Is avoidance part of autism?

Demand Avoidance refers to when individuals experience intense distress or anxiety or become overwhelmed or dysregulated when demand is placed upon them. It is not a behaviour born out of laziness or defiance, rather, it is often driven by anxiety. It is a term first coined by psychologist Elizabeth Newson in the 1980s and describes a group of behaviours observed in some individuals with autism who demonstrate an overwhelming need to avoid any situation where they feel they are being pressured to perform, whether the demand is verbal, social, implied or simply a given situation. This behaviour is often misunderstood, leading to frustration among families, educators, and clinicians. It is seen as contentious because experts have disagreed in the past on whether it should be part of the autism spectrum and whether it exists at all. Demand Avoidance can happen at any time and could be something as simple as asking someone to stop doing what they are doing or start a new task, even if it’s something they love doing.

Although demand avoidance, including the use of social strategies to avoid demands, is widely acknowledged as a characteristic reported by and observed in some people, no research has found strong evidence for the group of traits proposed for PDA or tested the validity or usefulness of Newson’s theory in clinical practice. The proposed core characteristics most commonly cited are: resisting and avoiding the ‘ordinary demands of life’ using social strategies as forms of resistance – for example, distraction, giving excuses. Some critics note that there is not enough research evidence to confirm PDA as a separate condition to autism and argue that: the complex characteristics can instead be understood by considering the individual’s social, sensory and cognitive sensitivities, any co-occurring conditions and whether their environment is suited to their needs. It has also been argued that the PDA label represents an unnecessary pathologising of differences in autistic people when: they act outside of social norms in attempt to gain autonomy. There is debate around how the characteristic of a persistent and marked resistance to demands relates to autism. PDA is not clinically recognised, which means you cannot receive a standalone diagnosis of PDA. Although it is not possible to receive a diagnosis of PDA, some people have a diagnosis of autism with a 'demand avoidant profile’ or a ‘PDA profile’ noted, and others self-identify with the PDA label.