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Dimensions of Difficulty in Children with Autism and Extreme Pathological Demand Avoidance

Year Published: 2017
Authors: Elizabeth O’Nions, Essi Viding, Caroline Floyd, Emma Quinlan, Connie Pidgeon, Judith Gould, Francesca Happé

This study explores the behavioural challenges of children with autism spectrum disorder (ASD) who also show traits of extreme/pathological demand avoidance (PDA). Based on parent interviews, it examines how these children obsessively avoid everyday demands, display ‘strategic’ (rather than manipulative) behaviour, and experience sudden mood changes.

Parents identified additional difficulties, such as the child’s need to control situations and others’ actions. The study found that extreme behaviours were often triggered by emotional responses to pressure, sensory sensitivities, phobias, and fear of the unknown. These findings support previous research while also providing new insights into how these behaviours manifest.

The research highlights the importance of addressing these challenges in daily life through targeted interventions. It also emphasises the need for further exploration of how PDA-related behaviours differ from or overlap with other behavioural profiles beyond autism.