The PDA Paradox

Understanding the Need for Autonomy

(The Abridged Version)

Have you ever heard of Pathological Demand Avoidance, or PDA?

It's a profile most widely understood to be part of the autism spectrum, but it can also be found in other neurodivergent individuals and can show up in some surprising ways.

You might be thinking it's just a kid who doesn't listen, but it's so much more than that. At its heart, PDA isn't about being disobedient—it's about an intense, overwhelming need for autonomy [1].

Think of it this way: for someone with a PDA profile, a simple request like "put on your shoes" can feel like a direct threat to their freedom. Their brain's alarm system goes off, triggering a "fight, flight, or freeze" response [2].

This isn't a choice; it's a nervous system reaction.

This is why traditional parenting or teaching methods, which often rely on demands and consequences, can backfire spectacularly. They just add more stress to an already overwhelmed system [3].

The child isn't trying to be difficult; they're genuinely trying to maintain a sense of equilibrium in an environment that feels threatening [4].

This drive for autonomy is so central to the PDA experience that it can manifest in unique ways. While many people on the autism spectrum might prefer routine and predictability, a person with a PDA profile might actively resist it. They may even avoid things they genuinely want to do if they feel like it's a demand [1].

The anxiety-driven need for autonomy can manifest in social strategies to instinctively deflect a request—like changing the subject, making a joke, or even appeasing the request with creative justifications—all as a means to avoid feeling controlled [5].

Instead of focusing on compliance, the best way to support someone with a PDA profile is to focus on connection. This means reframing how you communicate and approaching things with flexibility [6].

Here are a few simple shifts:

Move from commands to collaborative language

Instead of "You need to brush your teeth," try something like, "I wonder if we should go pick out a toothbrush?" This shifts the dynamic from an order to a shared task [7].

"Gamify" tasks

Make a boring chore into a fun game, like seeing who can get their pajamas on the fastest. This can make the activity less about a demand and more about play [8].

Give choices

Offering a sense of control, even with small things like, "Do you want to do your homework now or after a snack?", can make a huge difference. These small moments of autonomy can help prevent a larger meltdown [4].

Practice indirect communication

Rather than saying "It's time for bed," you could say "I'm going to put on a quiet movie now," allowing them to join without a direct command [8].

PDA can be difficult to spot, especially in people who are good at "masking"—hiding their struggles to fit in [9]. They might seem perfectly fine at school or work, only to melt down at home when they finally feel safe [10]. This is because they've been using up all their energy to appear "normal," and they're completely drained. This "boom-and-bust" cycle is a clear sign that their nervous system is in a constant state of high alert, and home is the only place where they feel safe enough to release that tension [10].

If you're a parent, teacher, or friend, understanding that PDA is rooted in anxiety, not defiance, is the key [3]. By shifting your approach from demands to empathy and collaboration, you can create a safe, low-stress environment where everyone can thrive [11]. It's about meeting them where they are and building a relationship based on trust, not control. This is the path to helping them build their skills and confidence without triggering their deep-seated need for autonomy [4].

References

[1] O'Nions, E., Christie, P., Gould, J., Gillberg, C., Viding, E., & Happé, F. (2016). Identifying features of 'pathological demand avoidance' using the Diagnostic Interview for Social and Communication Disorders (DISCO). *European Child & Adolescent Psychiatry*, *25*(4), 407-419. https://doi.org/10.1007/s00787-015-0740-2

[2] White, R., Livingston, L. A., Taylor, E. C., Close, S. A., Shah, P., & Callan, M. J. (2022). Understanding the contributions of trait autism and anxiety to extreme demand avoidance in the adult general population. *Journal of Autism and Developmental Disorders*, *52*(4), 1738-1754. https://doi.org/10.1007/s10803-022-05469-3

[3] O'Nions, E., Ceulemans, E., Happé, F., Segers, J., Viding, E., & Noens, I. (2020). Parenting strategies used by parents of children with ASD: Differential links with child problem behaviour. *Journal of Autism and Developmental Disorders*, *50*(4), 1409-1424. https://doi.org/10.1007/s10803-019-04219-2

[4] O'Nions, E., Happé, F., Viding, E., & Noens, I. (2021). Parenting goals: Links with parenting strategies in caregivers of children with autism spectrum disorder. *Advances in Neurodevelopmental Disorders*, *5*(1), 54-65. https://doi.org/10.1007/s41252-020-00167-6

[5] Egan, V., Linenberg, O., & O'Nions, E. (2019). The measurement of adult pathological demand avoidance traits. *Journal of Autism and Developmental Disorders*, *49*(2), 481-494. https://doi.org/10.1007/s10803-018-3722-7

[6] Doyle, A. (2022). Mapping experiences of pathological demand avoidance in Ireland. *Journal of Research in Special Educational Needs*, *22*(4), 352-363. https://doi.org/10.1111/1471-3802.12579

[7] O'Nions, E., Ceulemans, E., Happé, F., Segers, J., Viding, E., & Noens, I. (2020). Parenting strategies used by parents of children with ASD: Differential links with child problem behaviour. *Journal of Autism and Developmental Disorders*, *50*(4), 1409-1424. https://doi.org/10.1007/s10803-019-04219-2

[8] O'Nions, E., Happé, F., Viding, E., & Noens, I. (2021). Parenting goals: Links with parenting strategies in caregivers of children with autism spectrum disorder. *Advances in Neurodevelopmental Disorders*, *5*(1), 54-65. https://doi.org/10.1007/s41252-020-00167-6

[9] O'Nions, E., Happé, F., Viding, E., & Noens, I. (2021). Extreme demand avoidance in children with autism spectrum disorder: Refinement of a caregiver-report measure. *Advances in Neurodevelopmental Disorders*, *5*(2), 153-165. https://doi.org/10.1007/s41252-021-00203-z

[10] Connolly, H., Constable, H., & Mullally, K. (2023). School distress and the school attendance crisis: A story dominated by neurodivergence and unmet need. *Frontiers in Psychiatry*, *14*, 1237052. https://doi.org/10.3389/fpsyt.2023.1237052

[11] Kamp-Becker, I., Schu, U., & Stroth, S. (2023). Pathological demand avoidance: Current state of research and critical discussion. *Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie*, *51*(3), 1-12. https://doi.org/10.1024/1422-4917/a000927