If you’re the parent of a child with Pathological Demand Avoidance (PDA), chances are you’ve been on a journey already that’s included a lot of questions, challenges, and searching for the right kind of support. You may have noticed that your child struggles with everyday demands, becomes anxious in social settings, or seems to avoid certain situations that others handle with ease.
You’re not alone, and more importantly, there is help and hope.
Occupational Therapists as well as Speech Pathologists can work alongside families just like yours, helping children with PDA grow their confidence, build their social skills, and find ways to feel more secure and successful in daily life.
Let’s break it all down together, what PDA is, how it can impact your child’s social world, and how early evidence-based therapy can make a real difference.
How does PDA affect children overall?
Pathological Demand Avoidance (PDA) is a profile on the autism spectrum, sometimes linked to ADHD, where children experience extreme anxiety around everyday demands. This isn’t about being defiant, it’s a nervous system in constant fight-or-flight mode, trying to maintain control.
PDA affects more than just social skills. Children may want friendships but struggle with the pressure of social interaction, control, unspoken rules, and unpredictability. Beyond that, PDA can impact daily life: kids might resist routines, avoid tasks (even ones they enjoy), have emotional outbursts, or mask their struggles in public and release them at home.
Overall, PDA influences how a child interacts, learns, manages emotions, and copes with everyday expectations. With understanding and tailored support, children with PDA can build confidence and thrive.
How can therapy help?
Here’s how we support kids (and you, their parents):
1. Creating environments that reduce demand and increase choice
For children with PDA, everyday requests, even simple ones, can feel overwhelming and trigger anxiety. OTs and Speech Pathologists can help by:
- Adjusting routines and tasks so they feel collaborative rather than imposed
- Offering children meaningful choices to build autonomy and reduce pressure
- Supporting parents and teachers to frame communication in ways that feel flexible and respectful
- Helping children find safe, empowering ways to say “no” or “not right now”
This approach honours the child’s need for control and safety, while gradually building their confidence in managing everyday demands.
2. Building Social Communication Skills
Both OTs and Speech Pathologists support children to discover communication strategies that feel safe and authentic. This might mean:
- Exploring how to start and maintain conversations
- Noticing nonverbal cues like tone of voice or body language
- Recognising and expressing emotions — their own and others’
- Finding ways to navigate social misunderstandings
We always follow the child’s lead and honour their unique style of connecting with others, so that communication feels natural and empowering.
3.Supporting emotional regulation
For children with PDA, strong emotions are often linked to feeling unsafe or out of control. Therapy helps them to:
- Tune into their body’s signals of anxiety or overwhelm
- Explore soothing strategies such as movement, breathing, or visual supports
- Feel validated in their emotional experiences
- Build safe spaces where expressing feelings is understood and respected
Emotional regulation isn’t about “fixing” or suppressing feelings — it’s about supporting children to understand themselves and thrive in environments that meet their needs.
How can parents support their child with PDA?
We know that supporting a child with PDA can feel exhausting and confusing at times. That’s why part of our job is supporting you, too.
Using what we call the “coach approach,” we work closely with you to:
Understand your child’s behaviour and what’s driving it
Set realistic, meaningful goals for your family
Learn practical strategies to use at home
Feel more confident in your parenting
We’re not here to tell you how to parent, we’re here to partner with you so you feel more equipped and less alone.
Practical tools for home
Here are some strategies that often help children with PDA manage daily life:
- Structured routines with less demands: Predictable low demand days help reduce anxiety.
- Visual schedules: Pictures or charts can help your child see what’s coming next without feeling “told.”
- Breaking tasks into steps: One step at a time feels more manageable than a big demand.
- Offering choices: Giving your child a sense of control can lower resistance.
- Using their interests: If your child loves dinosaurs, Minecraft, or art — we use that as a bridge to connection and learning.
Is PDA always recognised by professionals?
That’s a tricky question. PDA is becoming more widely known, but it’s not yet officially recognised as a separate diagnosis in many countries. For example:
In New Zealand and the UK, it’s more accepted and included under the autism spectrum.
In other places such as Australia, it may not be formally diagnosed, but professionals may describe your child as having “demand avoidant traits” or “complex autism.”
No matter what it’s called, the important thing is finding a support approach that works for your child’s unique profile, not just a label.
When to reach out for help
If you’ve been wondering whether your child might have PDA, or you’re just feeling stuck and unsure of what to try next, it’s a good idea to speak with a professional. You don’t need a formal diagnosis to start working with an Occupational Therapist and Speech Pathologist.
We’re here to help with:
- Assessments and observations
- Individualised therapy plans
- Coaching for parents and caregivers
- Practical tools that fit your daily life
If you’re ready to explore how our Perth based therapy team can support your child and your family with PDA, please book an initial appointment today.