Research
Academic papers from research institutions developing the evidence base
Found 48 listings
Mapping experiences of PDA in Ireland
Mapping experiences of pathological demand avoidance in Ireland.
This national study sought to gather the viewpoints of PDA individuals, families, and practitioners, with the intention of determining levels of knowledge, recognition and understanding of PDA; exploring current pathways to assessment and diagnosis; capturing experiences of access to education and healthcare [...]
Extreme Demand Avoidance 8-item measure (EDA-8)
In 2013, Dr Liz O’Nions et al developed the Extreme Demand Avoidance Questionnaire (EDA-Q) to measure caregiver reported behaviours in clinical accounts of extreme/‘pathological’ demand avoidance in Autistic children and young people aged 5-17. This questionnaire sought to measure these traits consistently for research purposes, but was not designed [...]
Extreme Demand Avoidance in Children: Refinement of a Caregiver-Report Measure
Extreme Demand Avoidance in Children with Autism Spectrum Disorder: Refinement of a Caregiver-Report Measure
For anyone involved in either research or in the assessment of neurodevelopmental conditions, this adaptation of the EDA-Q will be of interest. Called the EDA-8, it is a refined and simplified scale that benefits from the [...]
Alternative perspectives on PDA
Alternative perspectives on PDA
The PDA Society’s current position, based on research, clinical evidence and lived experience, is that PDA is best understood as a profile on the autism spectrum.
However it’s important to acknowledge the alternative perspectives on PDA that are currently evident.
These relate to the usefulness of the construct, [...]
Pathological demand avoidance in children and adolescents: A systematic review
Pathological demand avoidance in children and adolescents: A systematic review
There has been a lack of funding of research into PDA to date and so this timely paper is particularly useful for giving an overview of the research history and looking to the future and what is needed.
With any newly [...]
Individual differences, ADHD, Adult Pathological Demand Avoidance and delinquency
Individual differences, ADHD, Adult Pathological Demand Avoidance and delinquency
In this paper, Egan et al looked at a range of different characteristics of a group of adults to analyse how PDA might fit with other described conditions. They used the EDA-Q developed in their previous work as a self-report tool [...]
The educational experiences of autistic children
The educational experiences of autistic children with and without extreme demand avoidance behaviours
Shining a light on the types of difficulties that all autistic children can experience in school and how it can vary individually. Parent’s views on the key causes of problems provides an insight into what can help [...]
An exploration of the PDA profile in children
An exploration of the Pathological (or Extreme) Demand Avoidant profile in children referred for an autism diagnostic assessment using data from ADOS-2 assessments and their developmental histories
This paper represents the first step in analysing and reporting on data gathered between 2015 and 2017 on 351 children referred to Dr [...]
Extreme/‘pathological’ demand avoidance: an overview
Extreme/‘pathological’ demand avoidance: an overview
In this article, Elizabeth O'Nions and Judy Eaton provide an overview of PDA, discuss the clinical presentation of individuals with a PDA profile, and differences compared to children with documented attachment difficulties. They then discuss empirical work describing how anxiety-driven avoidance of routine demands can [...]
Parenting strategies in ASD
Parenting Strategies Used by Parents of Children with ASD: Differential Links with Child Problem Behaviour
In this paper, Liz O'Nions explores a new scale which is designed to measure strategies for problem behaviour in ASD. The results are especially interesting as more than half of those involved in the study [...]
Role of Intolerance of Uncertainty and Anxiety
Intolerance of uncertainty and anxiety as explanatory frameworks for extreme demand avoidance in children and adolescents
This research was conducted by researchers at the Complex Neurodevelopmental Disorder Service and South Tyneside Community Team, Tyne and Wear NHS Foundation Trust, and School of Psychology, Newcastle University.
The abstract concludes:
"This study represents one [...]
CAMH Journal discussions
In 2019, a paper from Lisa Stuart, Victoria Grahame and others at Newcastle University described how intolerance of uncertainty and anxiety may have a role in the demand avoidant behaviour of those identified as having a PDA profile.
The May 2020 edition of the journal Child and Adolescent Mental Health [...]
Autism, PDA presentations and Theory of Mind
The Relationship between Theory of Mind and Traits Associated with Autism Spectrum Condition and Pathological Demand Avoidance Presentations
UCL Doctorate Thesis in Clinical Psychology by Ellie Bishop
Extracts from the Impact Statement:
The overall aim of this thesis was to contribute to an understanding of the relationship between theory of mind [...]
Emotion Regulation and Executive Function
Emotion Regulation and Executive Function in Children and Adolescents with Autism Spectrum Disorder and Pathological Demand Avoidance Traits
UCL Doctorate Thesis in Clinical Psychology by Anna Goodson
Extracts from impact Statement
The overarching aim of this research was to contribute to current understanding of cognitive processes and behaviours relevant to young people [...]
Progressing the research
Research Meeting Report
PDA is currently widely understood as being part of the autism spectrum. However, this area of research is in its infancy, with a range of perspectives currently evident. High quality, robust research is urgently needed to increase our understanding of autism as a whole, and demand avoidance [...]
Summary of Understanding of E/PDA
Extreme /’Pathological’ Demand Avoidance
This article addresses the topics of debate and controversy that exist surrounding the classification of extreme/’pathological’ demand avoidance as a profile of the autism spectrum. A comprehensive overview of the existing and ongoing areas of research is given.
