Key Takeaways:
- PDA is rooted in anxiety and nervous system responses, not behaviour choice
- Autonomy is a fundamental need for PDAers
- Persistent Drive for Autonomy reframes PDA through a needs-based lens
- The name change aims to reduce stigma and improve understanding
- Listening to and prioritising PDAers’ perspectives is essential
The language we use to describe different neurotypes can make a huge difference to how they are perceived within society. This can, in turn, have a direct impact on how neurodivergent people are treated. In recent years, many lived experience advocates have questioned whether Pathological Demand Avoidance (PDA) is a fair or accurate term.
Meanwhile, Persistent Drive for Autonomy is growing in popularity as an alternative. But what does it mean, and what do PDAers think of the change?
What is PDA?
PDA is a profile or “sub-type” widely associated with autism. It is characterised by a strong need for autonomy and a persistent, anxiety-based avoidance of everyday demands. This can include praise, as well as activities that the person typically enjoys.
Presentations often include:
- Drive to escape from direct and indirect demands
- A strong need to be in control and maintain autonomy
- High levels of anxiety linked to expectations
- Using social strategies, including role play, to avoid demands
- Challenges with emotional dysregulation
- Special interests that specifically focus on people
Although PDA is predominately associated with autism, not all people with PDA identify as autistic, with some having ADHD, for example.
PDA isn’t a behavioural “choice” but a response to high-anxiety surrounding the pressures associated with day-to-day demands. PDAers may avoid or outright refuse tasks, become non-verbal or overly passive. This is often interpreted negatively as being deliberately “difficult.” So, shifting the narrative and reframing the language surrounding PDA is very important.
➡️Learn more about PDA in our detailed guide.
What does autonomy mean in PDA?
Autonomy refers to having control over one’s own decisions and self. For people with PDA, this need is intense and integral to their lives.
In PDA, autonomy:
- Is a “need” not a “want”
- Reduces anxiety and supports emotional regulation
- Enables engagement without overwhelm
- Protects a sense of safety and agency
Losing autonomy, even in seemingly insignificant ways, can trigger threat responses in PDAers. Autonomy helps PDAers to feel emotionally safe and equal to those around them.
➡️Read about PDA from an adult’s perspective.
What does “Persistent Drive for Autonomy” mean?
Persistent or Pervasive Drive for Autonomy retains the PDA acronym, but shifts its meaning from avoidance to a fundamental need.
The phrase highlights that:
- PDAers’ need for autonomy is ongoing (“pervasive/persistent”), without using stigmatising language
- PDAers are “driven” by an inherent need for autonomy, rather than a stubborn defiance
- Autonomy is the core trait of PDA, rather than avoiding demands
As with other terms under the neurodiversity umbrella, this definition reframes PDA from a strengths-based perspective. It encourages respect for PDAers’ autonomy and lived experience.
Why change the name?
The original term Pathological Demand Avoidance has been criticised by members of the autistic and PDA communities, with several key concerns.
“Pathological” pathologises PDA
The use of the word “pathological” can contribute to stigma and presents the traits as an individualised “problem.”
Looking at the Cambridge Dictionary shows that “pathological” can mean:
- (of a person) unable to control part of their behaviour; unreasonable
- relating to or caused by a disease
These words: “unreasonable” and “disease” are highly negative, and cast PDAers needs as being beyond reason and associated with an illness. As well as stigmatising, it’s highly dismissive and suggests autism and PDA are diseases (which is highly inaccurate).
“Pathological” in particular raises complex feelings among PDAers. Laura Kerbey, founder of Positive Autism Support and Training (PAST), writes:
“Personally, I much prefer alternative terms to “Pathological Demand Avoidance.” I think the word “Pathological” has really negative connotations, and also sounds really medical. The only thing I do like about the term is that understanding the word “Pathological” means that the demand avoidance cannot be helped.”
Although “pathological” can be stigmatising, it’s essential that any alternative names for PDA still recognise that it is not a choice. As specialist SENsational tutor Lizzie states:
“What needs to be understood about whatever name we are calling PDA is that our young people don’t act in these ways because they choose to.”
“Demand” suggests defiance
Although “demand” refers to PDAers’ struggles with the demands placed on them, it can also make it sound as if the child is “demanding”. Words like “pathological” and “demand” join together to create an image of a “difficult” child.
Lived experience PDA Educator Jessie Townz shares her perspective:
“I HATE Pathological Demand Avoidance language. I just feel that it’s so awful for a child to have that label, as it sounds like they’re a serial killer.”
“Avoidance” implies intentional refusal
As with “school avoidance,” the use of the term “avoidance” suggests that people with PDA are wilfully avoiding something, rather than experiencing an innate, natural response due to their neurotype. This places blame on the “behaviour” of the child, rather than recognising the intense internal need to reduce or remove demands.
Many PDAers also feel that “Pathological Demand Avoidance” doesn’t accurately represent PDA as the profile goes far beyond demand avoidance. This can create a very rigid interpretation of what it means to have PDA, with implications for diagnosis, reasonable adjustments and broader social acceptance.
The name change aims to be more accurate and respectful, removing pathologised interpretations of the need for autonomy. This could help PDAers to feel more positive about their neurotype and make the profile easier for family and friends to understand.
What are the pros and cons of Persistent Drive for Autonomy?
As with most changes, there are pros and cons to “Persistent Drive for Autonomy”. If you’re not sure about the alternative name, the table below sums up the advantages and disadvantages below.
