Skip to main content

Pathological Demand Avoidance (PDA)


Autism spectrum disorder and PDA traits (O’Nions et al. 2018); Extreme demand avoidance (Gillberg 2014); Newson’s syndrome (Ogundele 2018); Pathological demand avoidance syndrome (Newson et al. 2003); Rational demand avoidance (Milton 2017)


Elizabeth Newson developed the concept of pathological demand avoidance (PDA) to describe a subset of children referred to her clinic based in Nottingham, UK, in the 1970s (Newson et al. 2003). Newson applied the term PDA to children that were traditionally diagnosed as either having pervasive developmental disorder-not otherwise specified or atypical autism, yet both parents and clinicians thought these terms did not adequately describe the child’s presenting difficulties (Newson et al. 2003). Consequently, PDA was first proposed in 1980 as a distinct pervasive development disorder with the following behavior profile (Gillberg 2014): consistent resistance to every day demands, ease at role-play and pretend play, language delay...

This is a preview of subscription content, access via your institution.

References and Reading

  • Christie, P. (2007). The distinctive clinical and educational needs of children with pathological demand avoidance syndrome: Guidelines for good practice. Good Autism Practice, 8(1), 3–11.

    Google Scholar 

  • Gillberg, C. (2014). Commentary: PDA – Public display of affection or pathological demand avoidance? – Reflections on O’Nions et al. (2014). Journal of Child Psychology and Psychiatry, 55(7), 769–770.

    CrossRef  Google Scholar 

  • Green, J., Absoud, M., Grahame, V., Malik, O., Simonoff, E., Le Couteur, A., & Baird, G. (2018). Pathological demand avoidance: Symptoms but not a syndrome. Lancet Child & Adolescent Health, 2(6), 455–464.

    CrossRef  Google Scholar 

  • Langton, E., & Frederickson, N. (2016). Mapping the educational experiences of children with pathological demand avoidance. Journal of Research in Special Educational Needs, 16(4), 254–263.

    CrossRef  Google Scholar 

  • Milton, D. E. M. (2017). A mismatch of salience: Explorations of the nature of autism from theory to practice. Hove: Pavilion Publishing and Media Ltd..

    Google Scholar 

  • Newson, E., Le Maréchal, K., & David, C. (2003). Pathological demand avoidance syndrome: A necessary distinction within the pervasive developmental disorders. Archives of Disease in Childhood, 88(7), 595–600.

    CrossRef  Google Scholar 

  • O’Nions, E., Christie, P., Gould, J., Viding, E., & Happe, F. (2014). Development of the ‘Extreme demand avoidance questionnaire’ (EDA-Q): Preliminary observations on a trait measure for pathological demand avoidance. Journal of Child Psychology and Psychiatry, 55(7), 758–768.

    CrossRef  Google Scholar 

  • O’Nions, E., Gould, J., Christie, P., Gillberg, C., Viding, E., & Happé, F. (2016). Identifying features of ‘pathological demand avoidance’ using the diagnostic interview for social and communication disorders (DISCO). European Child & Adolescent Psychiatry, 25(4), 407–419.

    CrossRef  Google Scholar 

  • O’Nions, E., Viding, E., Floyd, C., Quinlan, E., Pidgeon, C., Gould, J., & Happé, F. (2018). Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/‘pathological’ demand avoidance. Child and Adolescent Mental Health, 23(3), 220–227.

    CrossRef  Google Scholar 

  • Ogundele, M. (2018). Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World Journal of Clinical Pediatrics, 7(1), 9–26.

    CrossRef  Google Scholar 

  • Woods, R. (2017). Pathological demand avoidance: My thoughts on looping effects and commodification of autism. Disability & Society, 34(5), 753–758.

    CrossRef  Google Scholar 

  • World Health Organisation. (2018). ICD-11: The 11th revision of the international classification of diseases. Geneva: World Health Organisation.

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Richard Woods .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2020 Springer Science+Business Media, LLC, part of Springer Nature

About this entry

Verify currency and authenticity via CrossMark

Cite this entry

Woods, R. (2020). Pathological Demand Avoidance (PDA). In: Volkmar, F. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY.

Download citation

  • DOI:

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6435-8

  • Online ISBN: 978-1-4614-6435-8

  • eBook Packages: Springer Reference Behavioral Science and PsychologyReference Module Humanities and Social Sciences

Chapter History

  1. Latest

    Pathological Demand Avoidance (PDA)
    30 January 2020


  2. Original

    Pathological Demand Avoidance (PDA)
    01 October 2018