There is discussion of the behavioural traits displayed by [...]
Summary of research developments
This summary was prepared by Dr. Liz O’Nions, Post-doctoral Fellow at the Parenting and Special Education Research Unit, KU Leuven, Belgium. It relates to the work done up until April 2016.
Early research on PDA was carried out by Elizabeth Newson and colleagues and published through conference proceedings and informal [...]
Tool to support diagnosis of ASD / PDA / Attachment disorders
Modification of the Coventry Grid Interview to include the Pathological Demand Avoidant profile
The Coventry Grid Interview was designed to be used by clinicians as part of a comprehensive assessment process and not as a stand-alone diagnostic tool.
There is often diagnostic confusion over the differences between children presenting with autism [...]
An assessment pathway for children
Developing a multi-agency assessment pathway for children and young people thought to have a Pathological Demand Avoidance profile
Editorial comment: "Lisa Summerhill is the Lead Clinical Psychologist working in a specialist autism assessment service provided by the NHS. Kate Collett is the coordinator of the specialist post diagnostic autism team [...]
Pathological Demand Avoidance: symptoms but not a syndrome
Pathological Demand Avoidance: symptoms but not a syndrome
Summary
Pathological (or extreme) demand avoidance is a term sometimes applied to complex behaviours in children within—or beyond—autism spectrum disorder. The use of pathological demand avoidance as a diagnosis has, at times, led to altered referral practice and misunderstandings between professionals and the [...]
Correspondence: Demand avoidance is not necessarily defiance
Correspondence: Demand avoidance is not necessarily defiance
Jonathan Green and colleagues have usefully outlined possible mechanisms that might represent vulnerability factors promoting habitual avoidance of routine demands in autism spectrum disorder and other developmental disabilities. However, we are concerned that conceptualising pathological (or extreme) demand avoidance as a set of [...]
The Extreme Demand Avoidance Questionnaire (EDAq)
The ‘Extreme Demand Avoidance Questionnaire’ (EDA-Q) was developed to measure behaviours reported in clinical accounts of extreme/‘pathological’ demand avoidance (PDA). The questionnaire allowed these traits to be measured consistently for research purposes. The EDA-Q should not be considered a diagnostic test.
In the study of parent-reported behaviours in children and [...]
Development of the ‘Extreme Demand Avoidance Questionnaire’
Development of the 'Extreme Demand Avoidance Questionnaire' (EDA-Q): Preliminary observations on a trait measure for Pathological Demand Avoidance
This paper provides in-depth information about the development of ‘The Extreme Demand Avoidance Questionnaire’ (EDA-Q). It was published in 2013; a time when the awareness of PDA was increasing amongst professionals.
The purpose [...]
Identifying features of ‘PDA’ using the Diagnostic Interview (DISCO)
Identifying features of ‘pathological demand avoidance’ using the Diagnostic Interview for Social and Communication Disorders (DISCO)
This paper discusses the Diagnostic Interview for Social and Communication Disorders (DISCO) and existing items within the model which are more specific to PDA when compared to the rest of the autism spectrum. It [...]
Diagnostic tool: poster presentation
Features of Pathological Demand Avoidance Identified Using the Diagnostic Interview for Social and Communication Disorders (‘DISCO’)
This is a concise, diagrammatic summary of the original research paper. The aims of the original study were two-fold: to identify items of the DISCO that measure features of PDA most likely to discriminate [...]
PDA Behavioural Features: poster presentation
Extreme/ ‘Pathological’ Demand Avoidance: An Examination of the Behavioural Features Using a Semi-Structured Interview
This poster summarises a paper which examines the behavioural features associated with extreme/’pathological’ demand avoidance.
Parents of children with an ASD diagnosis who displayed features of extreme /’pathological’ demand avoidance, were questioned using a semi-structured interview model. [...]
PDA behavioural profile
Pathological demand avoidance: Exploring the behavioural profile
The aim of this paper was to report the profiles of children diagnosed with Pathological Demand Avoidance (PDA) compared to children with Autism Spectrum Disorders (ASD), Conduct Problems (CPs) and Callous Un-emotional Traits (CUs). The study addressed some of the controversy surrounding the [...]
Reflections on 2014 paper by O’Nions et al
Commentary: PDA – public display of affection or pathological demand avoidance? – reflections on O'Nions et al. (2014)
This commentary piece contains a succinct summary of the history of Pathological Demand Avoidance (PDA). It is an interesting read for professionals and parents as it raises points for discussion regarding the incidence, [...]
Disorders in childhood: Overview for paediatricians
Behavioural and emotional disorders in childhood: A brief overview for paediatricians
This is a review of all relevant published literature relating to behavioural, emotional and developmental problems in children and adolescents. It is intended as a guide for clinicians and aims to raise awareness of the importance of recognising and [...]
Dimensions of difficulty
Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme pathological demand avoidance
Background
A subset of individuals with autism spectrum disorder (ASD) resemble descriptions of extreme/‘pathological’ demand avoidance, displaying obsessive avoidance of everyday demands and requests, strategic or ‘socially manipulative’ behaviour and sudden changes [...]