Beyond High Demand and Low Demand: A Flexible Approach to PDA
By Michaela Gordon, OTR/L
Over the past year, conversations about PDA (Pathological Demand Avoidance) have grown louder — and sometimes more divided.
Some voices emphasize nervous system safety above all else.
Others emphasize skill-building and resilience.
Many parents are left wondering where they fit in that spectrum.
This post isn’t here to take sides. It’s here to widen the lens.
Because children are complex. Development is complex. And no single explanation captures every child fully.
What Is PDA?
PDA was first described in the 1980s by psychologist Elizabeth Newson in the United Kingdom. It is not currently listed as a separate diagnosis in the DSM-5 or ICD-11.
Today, PDA is generally described as a profile seen in some autistic children. Common characteristics include:
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Intense resistance to everyday demands
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High anxiety
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Strong need for autonomy
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Emotional reactivity
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Periods of shutdown or escalation
Many children described as having PDA traits also meet criteria for autism. Whether it is a subtype, profile, or overlapping presentation is still debated in research.
What is clear is this: the children described under this profile often experience demands as disproportionately stressful.
The Nervous System Explanation
In some communities, PDA is described primarily as an autonomic nervous system response — meaning everyday demands are perceived as threats, triggering fight, flight, or freeze.
From this perspective, reducing demands (often called a “low-demand approach”) is seen as protective and supportive. Many families report that lowering pressure reduces conflict and improves connection.
That makes sense. When stress decreases, capacity increases.
But regulation is influenced by more than one system.
A child’s ability to handle demands may be shaped by:
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Autonomic nervous system state
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Sensory processing patterns
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Executive functioning skills
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Cognitive flexibility
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Motor planning abilities
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Interoception (body awareness)
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Environmental stress load
No nervous system exists in a permanently fixed state. Capacity shifts day to day.
When a child struggles more than usual, that is not regression. It is responsiveness to stress.
Regulation First — But Not Regulation Only
You may hear the phrase: “Regulate first, then proceed.”
This is important. Children cannot learn new skills when they are overwhelmed.
But it’s also important to remember something else:
Learning always involves some stress. Trying something new, losing a game, making a mistake, or shifting plans. Discomfort is part of growth. The goal is not to eliminate stress completely.
The goal is to keep stress in a manageable range. Too much stress leads to shutdown. Too little stress can prevent growth. Supported stress builds resilience.
When a child shows intense avoidance, it signals that their stress system activates quickly. In those moments, the adult’s role is to stay regulated, stay connected, and calibrate the level of challenge carefully. We do not abandon expectations. We adjust the path toward them.
Safety means we do not push a child past their limit for the sake of compliance. It does not mean eliminating all discomfort. Children need safety from overwhelm. They also need experiences that build mastery.
The Risk of Over-Reduction
When PDA is explained solely as chronic nervous system flooding, there are potential risks:
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Assuming dysregulation is permanent
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Removing developmental challenges entirely
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Reinforcing avoidance instead of building skills
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Overlooking executive or motor skill gaps
In the short term, reducing demands can bring real relief. Stress lowers. Conflict decreases. Relationships stabilize. That matters!
But children described as having PDA traits also have goals.
They want friendships, competence, and independence. They want to grow.
The struggle is rarely a lack of desire. It is often an internal conflict between overwhelm and expansion.
Too little challenge can quietly narrow a child’s world.
This does not mean children need more pressure.
It means they need calibrated support. The goal is not high demand and it’s also not no demand. The goal is thoughtful demand — challenge matched to capacity, inside connection.
From Low Demand to Flexible Demand
Rather than eliminating demands indefinitely, I propose a concept I call Flexible Demand — adjusting expectations to match a child’s current regulation bandwidth.
Within this framework, I conceptualize support in bands — reflecting a child’s regulation bandwidth — rather than fixed, progressive levels.
Children move fluidly between support bands, as internal and external factors continually shift their window of tolerance. This movement is not necessarily regression —it is responsiveness to changing demands and environments.
Band A – Stabilization Mode
Reduce performance pressure. Increase predictability. Simplify tasks.
Band B – Scaffolding Mode
Introduce just-right challenges. Use collaboration. Gently expose to manageable discomfort.
Band C – Expansion Mode
Increase autonomy. Reduce scaffolds. Allow natural consequences with emotional availability.
Movement between bands is expected and healthy.
When Behaviors Feel Severe
It is also important to recognize that not all intense avoidance is purely developmental.
If you notice:
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Sudden regression in skills
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Extended mutism
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Prolonged shutdowns
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Episodes of unresponsiveness
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Self-injury or dangerous aggression
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Abrupt changes in baseline functioning
Medical or mental health evaluation may be appropriate.
Conditions such as seizure disorders, mood disorders, catatonia in autism, or other co-occurring challenges can sometimes present in ways that look like extreme avoidance.
Seeking clarity is not a failure. It is advocacy.
We’re Better Together
There are many conversations happening right now about PDA. Some prioritize nervous system safety. Others emphasize skill-building and graded exposure. Some focus strongly on autonomy. Others on structure.
Underneath the different language and models, most parents and professionals share the same goal:
We want children to feel safe, understood, and to grow into capable, confident humans.
We do not have to choose between compassion and challenge.
We do not have to choose between safety and growth.
These ideas do not compete.
They can work together.
If we stay curious instead of defensive…
If we stay collaborative instead of divided…
If we remember that no parent is trying to harm their child…
Then we are already moving in the right direction.
If this framework resonates with you, I’ve created a more detailed parent guide that expands on these ideas and offers practical examples of using the Flexible Demand model in everyday situations.
If you’d like a copy, feel free to reach out – I’m happy to share it.