My daughter has what’s called a PDA profile – in a non-neuroaffirmative way, it stands for Pathological Demand Avoidance. In a more neuro-affirming way, it means Persistent Drive for Autonomy. For the purposes of this article, we’ll talk about it as Pathological Demand Avoidance as it seems to be more well known, and honesty, I want this blog to be helpful for people who have it or loves someone who has it.

It was first described in the 80s by Dr. Elizabeth Newsom, and there’s debate on whether or not this is part of the autism spectrum or it’s own unique thing. The take home message is kids with these profiles have an extreme need for control and will automatically push back at anything that is perceived as a demand. Even simple every day requests can be perceived as a demand (i.e., time to sit at the table for dinner, let’s go to school, put on your shoes, etc.) (Nawaz & Speer, 2025). The diagnosis is controversial, but has more support in Europe and Australia compared to the United States.

Honestly to an outside observer, these children/people are perceived as brats, stubborn, defiant, and just generally difficult. Before I knew what was going on with my kids neurologically, I remember I would say things to her like, ‘baby, let’s please be easy today, ok?’ I knew pretty quickly from an early age she was a child who NEEDED choices in her day to day whenever possible. So it was never a “it’s time to brush teeth” but more a “should we brush teeth first or put on pajamas first?” Eventually I made her a little visual aid to help her build her own autonomy while still getting all the things done. We called it her morning 5 and bedtime 5

And it worked pretty well. So I’ve always known that I had to give her choices.

I needed a few days to recuperate after the mess of Thursday night/Friday morning. Things are not as raw about my child right now. I’ve realized that for this current situation, I cannot punish her. I cannot force things on her. I can only set my own boundaries.

A boundaries book I often use with my clients is Set Boundaries, Find Peace by Nedra Glover Tawwab. So I’m going to use it with my own child during this current emotional limbo we’re in.

I think what’s important about boundaries is they are not things you expect OTHERS to do. A boundary determines YOUR behavior. Telling someone they can’t call you at a certain time is not a boundary (and truly not enforceable) – deciding not to pick up after a certain time of night is a boundary, because you are the one doing it.

So while I haven’t finished thinking through what my boundaries are exactly, or even more importantly, how I will enforce them, it has given me a starting point which I think will make this feel less punitive (and ergo piss her off even more) and more framing this in a, “I have to protect myself” sort of way. One of the boundaries is Materials. I will definitely be limiting her access to my materials, primarily my money. I will not be providing an allowance, or opportunities to work for me. I will also not be doling out discretionary spending, so no more fun baking materials, no more late night bobba runs. Her choice with pathological demand avoidance in this matter is she can ask her father for money, or she can go out and make money (she’s old enough to do some very basic jobs, including babysitting). Intellectually, I will not be sharing my parenting rationale with her on why I make the decisions I make, which is typically how I roll as a parent. Her choice to try to get insight is to discuss it with other trusted adults, like her counselor who will provide more reality oriented options to her. I will not be spending my time trekking her across the city to hang with friends; they can come over, or she can ask from them to pick her up. In all of this, there is choice for her, but there are boundaries for me.

We’ll see how it goes.

If you have a Pathological Demand Avoidance child, I highly recommend the work of Dr. Ross Greene. He speciality is in Oppositional Defiant Disorder, but there’s still a lot of good tools for how to work with Pathologial Demand Avoidance. He’s got all sorts of books and YouTube videos that can support you in your parenting journey with a PDA’er.

Here’s a great visual from Speech Matters SLP to distinguish Pathological Demand Avoidance from Oppositional Defiant Disorder.

Nawaz, S., & Speer, S. (2025). What are the experiences and support needs of families of autistic children with Extreme (or ‘Pathological’) Demand Avoidance behaviours? Research in Autism Spectrum Disorders, 119, Article 102515. https://doi.org/10.1016/j.rasd.2024.102515