Pathological Demand Avoidance
The term Pathological Demand Avoidance (PDA) was first introduced in the 1980s by Elizabeth Newson, a developmental psychologist in the UK. Newson used PDA to describe a subset of children who displayed an extreme and pervasive avoidance of everyday demands.
However, the term Pathological suggests that this experience is a disorder or deficit rather than a valid neurological response. Over time, Autistic individuals and neuroaffirmative professionals have challenged this framing, advocating for terminology that better reflects lived experiences.
What Terms Do We Use Now?
Instead of Pathological Demand Avoidance, many Autistic advocates and professionals now use terms such as:
Persistent Demand Avoidance (PDA): A neutral term that removes the pathologising aspect.
Pervasive Drive For Autonomy: A term that acknowledges how individuals process and experience demands.
Demand Sensitivity: A term that acknowledges how individuals process and experience demands.
These alternatives move away from deficit-based language and better align with a neuroaffirmative understanding of Autistic & PDA experience. If unsure of what language to use, always follow the preference of the individual with PDA.
What is Pathological Demand Avoidance?
Pathological Demand Avoidance, or persistent driver for autonomy, refers to an intense, automatic nervous system response to both direct and indirect demands. This is not a conscious choice but rather a form of self-protection. For individuals with PDA, demands, whether external requests or internal expectations, can feel overwhelming, triggering the fight, flight, freeze, or fawn response.
Rather than being about opposition or defiance, persistent demand avoidance is an intrinsic need to maintain autonomy and control over one’s environment.
Key Characteristics of Pathological Demand Avoidance
1. An Overwhelming Need for Autonomy
Even minor requests may feel intrusive or overwhelming.
Resistance to demands is not a behavioural challenge but a nervous system response.
2. Sensitivity to Both External and Internal Demands
Direct instructions (e.g., “Put on your shoes”) and indirect expectations (e.g., being expected to engage in an activity) can both trigger avoidance.
Self-imposed goals can feel just as overwhelming as external pressures.
3. Adaptive Social Strategies to Navigate Demands
Many individuals with PDA use negotiation, humour, distraction, or role-playing to manage demands.
These are not acts of manipulation but protective responses to reduce distress.
4. Emotional Regulation and Nervous System Dysregulation
Mood fluctuations and heightened emotional responses often occur when demands feel overwhelming.
Shutdowns, meltdowns, or avoidance result from autonomic nervous system distress, not intentional opposition.
5. Masking and Burnout
Individuals with PDA often mask their struggles, appearing outwardly compliant while experiencing internal distress.
Prolonged masking can lead to autistic burnout, withdrawal, and exhaustion.
6. Intense Interests and Creativity
Many individuals channel their energy into deep interests, role-playing, or imaginative storytelling as a way to regain control and regulate emotions.
These activities provide a sense of autonomy, helping to reduce demand-related anxiety.
Parent to a PDA Child
Parenting a Child with Pathological Demand Avoidance
As an Autistic PDA adult raising two Autistic sons with PDA, this is a passionate interest of mine both professionally and personally.
Raising a child with persistent demand avoidance requires rethinking traditional parenting approaches. Compliance-driven methods often lead to more resistance and distress. Parents often find:
Daily routines can be challenging due to demand sensitivity.
Collaborative, trust-based approaches work better than authority-based models.
Connection and co-regulation are neuroaffirmative and reward or consequence-based strategies are not to be used.
Supporting a PDA child means reducing unnecessary demands, allowing autonomy, and adapting expectations to create a low-demand environment that fosters safety and trust.
Living as an Adult with PDA
For adults with persistent demand avoidance, challenges persist beyond childhood. Many struggle with:
Workplace expectations that conflict with their need for autonomy.
Balancing responsibilities while managing their own demand sensitivity.
The need for flexibility in commitments and routines to avoid burnout.
Understanding one’s own demand sensitivity can empower Autistic adults to advocate for accommodations, set boundaries, and create a lifestyle that supports their neurological needs.
How I Support Families and Schools with PDA Strategies
As an Autism & Visual Supports Specialist, I work with families, educators, and professionals to develop demand-sensitive approaches that respect autonomy and reduce stress responses.
Support for Families
PDA Parenting Coaching: Helping parents implement low-demand, connection-first strategies.
PDA Lived Experience Education: Supporting parents to have a paradigm shift in their understanding, connection and collaboration with their PDA child, teen and young adult.
Visual Supports for PDA: Customised PDA-friendly visual supports that allow for choice and flexibility.
Low-Demand Parenting Guidance: Teaching families how to reduce perceived demands while maintaining structure.
Support for Schools
Educator Training on PDA: Providing teachers with practical strategies for demand-sensitive learning environments.
PDA-Inclusive Classroom Strategies: Creating low-demand, flexible learning models to support Autistic students.
One-on-One Consultations: Helping schools adapt their support plans for PDA learners.
A Neuroaffirmative Approach to Pathological Demand Avoidance
Rather than enforcing compliance, neuroaffirmative strategies prioritise autonomy, trust, and emotional regulation. Effective approaches include:
Reducing Perceived Demands – Adjusting communication to minimise pressure and increase autonomy.
Prioritising Connection Over Compliance – Building relationships based on trust and co-regulation.
Creating Sensory and Emotionally Safe Environments – Supporting nervous system regulation by adapting surroundings.
Honouring Autonomy and Individual Needs – Recognising that avoidance behaviours are self-protective, not oppositional.
Do you need personalised support for PDA at home or in school? Get in touch to explore tailored strategies that meet the needs of PDA individuals in your life.
