Reframing Resistance: Why We Should Move Away from “Pathological Demand Avoidance” and Towards “Persistent Drive for Autonomy”
The term “Pathological Demand Avoidance (PDA)” has gained attention in recent years as a way to describe a previously overlooked profile of autism. In short, PDA is marked by an extreme avoidance of everyday demands. (Read more about PDA here.) While “Pathological Demand Avoidance” has provided folks with new language to describe their experience, the language itself can be problematic — particularly the word “pathological,” which implies illness, defect, or dysfunction and is rooted in white supremacy.
As such, many professionals are moving towards the more neurodiversity-affirming term “Persistent Drive for Autonomy.”
Persistent Drive for Autonomy shifts the profile’s focus from “pathology” and perceived deficits to reframing PDA as attempts to meet a deeply human need. It recognizes that what’s often labeled as avoidance or oppositional behavior is actually a neuro-driven protective response to feeling overwhelmed, unsafe, or out of control. For many autistic individuals—especially those with trauma histories or heightened sensory sensitivities—demands can feel intrusive or threatening. Their refusal isn’t defiance; it’s a survival strategy.” Read more about this idea here.
By using “persistent drive for autonomy,” we affirm that:
The individual is not broken.
Their need for control is understandable in context.
Support should come from reducing pressure, increasing choices, and honoring boundaries and not from attempts to “fix” PDA behavior.
Language matters. It shapes how we see people and how they see themselves. Moving away from pathologizing terms and toward strengths-based, affirming language helps create environments where neurodivergent individuals are not seen as difficult and wholly different but genuinely respected and understood.