Why Pathological Demand Avoidance is Not Oppositional Defiance Disorder
— And How to Tell the Difference in Your Child/teen.
Pathological Demand Avoidance (PDA) is a profile on the autism spectrum that’s characterized by an intense, anxiety-driven avoidance of everyday demands. But unlike deliberate defiance, the avoidance in PDA is rooted in a need to feel safe and in control — not a desire to challenge authority or misbehave.
PDA is most often seen in people who are autistic, though it is not a formal subtype of autism or a standalone diagnosis. Rather, it is a pattern of behavior that can co-exist with autism, and sometimes with other neurodivergent presentations. PDA-like traits can also be present in individuals who are not autistic, though it appears more commonly in autistic individuals due to their heightened sensory sensitivity, need for predictability, and differences in social motivation.
Some individuals go to great lengths to resist or avoid anything they perceive as a demand — even simple or routine tasks. This avoidance can take many forms: making excuses, shifting focus to something else, withdrawing, using humor or distraction, or in more intense moments, experiencing a shutdown, meltdown, or panic attack. When this pattern of avoidance becomes consistent and anxiety-driven, it is referred to as pathological demand avoidance.
Children and teens with PDA often have highly sensitive nervous systems. When a request is made — even something small like “Can you put your shoes on?” or “It’s time to brush your teeth”—it” can trigger a fight-or-flight response. Their brain perceives the request as a loss of autonomy, and their instinct is to push back in order to feel safe again.
Avoidance can take many forms. Some children may use humor, excuses, or distractions. Others may withdraw, hyperfocus on something else, or experience a shutdown or meltdown. In more intense situations, avoidance may escalate to panic, escape behaviors, or verbal and physical outbursts. These responses are not calculated — they are protective.
Experts suggest that PDA tendencies may appear more often in autistic individuals because they often experience greater difficulty with flexibility, managing uncertainty, and interpreting social cues. While many children complete everyday tasks because they understand the social expectations or want to fit in, autistic children may not feel that same external motivation. Instead, they may rely more heavily on internal control and predictability to feel secure.
What is PDA and How Does a Person Experiencing PDA Feel?
People experiencing PDA often describe feeling:
Trapped or cornered when asked to do something
Overwhelmed, even by tasks they enjoy or planned to do
Irritated or panicked by expectations placed on them
A strong need to regain control, often through resistance
This isn’t about oppositional behaviour or manipulation — it’s a protective response, often outside of their conscious control.
A Real-World Example (Mild PDA)
A parent of teenage girls, both with ADHD and suspected to be on the autism spectrum, describes them as gentle, creative, and kind. But when asked to do a chore like washing up, they’ll often say:
“I was going to do the washing up, but now that you’ve asked me, I don’t feel like doing it.”
On the surface, this may sound dismissive, but it’s a classic example of mild PDA. The moment a task is framed as a demand, their nervous systems register discomfort — even threat — and the impulse to resist kicks in. It’s not laziness or defiance. It’s how their brain protects them from perceived loss of autonomy.
Why PDA is Not Oppositional Defiance Disorder — And How to Tell the Difference
At first glance, PDA can look like Oppositional Defiant Disorder (ODD). Both can involve refusals, emotional outbursts, and resistance to everyday requests. But the underlying drivers behind the behaviours are very different — and understanding this difference is critical for effective support.
The Difference is in the Why
ODD is often characterized by persistent anger, irritability, and a pattern of challenging authority. Children with ODD may appear argumentative, deliberately defiant, and frequently test limits.
PDA, on the other hand, is driven by anxiety — not anger. The child isn’t trying to provoke or control others, but instead is trying to protect themselves from feeling overwhelmed, out of control, or emotionally unsafe.
Comparing ODD and PDA at a Glance:
FeatureODDPDAEmotional DriverAnger, frustration, testing limitsAnxiety, fear, loss of controlTypical ResponseArguing, blaming, refusalAvoidance, shutdowns, negotiationSocial AwarenessMay disregard others’ feelingsOften highly sensitive and awareBehaviour PatternPersistent across settingsTriggered specifically by demandsMotivationOpposition to authorityProtection from anxiety
How to Tell the Difference in Your Child
They were going to do it… until you asked. PDA often shows up when a child was willing or planning to do something — until it’s framed as a demand.
They show deep regret or shame after meltdowns. PDA children may feel guilty after their reactions. ODD behaviours are often more deliberate and less remorseful.
They’re warm and connected when not under pressure. Children with PDA are often affectionate and cooperative when they feel safe and autonomous.
