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Pathological Demand Avoidance

 

Pathological Demand Avoidance, commonly referred to as PDA, is a presentation which occurs in neurodivergent individuals, such as those identified as Autism or ADHD. PDA causes extreme avoidance of demands in children and adults, making it very difficult for children and adults to follow instructions, take directions, and engage in day-to-day tasks at home, school, or work. Often misinterpreted as behaviour similar to that seen in ODD (Oppositional Defiant Disorder), PDA is better understood as an extreme fear of losing control and being told what to do. Despite anxiety being a core part of the underlying cause of the demand avoidance, behaviour associated with PDA can be extreme including:

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• Regular defiance at home and school

• Refusal to comply with even simple daily tasks (e.g. brushing teeth, having a shower)

• Verbal Aggression

• Physical Aggression

• Absconding/Running Away​

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Not all children exhibit all of these traits of PDA, and different genders can present different. 

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The assessment of PDA is typically combined with an Autism and/or ADHD assessment, or can be completed in those already identified as neurodivergent. The assessment involves interviews and information-collecting from parents, teachers and any other important people in the child’s life, in addition to observation of the child in-session completing a variety of tasks.

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