By Leisa Pritchard, neurodiversity–affirming psychologist at The Heart & Mind Collective
Pathological Demand Avoidance, also known as Pervasive Drive for Autonomy (PDA), is a term gaining more attention, but it is far more than just a buzzword. PDA is a complex and often misunderstood profile of autism that can be exhausting for both children and parents. When not well understood, it can also be confusing for professionals trying to support PDA individuals.
What is PDA?
PDA is characterised by an extreme need to resist everyday demands. This resistance is not about defiance or choice – it is driven by anxiety and a fundamental need for control. Understanding PDA as a nervous system disability or difference rather than a behavioural issue is crucial. Although it usually occurs with neurodivergent brain types, it is the nervous system that is influencing different behaviours and impacting a child’s ability to access their basic needs and engage in daily life.
While PDA is generally considered a profile of autism, research is still developing. What we do know is that traditional behavioural approaches often fail because they do not account for the child’s nervous system responses.
What PDA Isn’t
PDA is not a standalone diagnosis; rather, it is a collection of traits that some autistic individuals display. It is not simply oppositional behaviour, stubbornness, or defiance. Instead, it is a deep–rooted neurological difference that requires a unique, understanding–based approach.
Signs Your Child May Have PDA
If you are struggling with traditional parenting strategies or find that conventional autism supports do not seem to fit your child, you may want to consider these key indicators of PDA:
A survival drive for autonomy – Your child’s need for control is so strong that it overrides basic survival instincts like eating, sleeping, hygiene, or safety awareness.
The need for constant undivided attention – Your child struggles with you being engaged in anything else, like phone calls, and may escalate to regain your attention.
“Equalising” behaviours – When faced with a boundary or demand, your child attempts to control the situation, often
escalating into oppositional or fight–flight responses.
High masking – Your child presents very differently outside the home, often appearing calm at school but experiencing meltdowns at home.
Unpredictable dysregulation – Your child’s nervous system activation builds over time, leading to seemingly sudden and intense emotional outbursts.
Not All PDA Looks the Same
Not all PDA children exhibit explosive behaviour. In fact, many are high–masking, and use subtle social strategies to avoid demands without obvious resistance. Because PDA presentations can differ from what is typically associated with autism, some children – especially autistic girls and PDA individuals – are often misdiagnosed (e.g., with Oppositional Defiant Disorder) or overlooked entirely, leading to poor long–term outcomes.
Understanding Nervous System Responses in PDA
Children with PDA typically respond to stress in one of two ways:
- Internalised nervous system response
- These children appear to manage well in public but struggle significantly at home.
- They may have meltdowns after school or resist attending school altogether.
- Their masking can make it hard to access support since their struggles are not always visible to educators or professionals.
- Externalised nervous system response
- These children are more visibly reactive.
- They may abscond, display verbal or physical outbursts, or struggle to follow instructions.
- Their behaviour is often mistaken for defiance rather than a nervous system overload.
Where to From Here?
Many parents of PDA children feel isolated and misunderstood. Educators, professionals, and even extended family members may not see the daily struggles that occur at home. It’s important to remember that the behaviours associated with PDA are driven by a nervous system response, not by choice or bad behaviour.
Traditional behavioural strategies based on compliance, rewards, and consequences typically backfire. Instead, PDA children and teens thrive in environments that prioritise:
A sense of safety – Building trust and minimising stress is key.
Collaboration over compliance – Working with the child rather than enforcing rigid expectations.
Flexibility – Adapting approaches to meet the child’s nervous system needs.
Low–demand environments – Reducing unnecessary pressures to create a more manageable daily life.
Communication strategies – Give choices and use declarative language (“Hmm, I notice you forgot something”) rather than imperative language (“Get your backpack”).
Early identification and tailored support are the strongest predictors of positive long–term outcomes for PDA kids and teens. By shifting our understanding and approach, we can create environments where PDA children feel safe, understood, and empowered to engage in life on their terms, and help the parents and carers supporting them feel seen, heard, and adequately supported.
Leisa Pritchard is a neurodiversity–affirming psychologist at The Heart & Mind Collective. Leisa has a special interest in providing neurodiversity assessments, and working with parents of neurodiverse children, or who are neurodivergent themselves, supporting them to transform their relationships with their child and stabilise the home.