Pathological Demand Avoidance (PDA), sometimes referred to as Persistent Drive for Autonomy, describes a unique profile characterized by an intense need for autonomy and a strong resistance to demands. While PDA is not yet officially recognized as a separate diagnosis, we, along with many other professionals and advocates, acknowledge its distinct features and challenges. PDA is most commonly observed as part of the profile of autistic individuals, but not always.
Individuals with PDA experience everyday demands—including requests, expectations, and even their own personal goals—as threats. Their nervous system reacts with a survival response, leading to avoidance behaviors. This is not simply about being "difficult" or "defiant"; instead, it is a deeply ingrained response to maintain a sense of control and manage overwhelming emotions- most commonly, anxiety.
Common Traits:
People with PDA may exhibit the following characteristics:
Strong resistance to everyday demands and expectations
A high need for autonomy and control over their environment
A sociable nature but difficulty with peer relationships
Anxiety-driven meltdowns or shutdowns
Extreme emotional responses
Types of Demands:
Individuals with PDA may struggle with different types of demands, including:
Explicit demands – Direct requests such as "Put on your shoes" or "Do your homework."
Implicit demands – Unspoken expectations like following social norms or taking turns in a conversation.
Internal demands – Self-imposed goals or expectations, such as wanting to complete a task perfectly.
External demands – Expectations placed by others, such as schoolwork or chores.
Demands within demands – Situations where multiple demands are layered, such as getting ready in the morning, which involves brushing teeth, getting dressed, and leaving the house on time all of which are expected behaviours.
Avoidance:
To cope with the overwhelming stress of demands, individuals with PDA may avoid things in different ways, including:
Boundary setting- Refusing outright to do the ask/expectation
Aggression – Dysregulation verbally or physically towards self or others
People-pleasing – Agreeing to demands but not following through
Perfectionism – Setting impossibly high standards as a way to control situations
Procrastination – Putting off tasks indefinitely
Running away – Leaving stressful environments
Shouting or negotiating – Attempting to argue or change the terms of a demand
Situational mutism/selective speaking – Being unable to speak in high-stress situations
Self-medicating – Using distractions or substances to cope
Restricting eating or toileting – Controlling bodily functions as a way to exert autonomy
PDA Strengths:
Individuals with PDA often have remarkable strengths, including:
A strong sense of humor
Determination and persistence
High intelligence and curiosity
Creativity and innovative thinking
Being multi-talented with diverse interests
A deep sense of justice and fairness
Social Profiles of PDA:
Social interactions can be complex for individuals with PDA. Some common social characteristics include:
Viewing themselves as an authority figure, expecting to be obeyed. Children with PDA often to not see power differentials within relationships and consider themselves on an equal playing field as the adults in their lives in a variety of ways.
Delayed Theory of Mind, leading to difficulties understanding others' emotions and perspectives
Struggles with friendly teasing, reciprocity, and conversational give-and-take
Initially appearing sociable but struggling with peer relationships over time
Difficulty intuitively knowing how to play or interact with others
Taking on leadership roles in play, often acting as a teacher or director
Being perceived by others as "bossy" or overly controlling in social situations. Keeping in mind, controlling play is helping them feel safe.
Less awareness of social hierarchies, boundaries, and responsibilities
How to Support Individuals with PDA?
Understanding and accommodating PDA involves respecting the need for autonomy while finding creative ways to reduce demand-based stress.
Some strategies include:
Using indirect language – Instead of saying, "You need to do this now," try, "I wonder if we should try this together."
Offering choices – Providing a sense of control can reduce anxiety. Strewing options is one strategy that can be helpful.
Incorporating humor and play – Engaging in tasks through fun and imagination can make demands feel less threatening.
Allowing flexibility – Giving time and space to complete tasks can ease pressure.
Building trust – Establishing strong relationships where the individual feels respected and understood can help them navigate challenges more effectively.
Navigating PDA with OPERATION SODA
Super Shamal: Living and Learning with Pathological Demand Avoidance by K.I. Al-Ghani
SWITCH ON THE THINKING BRAIN
Take a breath then slowly count backwards from seven to one
Go to a safe place or special person
Sit and use a mantra to acknowledge the feeling of panic
OXYGEN
Breathe in to a count of five, hold the breath, then breath out slowly
Blow bubbles/a balloon
Play a tune on an instrument
Have a drink through a straw
Increase blood sugar
DISTRACTION
Look at things that make you smile
Have a distraction box with fidgets and sensory toys, favourite books, etc.
See how many things you can name in a category in a minute (e.g., animals)
Color, draw, write a poem, listen to music
Read a comic book or joke book
Do something to meet your sensory needs
APPROVAL
Look in the mirror and do some positive self-talk
Get or give yourself a big hug and a pat on the back
Record the number of times you did a SODA and note down what worked best for you
Resources
Exploring my PDA
Super Shamlal - Living and Learning with Pathological Deman Avoidance
By K.I Al Ghani
Me and My PDA - A guide to Pathological Demand Avoidance for Young People
By Glòria Durà-Vilà and Tamar Levi
The Panda on PDA
By Glòria Durà-Vilà
Resources for Parents
Pathological Demand Avoidance Syndrome - My Daughter is not Naughty
By Jane Alison Sherwin
Helping Your Child with PDA Live a Happier Life
By Alice Running
Can I tell you about Pathological Demand Avoidance Syndrome? - A guide for friends, family and professionals
By Ruth Fidler and Phil Christie
I’m Not Upside Down I’m Upside Up - Not a Boring Book About PDA
By Herry Thompson and Danielle Jata-Hall
The Family Experience of PDA
By Eliza Fricker
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IMPORTANT: Information shared by WonderTree is not intended to replace or be constituted as clinical or medical care. It’s intended for educational purposes only. Each child is unique, and the information provided may not be applicable to your specific situation. If you need support, please establish care with a licensed provider so that they can provide tailored recommendations for you or your child. This blog is non-monetized.
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