Pathological Demand Avoidance

Photo by Mick Haupt

When you have worked in the field of autism as long as I have, you get in the habit of dismissing new developments as new theories. “Cures” pop up all the time. The majority are untrue. That was the case when I first heard of PDA years ago. Unfortunately, I did not pay attention.

A few years ago, a parent sent me article after article about PDA until I finally paid attention, and, boy, did it get my attention. I know these kids. You may as well. They are a subgroup of autistic, often twice-exceptional, children, teens, and adults who have an anxiety-based need for control and resist the demands of everyday life. Elizabeth Newson, an English developmental psychologist, named this profile of autism Pathological Demand Avoidance in 1983. These days, to get away from pathologizing neurodiversity, some people have rebranded PDA as Persistent Drive for Autonomy.

However it’s called, anyone who cares about neurodiversity, education, psychology, behavior, healthcare, and humans in general needs to understand PDA. These individuals are often very verbal, have good eye contact, are imaginative, and are socially motivated, characteristics that often prevents them from having an autism diagnosis. In fact, many parents of PDA children have been told firmly that their child is not autistic, only very intelligent, and their problems come from parenting issues. Confused parents are told that they need to be stricter, have firmer boundaries, and use rewards and consequences. But, after parents have created their hundredth sticker chart to get their child to brush their teeth or go to school, insisted on non-negotiable bedtimes, taken away...