top of page

Pathological Demand Avoidance (PDA) Assessment
 

Understanding Pathological Demand Avoidance (PDA)

This is an image of people on the beach using their bodies to spell out the word "RESIST" . The photo was taken from above and several dozen people are grouped together to form the word.

Pathological Demand Avoidance (PDA), also known as Pervasive Drive for Autonomy, is a condition where people show extreme resistance to demands and a strong need for autonomy.


Though not included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5 TR), PDA is recognized within the psychological community as a distinctive profile, often associated with autism spectrum disorders.

 

Learning about PDA is essential for fostering healthy relationships, as it affects how people interact and handle everyday tasks.

Those with PDA tend to resist instructions and avoid compliance due to an inherent need to maintain control over their environment. They might use various tactics to avoid tasks, including humor, defiance, or outright refusal.

 

These behaviors can lead to frustration and misunderstanding in relationships, so it's crucial to view PDA from a non-pathologizing
standpoint, recognizing that these behaviors reflect a different response to authority and social expectations.

Assessing Pathological Demand Avoidance 

Image of 2 large "No Trespassing Signs"

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:

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:

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

  • 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.

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.

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?

Image of a large white road sign that says "Turning Point"

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


ADD ON:

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

  • One session to review

  • $300

STAND ALONE:

​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.

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

Image of a white sign that says "You're Not Lost, You're Here".

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:

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

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

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

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

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

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

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

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

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

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

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

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.

bottom of page