Originally published in ANM’s Through My Lens LinkedIn newsletter on July 23, 2026. Republished here with the original author attribution.
Original LinkedIn edition: Read the source article on LinkedIn.
Part three of the Through My Lens series on PDA in the African Context
After learning about Pathological Demand Avoidance (PDA), many parents, teachers, and professionals experience a mix of relief and uncertainty.
Relief because certain behaviours suddenly make sense.
Uncertainty because the approaches they have relied on for years may no longer seem effective.
Across Africa, many of us were raised with a simple belief: children should do what they are told. Respect is often demonstrated through obedience. In schools, compliance is frequently rewarded, while refusal is viewed as defiance.
But what happens when a child experiences even ordinary expectations as overwhelming demands?
What happens when traditional discipline strategies make situations worse rather than better?
For many individuals with PDA, this is exactly what happens.
The challenge is not finding better ways to enforce compliance.
The challenge is creating environments where people feel safe enough to participate.
When Control Creates More Anxiety
One of the hardest things to understand about PDA is that the more pressure a person feels, the harder it often becomes for them to engage.
This can be deeply confusing for families and educators.
A child may happily complete a task one day and strongly resist the same task the next.
A student may appear capable, intelligent, and articulate yet become overwhelmed by seemingly simple expectations.
Parents may feel they are being ignored.
Teachers may assume they are being challenged.
But beneath the behaviour is usually something else: anxiety.
For individuals with PDA, demands can trigger a powerful fight, flight, freeze, or fawn response. What looks like refusal may actually be self-protection.
When we interpret these responses as manipulation, laziness, or disrespect, relationships become strained.
When we recognise them as signs of distress, our response changes.
And that change matters.
The Bus Stop
This morning, while running an errand off-site, I felt lazy.
Not the dramatic, life-is-too-hard kind of lazy. Just ordinary, everyday lazy.
I’d popped into a shop and decided that walking all the way back to the office felt like unnecessary effort. It was hot. There was a bus stop ahead that would take me most of the way. It seemed like the sensible option.
As I approached the stop, I noticed how quiet it was for around ten o’clock on a weekday.
As a neurodivergent person, that is good news.
No strangers staring.
No pressure to smile.
No awkward conversations when I have no energy for them.
Then I noticed a mother with two young children. One was in a stroller. The other stood beside her.
I gave a brief nod of acknowledgement and sat at the far end of the bench.
Within a minute, I heard her shout:
“Stop it! Stop it! Don’t hit Mummy!”
I looked away, trying not to intrude, but from the corner of my eye I could see the little boy becoming increasingly distressed.
He lashed out again.
The mother tried to hold herself together before repeating, more loudly this time:
“Stop it! Don’t hit Mummy!”
Two things were happening inside me at once.
First, my sensory overload was rising rapidly.
I experience two layers of sound sensitivity. One comes from Ménière’s disease, and can send me into a vertigo flare-up. The other comes from autism. The shouting was becoming difficult to process, and I was already regretting my decision to take the bus.
Second, my fight-or-flight response had kicked in.
I wanted to leave.
But I also worried that if I got up and walked away, the mother might think I was judging her or avoiding her children.
I did not want to add another layer of discomfort to what was already a difficult moment.
So instead of leaving, I stayed glued to the bench.
Then the second child started hitting her mother too.
At that point, the mother’s composure appeared to give way.
“I can’t do this,” she shouted. “Both of you stop hitting Mummy, you brats!”
Thankfully, the bus arrived.
We all gathered ourselves and got on.
I got off at the next stop.
And yes, by the time I had waited for the bus, boarded it and travelled a single stop, I probably could have walked back to the office, made myself a drink and forgotten the whole thing.
But I didn’t forget it.
Because what stayed with me wasn’t the hitting.
It was the distress.
The children’s distress.
The mother’s distress.
My own distress.
Within minutes, everyone’s overwhelm seemed to be amplifying everyone else’s.
Now, to be clear, I am not telling this story because I know those children had PDA.
I do not.
I witnessed a few minutes of one family’s life at a bus stop.
I cannot confirm why the children were distressed, whether they were neurodivergent, or what had happened before I arrived.
Nor am I telling this story to criticise the mother.
She was being hit by two children in public while trying to manage a pram and get somewhere. She looked exhausted and overwhelmed.
Her distress mattered.
Her physical safety mattered.
Nobody should be expected to tolerate violence in the name of being neuroaffirming.
What stayed with me was how quickly everyone’s distress fed into everyone else’s.
The children became more agitated.
The mother’s responses became louder and more urgent.
