Understanding Pathological Demand Avoidance (PDA): A Closer Look

Everyone occasionally experiences resistance to doing something requested or expected of them. However, demand avoidance refers to a persistent and marked resistance to the everyday demands of life. This can include essential tasks like eating and sleeping and expected activities such as going to school or work.

Pathological Demand Avoidance is often observed in autistic individuals and potentially other neurodivergent people. Despite this, research on demand avoidance is limited and often contested. This blog presents various views and the best information from lived experiences, research, and professional practice.

Types of Demand

People experiencing demand avoidance may resist various types of demands:

• Direct Demands: Instructions such as “brush your teeth” or “complete your tax return.”
• Internal Demands: Bodily needs or self-imposed expectations, like feeling hungry or willing yourself to do something.
• Indirect or Implied Demands: Expectations or situations requiring action, such as a question needing an answer, food that needs to be eaten, or a bill that needs to be paid.

Forms of Resistance

Resistance to demands can manifest in several ways:

Excuses: Often fanciful, like saying they can’t do something because they’re a tractor and tractors don’t have hands.
Distraction or Diversion: Changing the subject, making noise, or creating a situation needing immediate attention.
Point-Blank Refusal: Simply saying “No” and not negotiating.
Passivity/Withdrawal: Becoming unresponsive, walking away, or withdrawing into fantasy.
Aggression: As a last resort, when other forms of resistance fail, it can include physical actions like pushing, hitting, or biting.

The anxiety of realizing a demand cannot be avoided may result in meltdowns or panic, sometimes including aggression.

Real-Life Examples of Demand Avoidance

Demand avoidance can be challenging to understand, but real-life examples provide valuable insights:

• A parent describes children with PDA avoiding activities they want to do because they become a demand. For example, a child may melt down over their favorite food being served because it wasn’t asked for or is in the wrong color bowl.
• Parent: Shares that external demands cause great distress, even if the child wants to participate.
• Parent: Explains that if someone asks them to do something they planned, they cannot do it.
• Parent: Highlights that autonomy is crucial for individuals with PDA, leading them to resist authority figures and avoid demands through various techniques, including procrastination and aggression.

Relationship to Autism and Other Neurodivergence

Demand avoidance is often observed in autistic people and is a key characteristic of the proposed condition, Pathological Demand Avoidance (PDA). Although PDA is controversial and not recognised clinically, some view it as a distinct neurotype.

Demand avoidance may also be connected to other conditions, such as:

• Complex Post-Traumatic Stress Disorder (PTSD)
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Oppositional Defiant Disorder (ODD)

Conclusion

Understanding demand avoidance is crucial for supporting those who experience it. By recognising the various forms of resistance and their underlying causes, we can develop better strategies to help individuals manage their anxiety and improve their quality of life. Addressing demand avoidance requires a nuanced and empathetic approach, whether through early intervention programs, psychotherapy, or tailored parenting strategies.

Ione Inness
Ione is the Director at SEND Tutoring and has over 20 years’ experience working with children and young people. In the last 10 years she has worked with children of varying different needs, including: Autism, Pathological demand avoidance (PDA), Attention deficit hyperactivity disorder (ADHD), Attention deficit disorder (/ADD), Social, emotional and mental health needs (SEMH), Dyslexia, Dyspraxia, Dyscalculia, Speech and language delays or difficulties, Cerebral palsy, Nonverbal, speech/communication delays, Challenging behaviour, Profound and multiple learning disabilities (PMLD), Anxiety, Cognition difficulties, Learning difficulties.

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