Pathological Demand Avoidance

Also known as 'PDA' or Extreme Demand Avoidance or Pervasive Drive for Autonomy

crayons lined up in a row

What is PDA?

Pathological Demand Avoidance (PDA) or Extreme Demand Avoidance (EDA) is a specific profile displayed among some individuals with autism spectrum and/or attention-deficit/hyperactivity disorder.  Clinicians use the term "Pathological" to illustrate that this profile is characterized by the intensity and persistence displayed while resisting and avoiding everyday demands. Evaluating for pathological demand avoidance involves looking for specific symptoms and behaviors that are distinct from other features that contribute to the individual's neurodiversity. 

"Despite continued debate surrounding PDA, there is increasing consensus that description of a PDA or EDA profile . . .can be helpful in alerting caregivers and educational professionals to these particular challenges. . .the presence of PDA characteristics has implications for management. Unless avoidance of everyday demands, emotional reactivity, and their impact on day-to-day functioning are assessed, it is impossible to monitor the degree to which interventions are effective in managing them" (O'Nions & Eaton, 2020, p. 412).


The Evaluation Process


The evaluation process for Pathological Demand Avoidance (PDA) typically involves the following steps:

Developmental/Clinical History: You will complete  developmental history, medical history, and describe any previous assessments or diagnoses in the Intake form.

Observational Assessment: The evaluation includes video submission of your child's behaviors so that the evaluator can assess behavior, interactional style, and response to demands or requests.  This is also a live observation and interaction (if possible) that takes place during the Parent Interview.

Parent Interview: An interview with one or both parents allows the evaluator to further explore anything of note in the assessment thus far.  This also allows for parents to provide more information that was not asked about in the formal evaluation portion and ask questions.  

Standardized Assessment: This is the paperwork portion.  We basically load you up with lots of questions about your kid from a variety of standardized assessments available only to licensed professionals through publishers such as Pearson Assessments, Western Psychological Services, and PRO-ED.

Adaptive functioning assessment: An evaluation of the individual's adaptive functioning, including their ability to carry out everyday tasks independently, may be conducted. This assessment can provide a holistic understanding of the individual's overall functioning.

Collaboration with professionals: The evaluator may review documentation from other professionals involved in the individual's care, such as psychologists, speech therapists, or occupational therapists, to gain a comprehensive understanding of the individual's strengths and weaknesses.

Diagnostic formulation: Based on the gathered information and assessment results, the evaluator will assess whether the individual meets the criteria for a PDA profile. This may involve considering other possible explanations for the observed behaviors and ruling out any other conditions or disorders.

Feedback and recommendations: The evaluator will provide feedback to the individual or their caregivers regarding the findings of the evaluation. This may include recommendations for interventions, strategies, and support services to address the specific needs and challenges associated with PDA.

It is important to note that the specific steps and procedures involved in any evaluation may vary depending on the individual's age.


PDA Assessments with Dr. Mark Bowers
The fee for a PDA assessment with Dr. Mark Bowers is $875. We do not bill directly to insurance, but we accept HSA/FSA payments if you have that benefit. You may also be able to receive out-of-network insurance reimbursement for assessments.
Schedule an Evaluation