Demand avoidance phenomena: circularity, integrity and validity – a commentary on the 2018 National Autistic Society PDA Conference

There has been much discussion and debate on Pathological Demand Avoidance (PDA) since it was first described by Professor Elizabeth Newson in the UK in the 1980s. Is it part of the autism spectrum or a separate condition or can the features of PDA be found in other developmental conditions? If PDA can be separately defined, do the origins or underlying causes of PDA differ from other conditions and, if so, what are the implications?

The main consensus at present is that some autistic children and adults also have PDA and that where this is true, different strategies are needed (Christie et al, 2011). But PDA profiles have been found in people with other conditions too (Egan et al, 2019; Kaushik et al, 2015). There are some who assert that, as yet, there is insufficient evidence to determine the criteria for PDA and its classification.

Some autistic individuals have referred to PDA as rational demand avoidance where demands which are perceived to be aversive or illogical are avoided. Given that many autistic individuals show demand avoidant behaviour, there is a concern that without clear criteria for PDA, parents and professionals alike might assume that a person has both autism and PDA and then seek further assessment or follow recommended strategies for PDA which might not be useful or needed. So an ethical debate on PDA is needed. In this paper, Richard Woods, an autistic academic, presents his views on PDA or, in his words, the Demand Avoidance Phenomena.