Extreme/Pathological Demand Avoidance: An Overview

This article provides an overview of Pathological Demand Avoidance (PDA), focusing on how it presents in autistic children. The authors discuss key differences between children with a PDA profile and those with attachment difficulties. They explore how anxiety-driven avoidance of everyday demands can develop and highlight strategies to help reduce avoidance behaviours. These include creating positive routines that gradually increase a child’s tolerance for demands while avoiding reinforcement of avoidance behaviours. The article emphasises that recognising the PDA profile can help caregivers and educators better understand and support autistic children who struggle with daily requests. While PDA is not a standalone diagnosis, describing its traits can improve care and educational approaches for affected children.