Pathological Demand Avoidance (PDA), also referred to as Pervasive Drive for Autonomy, is a profile of autism where a child’s nervous system reacts to everyday demands as if they are a threat. It’s not about being oppositional or manipulative (though some adults may be perceiving it that way). It’s about anxiety and loss of control. In PDA, demands (e.g., put your shoes on) can trigger the same stress response that other people feel in danger. Their brain hears: “I’m being controlled → I’m not safe.” So their body goes into fight, flight, freeze, or fawn mode.

An evaluation for PDA is not a single test or a standalone diagnosis. Instead, it’s a comprehensive evaluation that looks at how a child experiences and responds to everyday demands, especially when anxiety is involved. PDA is considered a profile within autism - so hop on over to the “Autism Testing & Assessment” page to learn more about what that entails. The goal is to answer questions like: Why does this child struggle so much with demands that seem simple to others?; Are the avoidant behaviors driven by anxiety and a need for control?; How does the child respond to expectations, transitions, and loss of autonomy?; What strategies help them stay regulated and engaged? This helps guide support strategies, not labels for their own sake.

Fun facts: 1- Children with PDA often experience high levels of empathy and fairness sensitivity, being deeply bothered by injustice or imbalance. 2- Children with PDA are often highly creative and imaginative, with rich pretend play, world-building, role-play, and original ideas.