish clear and consistent rules and boundaries while remaining flexible to the student’s needs. 
  • Provide regular visual reminders of tasks and expectations. 
  • Offer choices when possible, such as selecting a seat or task order, so the student feels more in control of their environment. 
  • Allow extra processing time when needed before answering questions or responding to requests from others in the classroom. 
  • Create an environment free from loud noises, distractions, and other triggers for heightened anxiety levels – this will help reduce stress levels for those with PDA tendencies.

By using these approaches, educators can help ensure their students feel at ease while receiving the education they need. More importantly, you can trust your child will be cared for and supported in their learning environment.

Don’t avoid the effects of PDA

Pathological demand avoidance is yet another facet of autism that is difficult to recognize and understand and can affect people differently. By understanding what PDA is, how it affects your child’s behavior and development, and seeking guidance from medical professionals, parents can provide the support their kids need.

Most importantly, if you suspect your child may have PDA symptoms—trust your instincts! Don’t hesitate to reach out for help from an experienced healthcare provider specializing in autism-related issues so that you and your child can obtain the support you need.


If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

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