Pathological Demand Avoidance

Pathological Demand Avoidance (PDA) is a behavioral profile commonly associated with the autism spectrum. It is characterized by an extreme avoidance of everyday demands and a compulsion driven by anxiety. Although PDA is related to autism, its distinct features necessitate a different approach from the standard autism guidelines.

Parenting a child with PDA can be challenging, but with effective coaching, you can navigate it successfully.

Key points

Quick navigation

What does PDA look like?

People with PDA have a strong resistance to completing daily tasks and an overwhelming need to maintain control. This can make life challenging for everyone involved, including parents, siblings, and peers.

Children who have PDA exhibit an extreme need to maintain control at all times. Even simple daily instructions are met with fierce defiance and oppositional behavior. This can include actions such as feigning immobilization and meltdowns. They also often refuse to submit to authority, reject the instructions of parents and teachers, and can appear to be highly manipulative in order to get their way.

Characteristics unique to PDA include delayed speech development, intense fluctuations in mood, and difficulties with sociability. While PDA still has yet to be recognized as its own diagnosis in the US, it is important that parents and children receive proper support from a professional who understands the condition.

Parenting strategies for Pathological Demand Avoidance

It’s tempting, as a parent, to question yourself and wonder, “where did I go wrong?” But the fact that you are reading this, is a sign of your commitment as a parent. Seeking to understand your child and be a better parent shows immense care and dedication. It is important to remember this as you may be tempted to blame yourself. Navigating the challenges of parenting a child with PDA can be complex, and gaining insights from an expert who has experience working with PDA children can be incredibly valuable. Coaching for parents offers practical guidance and support as you navigate this unique journey with your child.

You might already be familiar with many of these strategies, but revisiting the fundamentals is crucial in creating a nurturing environment for your child’s growth, development, and emotional maturity. These essentials include:

  • Understanding your child and their triggers
  • Building trust and rapport
  • Establishing a structured and predictable routine
  • Allowing room for flexibility
  • Setting up environmental cues for success
  • Employing positive reinforcement
  • Seeking professional support

Each of these elements play a role when it comes to creating a strong foundation and they can help you to effectively guide your child through their developmental journey.

Understanding your child and their triggers

Let’s face it: just like any person, a child is more likely to listen and cooperate when they feel understood and respected. By deeply understanding your child and anticipating their most distressing triggers, you can proactively manage situations that may cause anxiety or resistance. Take, for instance, the common challenge of transitions, like leaving the house or school. Having a strategy in place, such as offering a favorite snack or planning a stop at the playground can alleviate anxiety. These predictable and enjoyable activities can not only prevent meltdowns but also create a sense of comfort and security for your child. This can make transitions smoother and more manageable for the both of you.

Building trust and rapport with your child

The key to effective guidance and leadership lies in a strong emotional bond between parent and child. This is especially true for children with PDA, where a trust and having a positive relationship are crucial. If you’ve had a challenging start, remember that it’s never too late to turn things around. Actively listening to your child, spending extra time engaging in activities they love, and ensuring that they receive moments of your undivided attention can significantly strengthen the relationship. These efforts can make all your other parenting strategies more effective and help build a nurturing and understanding environment for your child.

Structure and predictability

Nearly everyone thrives on some level of routine that brings predictability to their day. However, this is particularly true for children with PDA. Without a basic routine, these children may experience heightened anxiety, often leading to otherwise avoidable meltdowns. Maintaining a consistent schedule is beneficial even during less structured times like vacation. Crafting a simple yet steady routine, encompassing regular meal times, playground visits, bath time, and a set bedtime, can significantly improve daily functioning for both you and your child. This structure provides a sense of security and stability, easing anxiety and making the day more manageable for everyone involved.

Providing flexibility within the structure

While routine and structure often provide comfort to individuals with PDA, incorporating flexibility within that structure is equally important. Unexpected events, like a sudden downpour altering plans for an afternoon at the playground, can trigger a meltdown in children who struggle with changes in routine.

Coaching can give you the tools to teach your child how to cope when things don’t go as planned. By teaching them how to be more flexible, you help them learn how to manage unpredictable situations and equip them with adaptability skills. These skills are vital for their growth and maturity, enabling them to navigate life’s unpredictability with greater ease and resilience.

Setting up environmental cues for success

Visual aids such as schedules, charts, and diagrams can give your child clear expectations and reduce anxiety without you even having to verbalize any instructions for them to defy. Illustrations can be a visual guide for the child to understand what is expected of them while reducing the power struggle that may have become an everyday battle.

The power of positive reinforcement

Encouraging and reinforcing positive behaviors is a powerful strategy with proven effectiveness. The truth is that even while your child is acting out, your opinion still matters to them and secretly, they want nothing more than to earn your approval. So recognizing and praising your child for their efforts and achievements can help build their confidence and motivate them to keep up with those same positive behaviors.

Peer interaction and social skills

Promoting positive peer interactions and building social skills can help your child develop socially. Opportunities to see how other children behave will augment your positive parenting approach. Coaching can teach you how to create opportunities for socialization in a supportive and understanding environment.

Professional support can help

If you are the parent of a child with PDA you can benefit from individualized coaching by learning how to you tailor your efforts to suit your child’s unique needs. If your child struggles with severe task aversion and an inability to respect authority, it is crucial that you access specialized guidance from a skilled professional who understands the unique needs of a child with PDA.


While mainstream parenting approaches may prove frustratingly ineffective for your child, a tailored approach to parenting your child with PDA can deliver results.

References 

Kildahl, A., Helverschou, S., Rysstad, A., Wigaard, E., Hellerud, J., Ludvigsen, L., & Howlin, P. (2021). Pathological demand avoidance in children and adolescents: A systematic review. Autism, 25, 2162 – 2176. https://doi.org/10.1177/13623613211034382.

Newson, E., Maréchal, K., & David, C. (2003). Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders. Archives of Disease in Childhood, 88, 595 – 600. https://doi.org/10.1136/adc.88.7.595.

Malucelli, E., Antoniuk, S., & Carvalho, N. (2020). The effectiveness of early parental coaching in the autism spectrum disorder. Jornal de Pediatria, 97, 453 – 458. https://doi.org/10.1016/j.jped.2020.09.004.