This response to Malik and Baird (2018) continues the discussion on how to understand and conceptualise Pathological Demand Avoidance (PDA) within autism. O’Nions and Noens agree on the importance of exploring the underlying causes of demand avoidance in clinical settings, considering factors such as environmental context, specific triggers, and the mechanisms that reinforce these behaviours.
However, they caution against using co-occurring conditions, such as Oppositional Defiant Disorder (ODD), to describe PDA-like behaviours. They argue that this could lead to the use of reinforcement-based interventions that may not be appropriate for children with PDA. Instead, they stress the need for a nuanced understanding of demand avoidance that considers the complexities of autism-related difficulties. The paper highlights the risk of misinterpretation and emphasises the need for tailored, individualised approaches to support children effectively.