The noise overwhelmed me, a stranger sitting several feet away.
Within minutes, everyone’s distress was amplifying everyone else’s.
This is not about a bad parent or badly behaved children.
It was a moment in which everyone was struggling, and nobody felt safe.
And that pattern plays out in homes, schools and workplaces every day.
A child refuses to get dressed.
A learner puts their head on the desk when work begins.
A teenager cannot make themselves walk through the school gate.
The adult increases the pressure.
The child becomes more distressed.
The adult becomes more frustrated.
Soon everybody is fighting, and nobody feels understood.
In the previous article, When “I Can’t” Is Mistaken for “I Won’t”, I explored what happens when limited capacity is interpreted as deliberate defiance.
This time, I want to go a step further.
If increasing control is making the situation worse, what can we do instead?
First, we need some clinical honesty
PDA remains a contested concept. It is not recognised as a standalone diagnosis in either the DSM or the ICD.
Different people use different terms, including PDA profile, demand-avoidant profile and Persistent Drive for Autonomy. There is currently no universally accepted method for identifying it.
A systematic review published in 2026 examined the available evidence and found inconsistent identification methods, substantial overlap with other conditions and significant methodological limitations across the studies reviewed.
That uncertainty matters.
We should not hide it simply because a particular explanation feels useful.
But diagnostic uncertainty does not make a person’s distress imaginary.
The evidence gap should make us more careful with labels, not less responsive to what people are experiencing.
What we describe as demand avoidance may be connected to anxiety, sensory overload, intolerance of uncertainty, trauma, communication differences, pain, bullying, ADHD, learning difficulties or environmental stressors.
Sometimes several of those factors are present at once.
The goal should not be to force every struggling child into a PDA category.
The goal should be understanding the individual well enough to provide meaningful support.
The Shift from Compliance to Collaboration
Many conventional behaviour approaches focus on one question:
“How do we get this child to comply?”
PDA invites us to ask a different question:
“How do we help this person feel safe enough to engage?”
This shift is not about lowering expectations.
It is about understanding that regulation comes before participation.
Connection comes before cooperation.
Trust comes before learning.
For African families, this can feel uncomfortable at first because it challenges cultural assumptions about authority and discipline. Yet supporting autonomy does not mean abandoning boundaries.
It means recognising that genuine participation is far more powerful than forced compliance.
Collaboration is not the absence of boundaries
Whenever collaborative approaches are discussed, somebody eventually asks:
“So, are we just supposed to let children do whatever they want?”
No.
Collaboration does not mean children run the household.
It does not mean abandoning education, safety, health or responsibility.
The outcome may remain the same.
The route changes.
A child may still need to bathe.
Schoolwork may still need attention.
Family responsibilities may still exist.
What changes is the amount of flexibility, choice and shared problem-solving built into the process.
That is not weak parenting.
It is not poor classroom management.
It is an attempt to stop turning every necessary task into an unnecessary battle.
Collaboration looks different across the lifespan
Collaboration is not a single strategy that looks identical at every age.
A five-year-old, a fifteen-year-old and a twenty-five-year-old will need different levels of support, autonomy and responsibility.
A younger child may benefit from simple choices.
An adolescent may need greater involvement in decision-making.
An adult may need workplace accommodations, flexible communication methods or increased control over how tasks are completed.
Before repeating an instruction, pause and ask:
Does this genuinely need to happen?Does it need to happen now?Must it happen in this exact way?Is the person refusing the outcome or the way it is being imposed?What could be making the demand feel unmanageable?Is there a health, sensory, communication or safety issue I have missed?
Some demands are necessary. A child cannot be allowed to run into traffic because autonomy matters.
Somebody who is hitting another person must be stopped as safely as possible.
Medication may need to be taken within a particular period.
Other demands are habits dressed up as rules.
Does the homework have to be completed in one sitting?
Must the learner demonstrate understanding through handwriting?
Does a child have to hug a visiting relative?
Is eye contact really necessary?
Must a bedroom be cleaned immediately, or can the child decide where and when to begin?
We adults do not always like admitting how many of our rules exist because they make us feel in control.
At home: offer control without giving up care
Offer genuine choices
Instead of:
“Go and bathe now.”
Try:
“Would you like to bathe before or after supper?”
Instead of:
“Clean your room.”
Try:
“Would you rather start with the clothes or the books?”
Instead of:
“Do your homework.”
Try:
“Would you like to start on your own or do the first question together?”
The choice must be genuine.
A fake choice is still a command wearing softer clothes.
Sometimes circumstances genuinely cannot change.
