Understanding Pathological Demand Avoidance: What It Is and How to Work With It

Daniel Katz, Psy.D
Aug 7
5 min read

Angry and frustrated woman with red hair and a black and white striped shirt

Pathological demand avoidance is a pattern of behavior where a person resists or avoids doing things that others ask of them, even when those tasks are reasonable or align with their own goals. This behavior is often found in children, but some adults can display it as well. This avoidance is not always conscious. It can come from anxiety, fear of failure, or a need to stay in control.

What Is Pathological Demand Avoidance?

The term is often used in two ways. The first is general and refers to any pattern of avoiding demands due to stress, fear, or burnout. The second is more specific and comes from research on autism.

Pathological Demand Avoidance (PDA) is a proposed profile within the autism spectrum, first described by Elizabeth Newson in the 1980s. Although not formally recognized in diagnostic manuals like the DSM-5 or ICD-11, the concept is widely discussed among clinicians and educators in the UK and other countries.

In PDA, demand avoidance is not simply oppositional or defiant behavior. It is often rooted in anxiety. For some people, any request can feel like a threat to their autonomy, which leads to a strong emotional response. They may then avoid, distract, withdraw, or act out to escape the demand.

Common Behaviors for Pathological Demand Avoidance

While everyone resists demands at times, demand avoidance tends to show up in patterns that interfere with daily life. These may include:

Making excuses to avoid tasks
Withdrawing or shutting down when asked to do something
Arguing or negotiating to change the request
Using humor, distraction, or fantasy to avoid the task
Becoming irritable, anxious, or angry when pressured
Avoiding not only external demands but also self-imposed goals

In people with PDA traits, this behavior can be constant and not limited to high-pressure situations. Even simple or routine tasks ike brushing teeth, getting dressed, or making dinner may feel overwhelming.

Conditions Associated with Demand Avoidance

Demand avoidance is most often discussed in connection with autism spectrum conditions. Some researchers and clinicians consider PDA a subtype or profile of autism, though others view it as a broader behavioral pattern that may show up in people with other diagnoses, including:

Autism Spectrum Disorder (ASD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Anxiety disorders
Oppositional Defiant Disorder (ODD), though the motivations behind demand avoidance in ODD tend to differ

A 2014 study by O'Nions et al. found that children with traits of demand avoidance often had high levels of emotional dysregulation and anxiety, particularly in response to feeling controlled or overwhelmed (O'Nions et al., 2014).

An anxious male child with his head in his hands

How It Affects Daily Life

For children, demand avoidance can show up at school when they are asked to complete assignments, follow classroom routines, or comply with rules. At home, it might lead to difficulty with transitions, hygiene, or chores. Often, these difficulties lead to power struggles and a lot of animosity between parents and children.

In adults, demand avoidance can interfere with work, relationships, and self-care. Someone might want to apply for a job or go to therapy but avoid the process entirely. They may miss deadlines, procrastinate, or withdraw from activities that involve expectations or accountability.

Strategies for Coping and Change

Demand avoidance is not about laziness or oppositional behavior. It often reflects deep discomfort with pressure, even if that pressure is mild or self-imposed. Strategies that rely on rewards or punishment usually backfire. Instead, the goal is to reduce anxiety and build a sense of safety.

How Demand Avoidance Affects Children—and How Parents Can Help

Demand avoidance often appears in children as resistance to everyday tasks. This may include getting dressed, brushing teeth, going to school, or even engaging in activities they usually enjoy. These reactions can look like defiance or tantrums, but they are often rooted in anxiety or a need to feel in control.

Some children, particularly those with autism or ADHD, may show extreme avoidance behaviors that go beyond typical childhood resistance. This may include negotiating, distracting, withdrawing, shutting down, or even becoming aggressive. In children with Pathological Demand Avoidance (PDA), this pattern is persistent and not easily managed with typical parenting strategies.

mom and daughter and cute dog, getting along better after Houston Therapy helped

What Parents Can Do

Use indirect language. Instead of giving a direct instruction ("Put on your shoes"), try making it a game or a choice ("Do you want to wear the red shoes or the blue ones?"). This reduces the sense of pressure.
Lower the emotional temperature. Stay calm, even when your child is resisting. Avoid power struggles. Recognize that their behavior is likely anxiety-driven, not oppositional.
Give more autonomy. Whenever possible, allow your child to have control over decisions. Let them choose the order of tasks or help set the daily routine.
Use visual schedules. Visual aids can help children feel more prepared for what’s coming and reduce anxiety around transitions or unexpected demands.
Build in flexibility. Leave room for adjustments in your routines. If your child resists a task, see if it can be delayed or approached in a different way.
Work with professionals. A therapist, occupational therapist, or behavior specialist can help identify strategies tailored to your child’s needs. In some cases, formal assessment for autism or related conditions may be helpful.

Demand avoidance in children can be challenging. But with consistent, low-pressure support and a focus on connection over compliance, many families find that resistance softens over time.

Some helpful approaches include:

1. Reduce perceived pressure. Use indirect language when possible. Instead of “You need to do your homework,” try “What’s your plan for homework today?” This shifts the focus from compliance to autonomy.

2. Build flexibility into routines. Giving choices can reduce the sense of being trapped. For example, “Would you rather take your shower before or after dinner?”

3. Understand and accept the pattern. Self-awareness helps. For adults, noticing how they respond to internal or external pressure can help reduce shame and build healthier habits.

4. Address underlying anxiety. Cognitive behavioral therapy (CBT) and other anxiety treatments may be helpful. In children, working with a therapist or counselor who understands demand avoidance is often necessary.

5. Focus on connection and trust. Relationships based on safety and respect tend to reduce demand avoidance. People are more likely to meet expectations when they feel understood and supported.

6. Set small, achievable goals. Instead of trying to push through with willpower, break tasks down and take small steps. This reduces overwhelm and increases a sense of control.