What's Pathological Demand Avoidance? Parents Of “Defiant” Kids, Pay Attention

No one's parenting journey is easy, and unfortunately, it doesn't typically get any easier as they get older. Many parents face off with defiant or stubborn children and immediately feel like they're butting up against a "spoiled brat." But sometimes, those behavioral stumbling blocks are indicative of something bigger going on — like pathological demand avoidance or PDA (no, definitely not "public displays of affection... this is something different altogether).

When you're dealing with meltdowns from your kid, they could be stomping their feet in protest because they feel like they lack control over their lives. And we can all relate to that, right? While pathological demand avoidance is also rooted in a need for control, it doesn't blow over like a garden-variety tantrum. And because it's not a very common diagnosis, it's often overlooked in kids who push back at authority and demands.

To help you understand more about PDA, we spoke with experts for more insight. Here's what they say parents should know.

What is PDA?

If you've heard of pathological demand avoidance before, it may very well be because it has popped up on your FYP. Parents who've discovered the diagnosis through their own family's experience have been taking to the social media platform to share their stories.

But what are actual professionals and experts saying about PDA, how it's diagnosed, and how you can address it? "PDA is a profile under the autism spectrum," shares Sharon Kaye-O'Connor, LCSW, who is an autistic psychotherapist and autism educator. "PDA stands for 'pathological demand avoidance,' but some PDA self-advocates instead call it 'persistent drive for autonomy,' to view the profile through a more neurodiversity-affirming, less pathologizing lens."

What are the traits or "symptoms" of PDA?

"PDA folks are autistic, so they will naturally have other autistic traits like sensory issues, communication or social differences, and may have special interests. PDA folks may be adept at masking their autistic traits," Kaye-O'Connor says. "For someone who fits the PDA profile, demands can trigger anxiety or the fight-or-flight response. When there is a perceived threat to autonomy, a PDA person may then fight to maintain their autonomy."

In other words, a person with PDA will be triggered when they feel like they aren't in control.

How can you distinguish between PDA and typical childhood "stubbornness"?

This is where it gets especially tricky. During most meltdowns, outbursts, or push-backs, a "stubborn" child and a child with PDA want the same thing: more control over their lives. So, how do you know if your kid is just being stubborn or if they have PDA? First and foremost, consider whether your child displays any of Kaye-O'Connor's mentioned traits of autism.

If you're unsure, there are other ways to differentiate between PDA and stubbornness.

"Truthfully, it's hard to separate PDA from general child stubbornness," says Dr. Lauren Kerwin, PhD, an associate professor and founder of the Los Angeles DBT Collective. "However, PDA is unusual in that children and teens will go to great lengths and spend a lot of energy to avoid the demand — whereas regular child stubbornness or brattiness is usually borne out of a desire to use the least amount of energy possible."

Kerwin also explains that many kids with PDA might exhibit impulse control issues, mood swings, and obsessions with certain things or people as a way to avoid demands or assert some sense of control.

Does PDA look different in young kids vs. teens?

"In young kids, PDA may look like ignoring you when you ask them what a certain shape or color is, refusing to go to the toilet on principle, refusing to share toys in preschool, never wanting to put on their shoes or coats, running away whenever it's time for a bath/shower, etc," says Kerwin.

What about older kids, then? "[They] may do all the above and more," Kerwin says. "During school, they may refuse to complete assignments or 'go with the flow' of the classroom because they perceive it as a demand from the teacher. Teachers may have difficulty understanding their academic capabilities. These students could get disruptive as a result. They also use a variety of strategies to avoid demands from adults, including distraction, negotiation, lying, or even charming others to get their way."

How can you help a kid with PDA?

Support, validation, and empathy go a long way.

"For children diagnosed with ASD, it is important for those around the child to tune into when and why the demand avoidance may be occurring, what things are important to the child, and when the child behaves at their best," says Dr. Andrea Turner, licensed psychologist and research director at Pearson. "These things can be used to create a way to cooperate with the child to make tasks more engaging, create schedules and reminders of expectations and upcoming transitions, and ways to help the child understand the importance of a task.

Turner emphasizes that adults must also be open to taking an honest look at their own behaviors to see what they may be able to work on that could help decrease demand avoidance and negative reactions to it.

"It can also be helpful to remember that children in general, and especially children with developmental and other differences, do not have much control over their environments," she adds. "Many children with ASD and other disabilities are in a variety of therapies, have very rigid behavioral programs to follow, and can often have more expectations placed on compliance than their peers who are considered neurotypical. Thus, task avoidance may be a communication that they are fatigued with trying to please people and need a break from having to complete tasks."

So, positive interactions that require no demands from the adults in their lives — especially those frequently giving demands — can really boost a child's cooperation: "Letting the child choose a fun activity and lead the interaction can build trust and set a good foundation for the likelihood of compliance with expectations in the future."

Between pandemics and mom shamers, it can be hard to want to reach out for help. However, dealing with any sort of diagnosis should never be tackled alone. From support groups online to more specialized doctors and therapists, getting the support your child needs early on will go a long way in helping them succeed as they get older.

"Traditional autism interventions may not be effective for kids with PDA," says Kerwin. "It is essential to treat PDA with a tailored support strategy that includes building trust, reducing anxiety, and working collaboratively with the child to develop strategies for managing and reducing demand avoidance."

If you think your kiddo might fall into the PDA profile, talk to your doctor. If you don't like their response, get a second opinion. Or a third opinion. Talk to parents and online support groups until you've exhausted all resources. Doctors have a ton of training, and people often question their expertise without merit, but there's also a lot to be said for a mother's intuition. At the end of the day, no one knows your kid as well as you do.