This correspondence responds to Jonathan Green and colleagues’ discussion on demand avoidance in autism spectrum disorder (ASD). The authors caution against viewing extreme demand avoidance as a set of co-occurring conditions, such as oppositional defiant disorder (ODD), as this could lead to the use of reinforcement-based strategies designed for disruptive behaviours. Instead, they argue that avoidance in ASD is often driven by anxiety, not a desire for control.
They highlight research showing that some children with ASD experience demands as threatening, leading to extreme avoidance behaviours. Standard behaviour management techniques may escalate distress rather than help. Instead of labelling these behaviours as defiance, the authors emphasise the need for research into effective interventions that address anxiety-driven avoidance. They advocate for careful assessment and individualised support, rather than reactive responses that could worsen difficulties. Developing evidence-based strategies for managing demand avoidance in ASD is a key priority.