Pathological Demand Avoidance
Pathological Demand Avoidance (PDA) is an anxiety-driven need to avoid everyday demands and expectations, characterized by extreme resistance to ordinary requests regardless of consequences.
You're not alone
If traditional parenting strategies backfire spectacularly, your teen negotiates endlessly, and even positive activities become battles if presented as expectations, you might be dealing with PDA. This profile, identified within autism spectrum conditions, affects an estimated 1-2 percent of the population. Many families struggle for years before understanding PDA explains their teen's extreme avoidance.
What it looks like day to day
Student
Your teen wants to do homework but physically cannot start because it's expected, spending hours in distress avoiding a 10-minute task.
Parent
You ask your teen to put on shoes and trigger a two-hour meltdown, but later they spontaneously clean the entire kitchen when not asked.
Tiny steps to try
- 1
Indirect requests
Instead of "do your homework," try "I wonder when that assignment might get done." Reduce demand feeling.
- 2
Choices and control
Offer multiple options or let them suggest alternatives. "Would you prefer X or Y, or something else?"
- 3
Declarative language
State observations rather than commands. "The trash is full" versus "take out the trash."
- 4
Lower demands during stress
When anxiety is high, reduce all demands to absolute essentials. Recovery requires demand reduction.
- 5
Collaborative problem-solving
Work together on solutions. "How can we solve this homework situation?" gives control while addressing needs.
Why PDA is more than defiance
PDA isn't willful disobedience or oppositional behavior. It's anxiety-driven inability to comply with demands, even ones the teen wants to meet.
PDA characteristics:
• Resisting ordinary demands obsessively
• Using social strategies to avoid demands
• Appearing sociable but lacking depth
• Excessive mood swings and impulsivity
• Comfortable in role play and pretense
• Obsessive behavior often focused on people
The word "demand" includes any expectation, even self-imposed ones like hunger or needing the bathroom.
References
Newson, E., Le Maréchal, K., & David, C. (2003). Pathological demand avoidance syndrome: A necessary distinction within the pervasive developmental disorders. Archives of Disease in Childhood, 88(7), 595-600.
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Frequently Asked Questions
Is PDA a real diagnosis?
PDA is recognized in the UK and increasingly internationally as a profile within autism spectrum conditions. In the US, it might be identified as autism with demand avoidance or anxiety-driven opposition. Regardless of diagnostic labels, the strategies for supporting extreme demand avoidance remain consistent and effective.
How is this different from oppositional defiant disorder?
ODD involves deliberate defiance and anger toward authority. PDA involves anxiety-driven avoidance of all demands, including self-care and enjoyed activities. PDA individuals often want to comply but cannot. They avoid their own desires if framed as demands. Traditional ODD approaches often worsen PDA.
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