Pathological demand avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent.

Pathological demand avoidance (PDA) was a term first used by Professor Elizabeth Newson in the 1980s, to describe the profile of a group of children she had seen for assessment. Elizabeth Newson described PDA as sitting under the umbrella of Pervasive Developmental Disorder. Pathological demand avoidance (PDA) is increasingly, but not universally, accepted as a profile that is seen in some autistic people. The term Extreme Demand Avoidance emerged as an alternative term to Pathological Demand Avoidance as some feel extreme is a more acceptable term than pathological.

Features of a PDA profile

Autism is dimensional, meaning individual profiles can vary considerably depending on the combination of a person’s strengths and difficulties across two key dimensions:

  • How someone relates socially
  • The need for sameness, often resulting in repetitive or rigid thoughts and behaviours.

People with a PDA profile can appear to have better social understanding and communication skills than some other autistic people and are often able to use this to their advantage. However, these apparent social abilities can often mask difficulty with processing and understanding communication and social situations.

The distinctive features of a demand avoidant profile include:

  • Resists and avoids the ordinary demands of life
  • Uses social strategies as part of avoidance, for example, distracting, giving excuses
  • Appears sociable, but lacks some understanding
  • Experiences excessive mood swings and impulsivity
  • Appears comfortable in role play and pretence
  • Displays obsessive behaviour that is often focused on other people.

People with this profile can appear excessively controlling and dominating, especially when they feel anxious. However, they can also be confident and engaging when they feel secure and in control. It’s important to acknowledge that these people have a hidden disability.

People with a PDA profile are likely to need a lot of support. The earlier the recognition of PDA, the sooner appropriate support can be put in place.


Child Development Cemtre

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