Transport is waiting. Water is only available at a certain time. Medication must be taken safely.
In those moments, be honest about what cannot change and offer control somewhere else.
“We need to leave in ten minutes. Would you like to carry your bag or would you like me to carry it?”
Keep choices simple.
Too many choices can become another source of pressure.
Use less confrontational language
Direct commands can make some people feel trapped. Try:
“I wonder what would make this easier.”“Maybe we could start together.”“Your shoes are beside the door.”“The food will be ready in ten minutes.”“Would you like help, or would you prefer some space?”
This will not work every time. Nothing does. The point is not to discover a clever phrase that secretly forces compliance. The point is to reduce pressure and create room for cooperation. Build predictable but flexible routines.
Many autistic and ADHD adults describe growing up in constant conflict over demands that seemed simple to everyone around them but felt overwhelming from the inside. Years later, some still carry the belief that they are lazy, difficult or deliberately uncooperative because those were the explanations repeatedly offered to them.
A collaborative approach is not only about reducing today’s conflict. It may also shape how a person understands themselves for years to come.
Build predictable but flexible routines
Predictability often reduces uncertainty.
Rigidity can become another demand.
Give advance notice where possible.
Use visual schedules, reminders, pictures, written notes or familiar routines.
Allow the child to help shape the process.
When plans change, explain:
What changed?What stayed the same?What happens next?What choices are still available?
Connect before correcting
During moments of significant distress:
Use fewer words.
Lower your voice.
Reduce noise.
Reduce unnecessary attention from others.
Create space where possible.
This is rarely the moment for a lecture.
Reflection and accountability can come later when the person has enough capacity to engage.
Connection before correction does not mean harmful behaviour is ignored.
It means we stop trying to teach during a crisis.
Use humour carefully
Humour, stories, songs and playfulness can reduce pressure.
But humour stops helping when the person feels mocked.
Pay attention to their response.
If it increases distress, stop.
The strategy should serve the person, not the adult’s need to feel clever.
Repair after difficult moments
Adults lose their tempers too.
A parent might say:
“I shouted earlier. I was overwhelmed, and shouting didn’t help. I’m sorry. We still need to find a safe way through this.”
Apologies do not weaken authority.
They model accountability.
Repair creates opportunities to reflect on what happened, what made things worse and what might help next time.
Parents need support too
Collaborative approaches are sometimes discussed as though parents possess unlimited patience, energy and emotional reserves.
They do not.
Many caregivers are managing financial pressure, work responsibilities, family expectations, sleep deprivation and systems that provide very little support.
When parents lose patience, it does not automatically mean they are failing.
Often it means they are exhausted.
Supporting neurodivergent children also means supporting the people caring for them.
Caregivers need rest, understanding and practical support.
We cannot build sustainable care on burnout.
At school: dignity before discipline
Schools are full of demands:
Sit down.
Line up.
Be quiet.
Copy this.
Finish that.
Switch subjects.
Ask permission.
Wait your turn.
For learners who struggle with demands, the school day can feel like one long negotiation with their own capacity.
And that capacity is not fixed.
A learner who manages a task comfortably in the morning may struggle with the same task later in the day if they are tired, anxious, overwhelmed, hungry, unwell or recovering from earlier stress.
Understanding this reality helps move us away from the assumption that yesterday’s success guarantees today’s performance.
Correct privately
Public reprimands add shame and an audience.
Whenever possible, correct privately.
Ask what is wrong before announcing what you think is wrong.
Privacy protects dignity.
Give transitions a runway
Many learners need preparation before transitions.
Provide countdowns, timetables, reminders or familiar signals.
When plans change unexpectedly, explain what is happening rather than assuming the learner is overreacting.
Create safe ways to pause
A regulated space does not require expensive resources.
It might be:
A quiet desk.A library corner.A shaded outdoor area.Time with a trusted adult.A communication card when speaking becomes difficult.
These spaces should support regulation, not function as punishment.
Share control over learning
Learners may be able to choose:
Which task to start first.Whether to answer verbally or in writing.Where to sit.Whether to begin independently or with support.How to request help discreetly.
The question should never be:
“How do we excuse this learner from learning?”
The better question is:
“What is getting between this learner and learning?”
“But our schools do not have those resources”
This objection is real.
Across many parts of Africa, autism-related educational support remains limited. Access to specialist services is often restricted, trained personnel may be scarce, and available research remains heavily concentrated in certain countries, particularly South Africa.
Individualised support can sound impossible in a crowded classroom.
But not every adjustment requires money.
A calm voice costs nothing.
Private correction costs nothing.
