Parenting in the Shadow of PDA: From Challenge to Connection, with Research-Based Strategies

Your child resists the simplest everyday requests. They argue, make excuses, or become overwhelmed. You've likely thought to yourself more than once: "This isn't just simple defiance." You are right. What you might be experiencing is a recognized behavioral profile within the autism spectrum known as the Pathological Demand Avoidance (PDA) profile.

Recent research, including a study newly published in January 2025, clearly shows that the core of these behaviors is anxiety, not intentional disobedience. The brain of a child with PDA interprets demands as a threat to their personal "control" and activates the natural fight-or-flight response.

The hopeful news is this: when you understand the root of the behaviors, you can employ effective strategies that reduce tension and strengthen your relationship with your child. This article, based on the latest research findings and parental experiences, provides a step-by-step guide for this journey.

Understanding PDA – Beyond a Label

PDA is not a separate formal diagnosis in diagnostic manuals (like the DSM-5), but is considered a behavioral profile within the autism spectrum. Children with this profile often show two key features:

1. Extreme Avoidance: Resistance to everyday demands, even tasks they enjoy themselves.
2. Social Strategies: Clever use of tactics like negotiation, arguing, distraction, role-play, or pretending to escape demands.

Parents in research report that before learning about the concept of PDA, they were often blamed by those around them, or even some professionals, for being "permissive parents." While unconsciously, they were adapting to their child's anxiety-driven needs.

The Parental Experience – You Are Not Alone

A study of the experiences of mothers of children with PDA, published in 2025, highlighted four main themes:

• The 'Lightbulb' Moment: For many parents, learning about PDA was like a light turning on in the dark. All the puzzle pieces came together, and their child's seemingly incomprehensible behaviors made sense.
• The Heavy Burden of Responsibility: Life with PDA can lead to feelings of burnout, isolation, and grief for a "normal" life. The child's constant need for co-regulation severely drains parental energy.
• Judgment and Misunderstanding: Facing the ignorance of others, including some professionals, is one of the biggest challenges.
• Flexibility and Resilience: Despite all the difficulties, parents find ways to adapt. Connecting with support groups of parents with similar experiences is a powerful source of understanding and validation.

The Communication Toolkit – Seven Golden Principles

Effective strategies for children with PDA focus on reducing anxiety and the feeling of control, not on enforcing compliance.

1. Use Indirect Language Instead of Direct Demands

• Instead of saying: "Put your clothes on now."
• Say: "I see the clothes are waiting on the bed." or "What a nice outfit you've chosen for today!"

2. Offer Real, Limited Choices.

• Increase the sense of control by giving the right to choose in small matters.
• Example: "Would you like eggs or cheese for breakfast?" (Both options are acceptable to you).

3. Avoid Power Struggles.

• Do not insist in the face of the child's resistance. Your relationship is more valuable than winning that particular argument.
• Sometimes, a tactical retreat and returning to the topic later is the most effective way.

4. Use Play and Imagination.

• Frame demands within a game or story. For example, brushing teeth can become a "battle against cavity monsters."

5. Set Aside Traditional Praise and Rewards.

• Reward systems like star charts themselves act as a hidden demand and increase anxiety.
• Instead of praising the outcome ("What a beautiful drawing"), praise the effort or idea ("The idea of using these colors was interesting").

6. Provide a Safe Space for Meltdowns.

• During severe overwhelm (meltdown), arguing and reasoning are useless. Your calm, silent, and non-judgmental presence is the most important help.
• After the child has calmed down, talk about their feelings, not their behavior.

7. Focus on Adaptation, Not Compliance.

• Adapt the environment and your expectations as much as possible to the child's needs. This is not spoiling, but creating a foundation to reduce anxiety triggers.

Collaborating with School and Professionals – Who Helps?

Parents in research have found professionals more helpful who:

• Listen and do not judge.
• Are willing to learn about PDA, even if they have no prior knowledge.
• Focus on a comprehensive assessment of the child and providing practical strategies.
• Are accessible and establish a continuous relationship.
• Help the family access appropriate educational support.

Discuss these principles with the school: reducing direct demands, allowing unconditional breaks, and prioritizing learning over completing work in a specific way.

Self-Care – You Matter Too

The journey of parenting a child with PDA is a marathon, not a sprint. Your self-care is a necessity.

• Connect with support groups of parents with similar experiences.
• Dedicate time, however short, to recharge your energy.
• See your child's strengths: These children are often creative, intelligent, independent thinkers, and have remarkable honesty.

The goal is not to eliminate challenges, but to create a safer, more predictable space where your relationship can grow and your child's unique talents can flourish. Every small step towards understanding and adaptation is a significant victory on this path.

Authored by:

Dr. Alireza Sarmadi
Family Physician

Sources:

1.Kildahl AN, Helverschou SB, Rysstad AL, Wigaard E, Hellerud JMA, Ludvigsen LB, Howlin P.

Pathological demand avoidance in children and adolescents: A systematic review. 2021;25(8):2162–2176.

doi:10.1177/13623613211034382

2.O’Nions E, Gould J, Christie P, Gillberg C, Viding E, Happé F.

Identifying features of pathological demand avoidance using the Diagnostic Interview for Social and Communication Disorders (DISCO). European Child & Adolescent Psychiatry. 2016;25:407–419.

doi:10.1007/s00787-015-0740-2

3.Curtis S, Izett E.

The experience of mothers of autistic children with a pathological demand avoidance profile: An interpretative phenomenological analysis. Crown. 2025.

4.Gore Langton E, Frederickson N.

Parents’ experiences of professionals’ involvement for children with extreme demand avoidance. British Journal of Developmental Disabilities. 2016.

doi:10.1080/20473869.2016.1204743

5.PDA North America.

Supporting PDA (Pathological Demand Avoidance) in Education: A Short Guide for Educators.

6.Government of South Australia, Department of Education.

About Autism and Pathological Demand Avoidance (PDA) Profile.