Pathological Demand Avoidance (PDA)

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What PDA is

Signs and characteristics

Causes and relationship to autism

Getting assessed and diagnosed

Support in education

Helpful approaches and strategies

Related guidance

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What PDA is

Pathological Demand Avoidance (PDA) is a profile within the autism spectrum where a person experiences high anxiety and an extreme need to resist or avoid everyday demands.
It is not defiance in the traditional sense — the avoidance is driven by anxiety and a need for control.

Understanding PDA as part of the autism spectrum helps families and schools provide calm, flexible support rather than confrontation.

Related guidance

Autism Spectrum Disorder (ASD)
Oppositional Defiant Disorder (ODD)
Anxiety Disorders
Social Communication Difficulties
SEN Wellbeing

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Signs and characteristics

People with PDA may:

avoid or refuse ordinary requests, even enjoyable ones
use distraction, negotiation or withdrawal to manage anxiety
appear socially able but struggle with control and unpredictability
experience sudden mood changes or shutdowns
show strong interests or imaginative play
find transitions and authority difficult

Check signs of PDA
Learn how to recognise anxiety-based avoidance behaviours.

Types of Pathological Demand Causes and relationship to autism

PDA is understood as part of the autism spectrum, not a separate diagnosis.
It shares traits with autism and anxiety disorders, but avoidance is its defining feature.
Factors may include:

differences in brain development and sensory processing
difficulty managing uncertainty or loss of control
heightened emotional sensitivity

Learn how PDA relates to autism
Understand the overlap between PDA, autism and anxiety.

Getting assessed and diagnosed

Currently, PDA is not a stand-alone clinical diagnosis under DSM-5 or ICD-11, but professionals may recognise a “PDA profile of autism.”

Assessment involves:

developmental history and family interviews
observation of avoidance behaviours and triggers
autism assessment tools used alongside behavioural analysis

Professionals involved may include psychologists, paediatricians and speech and language therapists.

Find out how PDA is assessed and recognised

Support in education

Children and young people with PDA benefit from:

low-arousal, flexible environments
reduced direct demands and use of indirect requests
collaborative goal-setting rather than instructions
sensory breaks and calm-down spaces
emotionally intelligent staff who understand anxiety-based behaviour

Traditional reward–punishment systems often worsen distress.
Support should be built around trust, autonomy and emotional safety.

If needs are complex, an EHCP can formalise adaptations and therapeutic input.

Read about SEN and autism support for PDA

Helpful approaches and strategies

Effective strategies include:

Collaborative communication (e.g. giving choices, using humour or role-play)
Predictability — visual timetables and gentle transitions
Emotional literacy and self-regulation support
Therapy such as CBT, counselling or play-based approaches for anxiety
Parent training and specialist PDA guidance