Giving transition warnings costs nothing.
Offering two genuine choices costs nothing.
Asking a learner what helps costs nothing.
This does not excuse governments or institutions from properly funding inclusive education. We must continue advocating for trained staff, manageable class sizes, accessible school environments and culturally relevant services.
But while we advocate for those changes, we can still improve some of the interactions happening today.
Respect, culture and the fear of “spoiling” children
Many African families place enormous value on respect, responsibility and community.
Those values do not need to disappear.
A collaborative approach can still teach accountability, contribution and care for others.
What changes is the belief that respect must always look like immediate obedience.
Many parents already feel judged by relatives, neighbours and teachers.
They may worry that accommodations will be interpreted as weakness.
That fear is real.
But I do not believe we must choose between African cultural values and neuroaffirming support.
That is a false choice.
We can preserve community without preserving humiliation.
We can teach responsibility without relying on fear.
We can respect elders while also respecting a child’s dignity, communication and limits.
Respect is often discussed as though it only flows upward from children to adults.
Healthy communities require it to flow both ways.
When adults listen, explain, apologise and respond with curiosity rather than humiliation, they model the very values they hope to teach.
Children learn respect not only from what we demand of them, but from how we treat them.
Perhaps the hardest cultural shift is recognising that adults sometimes need to change first.
For health and education professionals
Do not use a PDA label as the end of an assessment.
Document what is actually happening:
Which demands appear to trigger distress?In which environments?With which people?What happens before, during and after the refusal?What sensory, communication, learning or health factors may be involved?What reduces the person’s distress?What makes it worse?
Avoid describing avoidance as manipulation without examining what the person may be attempting to communicate, escape or regain. Train everybody who regularly interacts with the learner—not only one specialist teacher. A support plan is unlikely to work if one adult uses a collaborative approach while everyone else responds with threats and punishment. Include families, but do not blame them. Most importantly, include the person themselves.
Too often, assessments become conversations about a person rather than conversations with them.
Professionals may gather extensive information from teachers, parents and reports while overlooking the individual who is living the experience.
Even when communication differences are present, people still communicate. The challenge is for professionals to listen carefully enough to recognise how that communication is happening.
Someone who does not communicate through speech may still express preferences through movement, gestures, behaviour, assistive communication or changes in expression and affect. Their voice still counts.
What collaboration does not mean
Collaboration does not mean accepting violence.
It does not mean removing every expectation.
It does not mean ignoring the safety or learning needs of other children.
It does not mean that one script will work for every person.
It means protecting immediate safety while remaining curious about what caused the crisis.
It means recognising that a consequence may stop a behaviour temporarily without addressing the distress underneath it. I
t means asking what we can change before demanding that the neurodivergent person does all the changing.
One practical step this week
Choose one recurring conflict.
Perhaps it involves:
Getting dressed.Leaving for school.Starting homework.Completing chores.Transitioning between activities.
For one week, change one part of the adult response.
Reduce an unnecessary demand.Offer a genuine choice.Give more preparation time.Change the language.Correct privately.Allow a safe pause.Ask what would help.
Then observe.
Not whether it “worked.”
But what changed.
What patterns became visible?
What reduced distress?
What increased it?
What should be tried differently next time?
Back at the bus stop
That brief encounter stayed with me because everyone involved appeared to need something.
The mother needed support, safety and breathing space.
The children appeared overwhelmed, though I cannot know why.
I needed quiet and a way out before my own nervous system shut down.
None of us deserved to be reduced to the most difficult few minutes of that morning.
The bus stop also reminded me of something we often forget:
Distress is contagious.
But so is regulation.
The tone of a classroom, a family interaction or a professional consultation can either increase pressure or reduce it.
None of us can completely control what another person feels.
But we can influence the environment we create around them.
Moving from control to collaboration is not one perfect strategy, parenting style or educational technique.
It is a shift in mindset.
It is the difference between asking:
“How do I make this person do what I need?”
and asking:
“What is making this so hard right now?”
That shift will not solve every problem.
There will still be difficult mornings.
There will still be boundaries.
There will still be mistakes.
Parents, educators and professionals are human too.
But understanding changes the direction of our response.
When we become curious about the distress underneath behaviour rather than fighting the behaviour alone, we create more opportunities for safety, learning and repair.
Sometimes the most powerful intervention is not a new strategy.
Sometimes it is a different way of being with another human being.
Perhaps the most useful question is still the simplest:
What changes when we stop asking, “How do we make them comply?” and start asking, “How do we help them feel safe enough to participate?”
That question does not solve everything.
But it gives us a much better place to begin.
