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Pathological Demand Avoidance (PDA) Assessment
Image by Matthew Henry
Understanding Pathological Demand Avoidance (PDA)

PDA isn’t about being defiant.

It’s about a deep, hardwired need for autonomy — what some call a "pervasive drive for autonomy."
 

If you find yourself resisting even things you want to do, feeling trapped by everyday requests, or needing control just to stay calm, you’re not alone — and you’re not broken.
 

PDA is a distinct profile within the autism spectrum that deserves to be seen with nuance and respect.

Our assessment helps uncover the patterns underneath, giving you clarity, validation, and a better way forward.
 

You’re not “too oppositional.”

You’re wired for freedom — and that’s worth understanding.

What Is PDA — and Why Does It Matter?


Pathological Demand Avoidance (PDA) is a profile on the autism spectrum where demands — even ordinary, everyday ones — can trigger intense anxiety and resistance.

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But let’s be clear:

This isn’t laziness.
It’s not rebellion.
And it’s definitely not a character flaw.
 

PDA is your nervous system sounding the alarm.

For people with PDA, demands can feel like threats to autonomy, identity, or safety. The result? A powerful drive to regain control — by avoiding, withdrawing, negotiating, masking, or even melting down.
 

This can look like:

  • Putting off tasks you genuinely want to do

  • Spiraling when routines or expectations shift

  • Becoming explosive or shut down when pressured

  • Seeming “fine” on the outside while quietly unraveling inside
     

But here's the deeper truth:

PDA isn’t just about avoidance — it’s about a pervasive drive for autonomy.
It’s the brain’s way of protecting a sensitive system from overwhelm, loss of agency, and emotional threat.
 

When misunderstood, PDA can hold you back.

  • Strained relationships

  • Self-blame or shame

  • Misdiagnoses (like ODD or anxiety alone)

  • Burnout from constant internal tension
     

But when recognized and supported, PDA becomes easier to live with.

  • You stop fighting yourself

  • You start building structure on your own terms

  • You learn to reduce demands without reducing your goals

  • You regain energy and emotional space
     

A PDA-informed assessment helps you understand the why behind your resistance — and gives you language to ask for what you need.

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You’re not difficult. You’re deeply wired for autonomy.

And with the right insights, that can become a strength, not a struggle.

Explore without pressure. Take a free screener now.
Assessing Pathological Demand Avoidance 

The clinical assessment of Pathological Demand Avoidance at the Adult Autism Assessment Center involves evaluating a person's reactions to demands and their desire for autonomy.


Typically, the assessment spans two sessions. Here are the core components:

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Semi-Structured Interviews:

 

Clinicians conduct semi-structured interviews to understand a person's behavior patterns, communication style, and responses to demands. They ask about the individual's personal history, family background, and current relationships.

 

Self-Report Questionnaires:

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Extreme Demand Avoidance Questionnaire for Adults (EDA-QA): Assesses four core areas:

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  • Regulation, flexible thinking, sensory coherence, and social perspective-taking.

  • This questionnaire helps clinicians identify the extent and nature of a person's demand avoidance behaviors.

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Behavioral Observations:

 

Clinicians observe the individual's behavior during the assessment - noting their responses to instructions, non-verbal cues, and overall behavior patterns.

 

Collateral Information:

 

Information from family members, friends, or significant others provides
a more comprehensive view of the individual's reactions to demands and social expectations.

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These elements enable clinicians to understand the extent of PDA and suggest appropriate interventions or treatments. This knowledge can improve relationships through enhanced communication and empathy.

Stand Alone or Part of an Assessment?

This assessment is available as an add on to a diagnostic assessment of autism or ADHD. 


ADD ON:

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  • As an add-on to an ASD or ADHD assessment provided by one of our clinicians

  • One session to review

  • $300

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STAND ALONE:

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​If you are not interested in a diagnostic assessment but still wish to explore PDA, talk to your clinician for ways to explore your questions.

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Because the post-assessment therapy is essential to gaining the full value of this assessment, we do not offer this service without an accompanying plan for on-going therapy. The additional related therapy would be at the regular session rate for your therapist.


These costs cover the time, resources, and expertise of our clinicians to conduct the assessment and provide comprehensive feedback.

Working with PDA: Individual and Couples Sessions

After the assessment, clinicians at the Adult Autism Assessment Center offer follow-up sessions to work with individuals and couples dealing with Pathological Demand Avoidance (PDA).

 

These sessions are not part of the initial assessment and are charged at the clinician's regular rate.

 

In individual sessions, clinicians help clients learn strategies to manage PDA and develop more adaptive behaviors. During these sessions, they work on the following:

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  • Understanding PDA: Clinicians explain the key characteristics of PDA to help clients better understand their behaviors and responses to demands.

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  • Coping with stress: Clients learn techniques to manage stress and reduce anxiety associated with demands and expectations.

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  • Developing flexibility: Clinicians guide clients in practicing flexibility and exploring new approaches to tasks and activities.

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  • Improving regulation: Clients are taught methods to enhance emotional regulation and reduce impulsivity.

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  • Building autonomy: Clinicians help clients find ways to achieve a sense of control and autonomy in a balanced and healthy manner.

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In couples sessions, clinicians work with partners to address the unique challenges of PDA in a relationship. They aim to:

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  • Promote communication: Clinicians encourage open and honest communication to address misunderstandings related to PDA behaviors.

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  • Develop empathy: Partners are guided to empathize with each other's experiences and understand the impact of PDA on their relationship.

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  • Resolve conflicts: Clinicians help couples navigate and resolve conflicts that stem from resistance to demands or differing expectations.

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  • Establish boundaries: Partners work on setting healthy boundaries to maintain a sense of autonomy while fostering connection.

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  • Strengthen the relationship: Clinicians focus on activities and discussions that reinforce the bond between partners, even in the presence of PDA-related challenges.

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These follow-up sessions aim to provide ongoing support and guidance for individuals and couples navigating the complexities of PDA. By working with clinicians, clients can find effective ways to cope with PDA, enhance communication, and foster stronger relationships.

Explore without pressure. Take a free screener now.
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