Pros | Cons |
Less stigmatising language | Not formally recognised diagnostically |
Focuses on needs, not deficits | Risk of confusion with multiple terms |
Aligns with neurodiversity principles | May not change practice on its own |
Encourages collaborative, low-demand approaches | Could obscure how debilitating PDA can be |
Reflects lived experience more accurately | Some PDAers prefer existing terminology |
What do PDAers think about “Persistent Drive for Autonomy”?
It’s incredibly important for any changes or developments within PDA terminology to be led by those with lived experience. Whilst the term “Persistent Drive for Autonomy” was developed by PDAers, it’s essential to explore various perspectives, as every experience of PDA or autism will be different.
Views within the PDA community are diverse, with many feeling validated and better understood by “Persistent Drive for Autonomy” as it shifts away from pathology.
As Jessie Townz states:
Persistent Drive for Autonomy in my eyes is the key reframe for education settings and EHCP, as it allows them to understand the child better.”
Laura Kerbey also highlights the increased accuracy of the name change:
“I think terms like, Pervasive / Persistent Drive / Desire for autonomy are not only more positive, but do also describe the reason for demand avoidance.“
Some PDAers use a mix of terms, including parenting coach and writer Amanda Diekman (Low Demand Parenting):
“I use both terms personally and professionally as I find elements of each speak to my experience of being PDA […]. No matter what term people use, the most important thing, from a PDA perspective, is to affirm the language and decision of each individual PDAer.
We hate being told who we are and how we are supposed to describe ourselves. Self-determination and autonomy is king. Language and identity are deeply personal. Some people will reject any and all language and descriptors, and that makes total sense for a PDAer to do.
Perhaps there will always be multiple terms to describe PDA because of the very nature of the neurotype and disability. We will always reserve the right to name ourselves and always resist being named from the outside.”
Others have some very valid concerns about a potential rename, including Danielle Jata-Hall, autistic author and founder of PDA Parenting:
“I do feel the word “pathological” can be stigmatising and overly clinical, particularly for families and young people encountering it for the first time. At the same time, I’m cautious about rushing to rename without a strong and growing evidence base, as research is still expanding and clarity really matters for families navigating support systems.
For me, the most important focus is less on the label itself and more on understanding the cluster of features, such as the need for autonomy, nervous system threat responses, a strong sense of justice, intensity of interests, and relational sensitivity, and how these show up across different environments. I think there’s real value in keeping space for discourse, research, and community reflection, rather than seeking a single “final” answer too quickly.”
Ultimately, whatever term is used, the goal should remain the same: understanding PDA in a way that honours lived experience and respects PDA autonomy.
➡️Improve your PDA inclusivity with LGBTQ+ inclusive approaches to PDA and autistic education.
Pervasive Drive for Autonomy? Low demand support is key
If your child has Pervasive Drive for Autonomy, they will need alternative methods to support their education. Some common teaching strategies, including praise and rewards, can be highly triggering for PDA children, as they create additional demands.
At SENsational Tutors, all our tutors have 6+ years of specialist experience in teaching PDA and SEN students. Our tutors provide low-demand, neuro-inclusive sessions that enable children to enjoy learning in a way that values their autonomy and allows them to build trust with tutors.
Find a SENsational PDA tutor to inspire a love of learning in your child and help them to thrive. Browse tutors on our Find a Tutor page or take a look through the PDA resources on our blog.
Discover low-demand, autonomy-affirming tutoring for children with PDA
Finding the right tutor for a child with a Persistent Drive for Autonomy (PDA) can feel overwhelming. Many families struggle to find support that truly understands the anxiety-driven need for control and emotional safety that underpins PDA.
Our experienced tutors specialise in low-demand, neuro-affirming approaches that prioritise autonomy and emotional regulation. We create calm, flexible learning environments where children feel safe and empowered to engage without pressure.
Frequently Asked Questions
What is a Pervasive Drive for Autonomy?
Pervasive Drive for Autonomy is an ongoing, essential need to have control over one’s own actions and decisions. For PDAers, loss of autonomy can trigger intense anxiety and nervous system stress, which can present through threat responses.
Can you have PDA and not be autistic?
Yes. While PDA is commonly associated with autism, not all PDAers identify as autistic, and some may have ADHD or trauma, for example.
What is Persistent Drive for Autonomy?
Persistent or Pervasive Drive for Autonomy may show up as distress around everyday demands, including at school or home, social expectations, or loss of control. Without autonomy-affirming support, this can contribute to burnout or shutdowns.
Why is PDA being renamed Persistent Drive for Autonomy?
Many PDAers feel the term “Pathological Demand Avoidance” is stigmatising and inaccurate. “Persistent Drive for Autonomy” reframes PDA as a fundamental, ongoing need for autonomy rather than intentional avoidance or defiance.
Is Pervasive Drive for Autonomy the same as PDA?
Yes, it refers to the same profile, but adopts different language to be more inclusive than “Pathological Demand Avoidance”. Instead of outward behaviour and avoidance, Pervasive Drive for Autonomy centres lived experience and needs.
Please note: The information provided within this blog, by SENsational Tutors, is for general information purposes only. We appreciate that every person is unique and any advice/experiences mentioned within the content of each blog may not be reflective of your own personal experience. All information on the site is provided in good faith and is for educational informational purposes only. It is not a substitute for professional advice. Before taking any actions based upon such information, we encourage you to consult with appropriate professionals.
