When a child goes to extreme lengths to avoid any demand or expectation—even those they have of themselves—parents can be left feeling frustrated and overwhelmed.
Every child will resist or defy parental demands and requests from time to time. But when a child goes to extreme lengths to avoid any demand or expectation—even those they have of themselves—parents can be left feeling frustrated and overwhelmed. Dr. Nanika Coor offers suggestions for coping with life with a child who struggles with Pathological Demand Avoidance.
Project Parenthood is hosted by Dr. Nanika Coor. A transcript and links to sources are available at Simplecast.
Find Project Parenthood on Facebook and Twitter, or subscribe to the Quick and Dirty Tips newsletter for more tips and advice.
Project Parenthood is a part of Quick and Dirty Tips.
Hey parents! You're listening to the Project Parenthood podcast. I'm your host, Dr. Nanika Coor, clinical psychologist and respectful parenting therapist. Each week, I’ll introduce you to the same respectful parenting practices that I use to help parents repair and deepen connections with their children. You’ll get tips for cultivating more parental self-compassion, more cooperation from your kids, and more joy, peace, and resilience in your relationship with them.
In today’s episode, I’m talking about kids who are extremely resistant to routine and everyday demands and how to understand them and their experience. I’ll also offer some strategies that may help you better connect, collaborate and find calm with your demand-avoidant kiddo. Stick around till the end for ways to mentally reframe your child’s challenging behavior.
Over the last four years, I’ve seen a marked increase in my private practice of parents struggling to raise children who show extreme avoidance behavior in the face of everyday demands. My quest to help parents find answers for how to reduce conflict and help their unique kids thrive led to my discovery of a syndrome called “Pathological Demand Avoidance” or PDA.
PDA is still in its infancy, research-wise, and is a widely but not universally recognized symptom profile. As such, there is still much to be learned about children who have rigid demand avoidant traits.
PDA is a profile of strengths and challenges that is currently understood to be a part of autism spectrum disorder (ASD). Like those on the autism spectrum, PDA kids often have difficulties with social communication and social interaction; restricted and repetitive activities, interests, and patterns of behavior; and sensory processing problems that impair and limit daily functioning.
In addition to those ASD traits, a child with a PDA profile will show an obsessive and extreme avoidance of everyday implicit and explicit demands—even things they want to do or would enjoy—that is rooted in an anxiety-based need to be in control. They may use strategies that are social in nature or show behaviors considered “shocking” in extreme attempts to avoid demands. These kids are impulsive, have quickly shifting and extreme moods, and may get lost in role play or fantasy.
Social relationships may be difficult to maintain due to their controlling behaviors, and they might become obsessed with specific people. The extreme anxiety PDA kids experience results in persistent fight/flight/freeze reactions. This can lead to them running away, having verbally or physically violent meltdowns, or their anxiety may be directed inward toward themselves and they shut down. Kids with this profile will have several PDA traits rather than only one or two.
PDA is less well-known in North America than it is in the UK, and even in the UK, parents still struggle to find clinicians who have heard of PDA let alone clinicians who are able and willing to officially identify demand avoidance in their child.
Before they learn about PDA, parents raising these kids have often visited various professionals to try and get help for their family. The habit of “masking” in neurodivergent people can also complicate matters. This is when a PDA child can “appear” neurotypical by mimicking the social behavior of those around them. This is usually done unconsciously in order to “stay safe” by trying to blend in and not look too “different” which can invite negative reactions in others. Thanks to masking, PDA kids can often attend school without having their teachers see the big meltdowns they have at home where they feel safe enough to be authentic.
When the situation is construed as a parenting or parent-child relational problem, professionals usually recommend behavior management strategies. Parents are advised to use rewards and consequences/punishments, believing the child’s challenging behavior to be a result of parenting that is too permissive. So parents double down on rules, consequences, scolding, pleading, rewarding and bribing in an attempt to eliminate what’s interpreted as defiant or willful behavior.
Unfortunately, these behaviorally-based strategies only exacerbate a PDA child’s anxiety. The higher their anxiety, the more extreme their attempts will be to avoid a real or perceived demand.
Due to their intense need for freedom, control, and self-determination, PDAers have described feeling compelled—against their own will—to refuse or do the opposite of what’s being demanded of them. Demands include not only the things that people ask a child to do, but also the expectations others have of them, that society has of them, and that they have of themselves. Demands can be real or imagined, or they can be attempts to influence a child via recommendations, reminders, and suggestions. All of these kinds of demands impede a child’s freedom to self-direct—which causes anxious distress and leads to automatic and involuntary fight/flight/freeze avoidance behaviors.
However, when allowed to do/not do something of their own accord in their own time, they feel no resistance to that task or activity. When told to do something, on the other hand, especially when coaxing or insisting or rewards-punishment coercion is involved, they automatically can’t comply even if they want to or had already been planning to. There can also be anger toward the person making the demand, who has now put them in the position of having to struggle against their own involuntary resistance!
How a person deals with stress and anxiety can be thought of as a bucket. Stressors flow into the bucket via the “tap” of anxiety-provoking stressful life experiences. At the bottom of the bucket are several holes where excess anxiety can drain out of the bucket as a person uses healthy coping strategies like sleeping well, getting exercise, socializing, going to therapy, etc. Ideally, the bucket never fills, but drains gradually, releasing stress and anxiety gradually over time.
