Demand avoidance

Characterised by an overwhelming and anxiety-driven need to avoid, resist, or control everyday demands and expectations. Though PDA is not currently seen as a medical diagnosis, it is widely acknowledged by clinicians, families, and advocacy organisations as a profile that requires a specific support.

Key Features and Behaviours

The defining feature of PDA is an extreme avoidance of ordinary demands. This avoidance is typically driven by anxiety and a need for autonomy and control. Common features include:

Obsessional resistance to everyday demands: Even simple requests-such as brushing teeth or putting on shoes may trigger a strong urge to avoid or resist.
Use of social tactics to avoid demands: This might include distracting, procrastinating, negotiating, making excuses, or shifting blame.
Utilising social skills: Children may employ their social charm or humour to avoid demands. E.g. asking you a question about you, giving compliments or telling a joke about the activity instead of doing it.
Mood swings: Some children have sudden and intense emotional reactions which seem extreme for the stimulus. These are especially common in response to feeling out of control.
Imaginative play: Children may engage in elaborate role-play, sometimes as a method of avoiding demands. Pretend broken limbs, illnesses and becoming animals are common

Stages of avoidance

PDA behaviours can escalate depending on stress and perceived pressure

Examples of avoidance:

Distraction, procrastination, negotiation, excuses.

Make believe excuses, exaggeration or outright refusal.

Meltdowns, panic attacks, self-injury, harm to possessions.

What Triggers PDA?

Any expectation: Both external (from others) and internal (from themselves) demands can prompt
avoidance behaviours.
Loss of control: Routine disruptions and transitions can trigger
significant distress.
Historic expectation: Being in environments or with people where there has
previously been high demand can trigger avoidance.
Sensory sensitivities and anxiety: High levels of anxiety, or sensory overload
can increase demand avoidance.

Differences from everyday demand avoidance

Typical demand avoidance is common, most people resist unwanted demands occasionally. What distinguishes PDA is the extremity, frequency, and anxiety-driven nature of the response. For chilren with PDA profiles, even enjoyable tasks or demands they put on themselves may feel impossible if perceived as a demand.

Social and Daily Life Impacts

PDA can significantly affect daily functioning. Ordinary activities like attending school, maintaining routines, or building relationships can become extremely challenging. Even when the child is able to complete the task it may take more energy or time. Individuals may be mislabelled as wilful, defiant, or oppositional, when in fact their behaviours are rooted in anxiety and a pathological need for control.

Support

Direct approaches and traditional behaviour support can typically worsen anxiety and avoidance. Therefore tailored and compassionate strategies are essential:

Reducing the number and intensity of demands whenever possible. Some demands are unavoidable, and that’s ok. But think about all the demands you can let go of.
Collaborative approaches: Let you child see themselves as your equal or even at time above you. Let them go in first or choose the film. This make it easier for them when it’s your turn to be in charge. Work with your child, not against them.
Indirect communication: Framing requests as choices or suggestions, using humour, or making tasks part of a joint activity, story or game can prevent the demand from triggering your child.
Sensory regulation: Providing a calming, low-pressure environment and addressing sensory triggers. Giving your child a solid regulated base to work from with help them in so many ways.
Therapies: Cognitive-behavioural therapy (CBT), occupational therapy, and other multidisciplinary approaches can help a child feel more comfortable and cope with demands. Any interventions must be adapted to minimize perceived demands and foster autonomy.
Building supportive environments: Encouraging trust, flexibility, and . Praising successes and not focusing on failures supports self-esteem and resilience. Encourage family to follow your lead.
Identify triggers: Work with your child to

Pathological Demand Avoidance is a complex and often misunderstood neurodivergent profile, marked by intense and persistent avoidance of everyday demands.

Recognition, understanding, and individualised support are crucial for helping individuals with PDA thrive. Traditional approaches may increase anxiety and resistance. By acknowledging the anxiety and need for control that underlie these behaviours we can foster environments in which children with PDA feel safe, empowered, and better equipped to navigate daily life.