They can become angry or explosive — but the trigger is anxiety. Anger in PDA is usually a defensive response, not a deliberate act of defiance.
Negotiation or playfulness can help. Children with PDA may respond to choices, humour, or collaborative language, while ODD behaviours often persist regardless of tone.
They may miss the social cues others rely on to guide behaviour. In classroom or group settings, they may not pick up on the rhythms or structures others instinctively follow, which can make demands feel sudden or unfair. This mismatch can increase anxiety and result in stronger avoidance.
Motivation needs to be meaningful. Working with children with PDA involves tapping into what matters to them. It’s not about bribery or control — it’s about connecting to internal motivation and shared goals.
Why This Distinction Matters
Children with PDA still need structure, boundaries, and guidance. Like all children, they must learn how to manage everyday responsibilities and live in a world full of expectations.
But how we provide that structure matters.
What helps is a coaching approach — one that offers predictability, but also provides choice and respects the child’s need for autonomy. Rather than enforcing control, we work collaboratively, offering flexible options within firm but kind boundaries.
The goal isn’t to eliminate all demands — it’s to reduce the perceived threat those demands carry. This creates space for connection, regulation, and trust.
If you see aspects of your child in this description, trust what you’re noticing. The right understanding makes all the difference — for your child, and for you.
Working With Children Who Display PDA Behaviours: Insights from the Child Mind Institute
A recent article featured by the Child Mind Institute shares helpful insight from Dr. Mary Barbera Martin on how to work with children who display PDA-like behaviours. Dr. Martin notes that traditional approaches used with autistic children — such as direct, boundary-based communication — often trigger anxiety and resistance in children with PDA profiles. Instead, a more collaborative and flexible approach is needed.
The key, she explains, is to identify what the child is intrinsically motivated by, and use that as the foundation for building engagement and cooperation. Rather than framing tasks as demands, adults are encouraged to scaffold the process — breaking tasks into small, manageable steps and allowing the child to feel in control.
“It’s easy to assume that a small, routine task shouldn’t be that big of a deal,” says Dr. Martin. “But from a neurobiological standpoint, that may be asking the child to climb a mountain. We want to get them to climb the mountain, but we need to create steps in the scaffold for them to get up there.”
She emphasizes that working with the child, not against them, is key to avoiding escalation and fostering lasting progress. For example, if a child is fascinated by sharks or obsessed with cataloguing music playlists, those interests can be incorporated into interventions to spark motivation.
Dr. Martin also highlights the importance of focusing on adaptive skills — everyday life skills that support independence and quality of life. While some parents may hesitate to push these tasks, believing their child will eventually “grow out of” avoidance, many children with PDA continue to struggle unless their underlying needs are understood and addressed.
Establishing clear boundaries is still important, but how those boundaries are presented matters. By reducing anxiety and offering choices, we create the conditions in which children are more likely to engage.
Programs like Unstuck and On Target help children build flexibility, manage emotional responses to change, and learn that being flexible can actually help them get more of what they want. Dr. Martin notes that helping children distinguish between situations where they have choice and those where they don’t can be empowering — particularly when they feel heard and included in problem-solving.
Ultimately, children with PDA profiles make more sustainable progress when they know their voice matters. As Dr. Martin explains, when interventions are too rigid or solely focused on reward and consequence, they may show initial improvements — but those gains often taper off over time. True growth happens through relationship, collaboration, and responsiveness.
References
Child Mind Institute. (n.d.). Pathological demand avoidance in kids. Retrieved from https://childmind.org/article/pathological-demand-avoidance-in-kids/
Autism Awareness Australia. (n.d.). A brief history of pathological demand avoidance (PDA). Retrieved from https://www.autismawareness.com.au/aupdate/a-brief-history-of-pathological-demand-avoidance
Children’s Hospital of Philadelphia (CHOP). (2018). Teens with autism can become safe drivers. Center for Autism Research. Retrieved from https://www.carautismroadmap.org/teens-with-autism-can-become-safe-drivers/
JAMA Pediatrics. (2020). Association of ADHD diagnosis with risk of traffic crashes among adolescents. JAMA Pediatrics, 174(5), 453–459.
O'Nions, E., Happé, F., Viding, E., & Leekam, S. (2014). Pathological demand avoidance: Exploring the behavioural profile. Autism, 18(5), 538–544.
Newson, E., Le Maréchal, K., & David, C. (2003). Pathological demand avoidance syndrome: A necessary distinction within the pervasive developmental disorders. Archives of Disease in Childhood, 88(7), 595–600.
White, R. (2021). Understanding PDA: A Guide for Parents and Professionals. Jessica Kingsley Publishers.