PDA (Pathological Demand Avoidance) is a profile on the autism spectrum characterized by an extreme avoidance of everyday demands and an anxiety-driven need to be in control. People with PDA struggle with social communication, have difficulty managing emotions, and engage in behaviors that are perceived as manipulative or oppositional.

However, these behaviors are often a response to overwhelming anxiety.

Key features of PDA include:

1. Avoidance of Demands: This can include avoiding tasks or requests others may find simple, such as getting dressed or following a schedule.
2. High Levels of Anxiety: Demand avoidance is often rooted in deep anxiety, which can manifest in controlling or defiant behavior as a coping mechanism.
3. Social Manipulation: Individuals with PDA may use social strategies to avoid demands, such as distraction, making excuses, or even flattery. However, this is usually a learned response to avoid situations that cause them anxiety.
4. Resistance to Routine: Unlike other forms of autism, where routine can be comforting, those with PDA may resist routines and prefer spontaneity or situations where they can feel in control.
5. Difficulty with Social Boundaries: This may include being overly familiar with strangers or avoiding social situations altogether.
6. ‘Obsessive’ behavior, often focused on other people or can be focused on performance demands (due to acute anxiety);

PDA Support and Accommodations

Understanding PDA as part of the autism spectrum helps in providing the right support and accommodations, for instance, reducing pressure, offering choices, and creating a supportive environment that minimizes anxiety triggers.

The overwhelming need to be in control is a driving force behind many PDA behaviors. The loss of autonomy is perceived as a threat that activates the fight-flight or freeze response. This can lead to heightened anxiety and escalatation to a state of panic, especially when individuals perceive a lack of control or vulnerability.

Suppose an individual with PDA reacts with a fight-or-flight response. In that case, it can result in emotional outbursts that might mistakenly lead to a misdiagnosis of Oppositional Defiant Disorder (ODD) or other behavioral conditions.

PDAs and Social Interactions

Individuals with PDA may exhibit a higher level of sociability than expected, displaying good eye contact and conversational skills. However, they may struggle with comprehending social interactions on a deeper level and lack social responsibility. Difficulties in peer relationships and a lack of social boundaries and constraints are common.

Children who experience PDA may face challenges in finding their position within the social hierarchy. They may insist on being treated as adults, disregarding their parents’ authority. While they may understand rules, they often do not feel that these rules apply to them. Additionally, they may engage in behaviors intended to shock or upset others, such as asking personal questions or making inappropriate comments loudly.

In terms of social strategies, PDA-ers may be very good at ‘masking’ difficulties with certain people or in certain situations. They may present differently in different settings depending on their anxiety levels. For example, they may employ various tactics such as distraction, excuse-making, outright refusal, or role-playing to avoid demands.

Obsessive Behavior

The obsessive behavior exhibited by individuals who experience PDA may also differ from others who also experience obsessive behavior. PDA-ers fixations often revolve around other individuals, whether fictional or real, to the extent of becoming overwhelming for the person on the receiving end. While these defining characteristics provide some insight into how these individuals with PDA may behave, remember that, similar to all autistic persons, presentations can vary from one person to another.

A person with Pathological Demand Avoidance (PDA) may appear composed, collected, and compliant at school but exhibit more challenging behavior at home/in their “safe space.”  This is often because they have reached their threshold of tolerance and need to release the suppressed anxiety they have been experiencing.

Additionally, people who experience PDA may enjoy role playing, sometimes to the extent that the character they are playing feels more comfortable for them to inhabit than their reality. They may appear to “lose touch” with reality. They may adopt the personality of someone or something (e.g., a favorite teacher, animal, friend, or co-worker) for an extended period. This can often become obsessive and can get in the way of the person forming friendships and having healthy social interactions.

Types of demands include: 

• A direct demand (an instruction, such as ‘brush your teeth’, ‘do the dishes’ or ‘go to work now’);
• An internal demand (for example willing yourself to do something such as take a shower, or bodily needs such as hunger or needing to use the toilet); and
• An indirect or implied demand (including any expectation, such as a question that requires an answer (‘When are you coming home today?’), food in front of you that you are expected to eat, or a deadline arriving that needs tending to).

Types of resistance

A PDA-er may display resistance in many ways, depending on a multitude of variables, including the person’s age, personality, general stress response tendencies, and more.

Some key forms of resistance include:

• Distraction or diversion (such as giving compliments; changing the subject, making noise that makes further discussion difficult, or by creating a situation that needs more immediate attention, for example, by feigning injury or tipping something over);
• Excuse giving (which may be outlandish– for example, ‘I can’t put my toys away because I am a duck and ducks don’t have hands’ or ‘I can’t because my legs don’t work’;
• Point blank refusal (saying “No” and not entering into negotiation; physically resisting and/or shutting down);
• Withdrawal and/or passivity (becoming floppy; curling up into a ball; not responding; walking/running away; withdrawing into a fantasy world); and
• Aggression (usually as a last resort, when other forms of resistance have failed, such as pushing someone or throwing something away; hitting or kicking; biting