From Pathological Demand Avoidance(PDA) to Pervasive Drive for Autonomy(PDA)

From Pathological Demand Avoidance(PDA) to Pervasive Drive for Autonomy(PDA)

For years, the profile known as PDA has been described as Pathological Demand Avoidance. Many in the autistic and wider community have pushed back against that wording. The word pathological implies that the person is disordered, when in reality, what we are seeing is a powerful need for autonomy and self-direction.

That’s why you’ll now hear PDA being described instead as Pervasive Drive for Autonomy. This change matters because it shifts the focus away from “refusal” and “avoidance” towards the underlying reason, the person’s intense need to remain in control of themselves and their world.

It’s more than a child refusing to put their shoes on because someone asked them to. That’s the surface behaviour. Beneath it lies a brain wired to protect autonomy at all costs.

Real-life examples

Everyday routines – even enjoyable things like going to the park can be rejected if it feels like someone else’s idea rather than their own choice.

Simple requests – “Come sit at the table for dinner” can feel overwhelming, not because eating is difficult, but because it came as a directive.

Homework time – a teacher says, “You need to finish this worksheet now.” Even if the child can do it, the demand itself triggers anxiety. They might rip up the paper, make jokes, or freeze.

Lifts and independence – someone kindly offers to drive you so you don’t have to take your own car. On the surface, that sounds helpful, but to someone with PDA, it feels like your control has been taken away. Having your own car means you can leave whenever you choose, even if you don’t actually want to. Without that option, you feel trapped.

Being a passenger in a car – for some people with PDA, not being the driver is difficult. When you are the passenger, you don’t control when the car stops, what route is taken, or when you can leave. That loss of autonomy can create huge anxiety, even if you trust the driver.

Driving on the motorway – A large van pulls in front of you, suddenly you can’t see what’s ahead and you feel boxed in. For someone with PDA, that sudden loss of vision and space can create a wave of anxiety, even though nothing dangerous has actually happened.

Why the new name matters

The shift to Pervasive Drive for Autonomy helps people see that these behaviours are not about being naughty, difficult, or oppositional. They are protective responses, strategies the brain uses to hold onto a sense of control.

Understanding this allows parents, teachers, and professionals to respond with empathy instead of frustration. Instead of thinking “Why are they being so defiant?” we can think “How can I give them more choice, more autonomy, and reduce the pressure?”

Language shapes perception. By moving away from Pathological Demand Avoidance towards Pervasive Drive for Autonomy, we move from judgment to understanding.