When the amount of incoming anxiety exceeds the speed at which the bucket can drain, the bucket will overflow so that there is no longer any space to handle new stressors. A person with an overflowing bucket will be in fight/flight/freeze and experience a meltdown or shutdown state in the face of even a tiny stressor.
No one’s bucket will ever be completely empty, but a child struggling with PDA has a bucket that has only one tiny hole, so anxiety builds up more easily and is harder to discharge.
A PDAer’s bucket’s capacity to manage new stressors depends on how many demands they’ve dealt with over the last few days and weeks, how much anxiety they have about other things in life, and how much autonomy they’ve been allowed to have recently. The demands of getting out of bed, getting dressed, and eating breakfast may already have a child’s bucket overflowing so much that now they can’t leave the house for school, for instance.
It makes sense to get to know what a PDA child’s triggers are so you can be proactive and adapt as necessary. Sometimes it might make sense to save whatever bucket space there is for an activity you know must happen, or that a child might enjoy (but involuntarily resist) by letting go of any other demands that might deplete their capacity to take part in the necessary or enjoyable activity.
When parents become less regimented and rule-bound, PDA kids tend to flourish. Consider unnecessary demands carefully and be willing to accommodate your child’s individual needs. Do your days need to be “perfect” or can you lower some expectations and reduce pressure on your child (and yourself) in some way? Can you give them extra time to transition to the next task or recover from the last one?
If your child seems to fit the PDA profile, take the next 30-90 days to work on your internal dialogue. When you notice yourself judging your child as defiant or disobedient, remind yourself that their challenging avoidance behaviors are not in their conscious control or an attempt at manipulation. These difficult reactions are caused by their nervous system perceiving a threat to their autonomy and freedom—they feel unsafe and need to feel safe again. So when you notice your thoughts drifting toward: “I need to get them to obey me right this second!” shift your internal gears to “I need to help them feel safer right now.” And start sending their nervous system (and your own) cues of safety!
Let me know how it goes!
Parenting a PDA child requires a lot of work on yourself as a parent to make sure your own stress bucket has room to manage the ups and downs of life with a little one struggling with persistent and extreme demand avoidance. This means cultivating a lot of self-compassion for yourself and empathy for your child, because overall, the best way to reduce your child’s strong avoidance reactions, meltdowns, and shutdowns is to shore up the parent-child trust and connection.
Stay curious and flexible, take their perspective, and don’t take their over-the-top avoidance behaviors personally, but rather view them as communication of a need for safety in the form of autonomy and control. Allow your PDA child to be an equal participant in family decision-making—giving them control of their lives as much as is possible and reasonable. Use collaborative and proactive problem solving strategies to help identify their triggers and come up with mutually satisfying solutions. Remind yourself that there are plenty of positive aspects of PDA as well. As challenging as they can be in hard moments, in their good moments these kids can be incredibly sensitive, creative, charming, caring, and kind.
Expect that your strategies that have been working will eventually lose their potency—PDAers often crave novelty—but don’t get discouraged, because old strategies you haven’t used in a while can feel new enough for them to start working again! Ongoing co-regulation on the day to day can also keep the stress in their bucket at manageable levels for them and as a result for the whole family. Instead of trying to get your neurodivergent PDA child to change to fit the neurotypical world, make the adaptations to your child’s environment that let them take part in life in the ways that bring them joy.
I hope that’s helpful!
Project Parenthood is a Quick and Dirty Tips podcast. It's audio-engineered by Dan Fireabend with script editing by Adam Cecil. Our Podcast and Advertising Operations Specialist is Morgan Christianson. Our Digital Operations Specialist is Holly Hutchings. Our marketing and publicity assistant is Davina Tomlin, and our intern is Brendan Picha.
You can learn more about my work with parents at www.brooklynparenttherapy.com and on Instagram at BKPARENTS. If you have more questions about PDA, or any other parenting questions or stories, leave me a message at (646) 926-3243 and be sure to let me know if it's okay to use your voice on the show. Or, send an email to firstname.lastname@example.org. And don’t forget to subscribe to Project Parenthood on Apple Podcasts, Spotify, or wherever you listen to podcasts.
That's all for this episode. Thanks for listening! Catch you next week!
What is PDA? PDA North America. (n.d.). Retrieved May 25, 2022
Butler, I. C. (2021). Sensory Processing Disorder and Solutions: An Overview of How to Help Children Living with SPD.
The difference between ODD and PDA. (2019, May 19). Tomlin Wilding.
Understanding Pathological Demand Avoidance. (2020, September 2). Autism Parenting Magazine.
Stress Management Guidelines (Adapted by Wellcoaches from Health Behavior Change, Stephen Rollnick). (n.d.). Retrieved May 25, 2022
The Critical Importance of Declarative Language Input for Children with ASD. Autism Spectrum Quarterly • Winter 2010. Retrieved May 25, 2022
Curtis, S. (n.d.). Autism and PDA Positives. Steph’s Two Girls. Retrieved May 25, 2022