Originally published in ANM’s Through My Lens LinkedIn newsletter on July 14, 2026. Republished here with the original author attribution.
Original LinkedIn edition: Read the source article on LinkedIn.
Following my recent article about my personal journey, many people reached out to thank me for putting words to experiences they had never been able to explain.
One subject that came up again and again was PDA.
Because understanding of PDA is still evolving, it is worth exploring it with both openness and care.
PDA is usually short for Pathological Demand Avoidance, a term associated with work by British psychologist Elizabeth Newson and colleagues. Some neurodivergent people, as do I, prefer the term Persistent Drive for Autonomy, because it focuses less on pathology and more on the underlying experience: an intense need to maintain a sense of control when demands feel overwhelming.
The language matters. Words shape understanding.
For some people, the issue is not simply avoiding demands. It is that everyday expectations—whether they come from another person or from within—can trigger a powerful stress response.
A demand might be:
A direct demand, such as “get dressed” An internal demand, such as bodily needs, hunger or needing the toilet, or An indirect or implied demand, including expectations such as replying to a message, attending work, starting a task, or even doing something the person genuinely wants to do.
From the outside, this can be confusing.
“Why won’t they just do it?”
“They are clearly capable.”
“They did it yesterday.”
“They are choosing not to.”
But capability and capacity are not always the same.
A person may have the skills to complete a task and still struggle to access those skills during periods of overwhelm or heightened stress. That is not necessarily about intelligence, motivation or character. It may be about stress, anxiety, sensory overload, executive-function difficulties, or the way a nervous system responds to a perceived loss of control.
This is why it is so important not to treat every form of avoidance as defiance.
Forms of resistance include:
giving excuses distraction or diversion: such as making a jokepoint blank refusal: saying “No” and not negotiating at allpassivity/withdrawal: curling up into a ball, shutting down, walking/running away aggression: usually used as a last resort, such as pushing someone or throwing something away, hitting or kicking, biting.
PDA Is Still Debated
PDA is not a standalone diagnosis in major diagnostic manuals such as the DSM-5 or ICD-11. Researchers and clinicians continue to debate whether it is a distinct profile, part of autism for some people, or better explained through overlapping experiences such as anxiety, trauma, ADHD, autism and demand avoidance more generally.
The evidence base is still limited and is concentrated largely in the United Kingdom. A systematic review found major differences in how PDA is defined and identified across studies. That uncertainty matters. It means we should be cautious about presenting PDA as a settled diagnosis or assuming that one explanation fits everyone.
Systematic review:https://doi.org/10.1177/13623613211034382
But uncertainty should not stop us from listening.
When people describe a repeated pattern of panic, shutdown, avoidance or burnout in response to demands, their experience deserves compassion and curiosity—not judgement.
Why Women May Be Overlooked
For many adults—particularly women—these experiences can remain hidden for decades.
Girls are often socialised to be polite, compliant and accommodating. Many become highly skilled at masking: watching others, copying expected behaviour and suppressing their own distress to fit in.
This can mean a woman appears to be coping while privately experiencing anxiety, exhaustion or burnout. Instead of recognising possible neurodivergence, people may describe her as perfectionistic, disorganised, overly sensitive, anxious, difficult, or simply “not coping.”
A useful distinction is this: someone can look successful and still be struggling enormously to meet the demands that success requires.
What Do We Know About PDA in African Contexts?
The honest answer is: very little direct research exists.
Most published PDA research comes from the United Kingdom, with a smaller body of work from Europe, North America and Australia. At present, there appears to be no substantial peer-reviewed research specifically examining:
PDA prevalence in African populationsPDA experiences in African schoolsCultural understandings of demand avoidance across African communitiesValidation of PDA assessment tools in African settingsOutcomes of PDA-informed support in African countries
The absence of evidence does not mean that demand-related distress or avoidance does not exist in African contexts.
It means that researchers have not yet established how common these experiences are, how they are understood across different cultural settings, or whether existing PDA frameworks accurately capture them.
There is growing research on autism across African countries, but it has tended to focus on identification, access to diagnosis and support, family experiences, stigma, cultural beliefs and educational inclusion. Reviews consistently point to uneven research coverage, limited specialist services and the need for culturally appropriate tools and support.
Review of autism research in Africa: https://pmc.ncbi.nlm.nih.gov/articles/PMC10473371/
Why an African Perspective Matters
Africa is not one culture, one health system or one experience. Any discussion must recognise the enormous differences between countries, communities, languages and family structures.
Still, many African communities place a high value on respect for elders, communal responsibility, cooperation and contribution to family life. These values can be sources of belonging and support. But they may also make anxiety-driven avoidance easier to misread.
A child or adult who struggles with demands may be seen as disrespectful, lazy, stubborn, spoiled or badly parented. A woman who cannot sustain the expectations placed on her may be judged rather than supported.
That raises important questions:
How is demand-related distress interpreted when compliance is strongly expected?How do families distinguish distress from disrespect?How do extended-family structures shape support or misunderstanding?Which approaches are culturally acceptable, affordable and effective?How can schools and health professionals respond without importing models that do not fit local realities?
These questions deserve African-led research, African voices and African solutions.
Understanding Before Labels
At the African Neurodiversity Movement, the goal is not to put people into boxes or encourage self-labelling without reflection.
The goal is understanding.
Sometimes a diagnosis can offer clarity and access to support. Sometimes a person may not have access to a formal assessment, or may find that existing labels do not fully describe their experience. Either way, people deserve to be met with dignity.
Instead of asking, “Why won’t they just do it?”, we might ask:
“What is making this feel impossible right now?”
“What would help this feel safer or more manageable?”
“How can we offer support without taking away dignity and autonomy?”
Those questions can change the conversation—and, sometimes, a person’s life.
Understanding does not require certainty. Sometimes it begins with listening.
