Pathological demand avoidance: What and who are being pathologised and in whose interests?

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

About the autistic author marker

Metadata sources used for this reference

OpenAlex Crossref BibTeX OpenCitations
Learn more about the sources used

Moore, A. (2020). Pathological demand avoidance: What and who are being pathologised and in whose interests? Global Studies of Childhood, 10(1), 39-52. https://doi.org/10.1177/2043610619890070

Publication date: 28 Feb 2020 Added to AutiHub: 4 Oct 2026 Type: Article Article language: English
Publisher source (DOI) OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
1
Publication authors identified as autistic
1 / 1 (100.0%)
  1. Allison Moore *

Abstract

The term ‘pathological demand avoidance’ was first coined in 1983. In recent years, diagnostic tools have emerged to enable practitioners to identify, name and treat pathological demand avoidance and, at least in the United Kingdom, there is an increasing number of children who attract this label. In addition to what are defined as the core ‘deficits’ of autism, including assumed difficulties in social communication, difficulties in social interaction and restrictive interests, children with pathological demand avoidance are thought to have an extreme anxiety-driven need to control their environment and control the demands and expectations of others. This article will argue that we must exercise extreme caution in accepting the validity of pathological demand avoidance and will suggest that it can be seen as an attempt to psychiatarise autistic children’s resistance, which, in so doing, restricts their agency. First, it will draw on the arguments put forward by some autistic scholars who have claimed that pathological demand avoidance is better understood as rational demand avoidance – an understandable and rational response to the circumstances that one finds oneself in. Second, it will consider the intersection between autism and childhood. When one of the defining characteristics of pathological demand avoidance is an inability to recognise and, presumably, respect social hierarchy, children’s competencies as social actors and active meaning makers of their world can easily become pathologised as defiance. Finally, the article will address the intersections of autism, childhood and gender. Girls are much less likely to be diagnosed as having an autism spectrum condition than boys are, with a ratio traditionally estimated at approximately 1:4. However, pathological demand avoidance diagnoses are fairly evenly spread between boys and girls. It will be argued that it is girls’ resistance to the ordinary and everyday demands of her as a girl and her subsequent rejection or transgression of those expectations that is being pathologised.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 17 Oct 2026 01:28.

Cited references
69
With a DOI
44
Without a DOI, from raw bibliography text
24
9 / 69 (13.0%) cited references include at least one author identified as autistic.
References with data to complete
10 / 69 (14.5%)
References with detected author names
61 / 69 (88.4%)
Without detected author names
8
Without a structured title
9
Without a stable identifier
22
References with raw author names still to review
7
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
93
From DOI or external metadata
93
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
8
27 / 93 (29.0%) names are linked to an author already present in AutiHub. 66 / 93 (71.0%) names are not yet linked.
Names linked to a person identified as autistic
12 / 93 (12.9%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 12 / 27 (44.4%). Distinct people identified as autistic: 6 / 76 (7.9%).
  1. Naima Browne (2004). Gender Equity in the Early Years . Gender Equity in the Early Years.
    Type: Article OpenAlex: https://openalex.org/W49773809
    Crossref OpenAlex
  2. O Bogdashina (2013). Sensory theory in autism makes sense: A brief review of the past and present research . OA Autism, 1(1). Open Access Publishing London.
    Type: Article DOI: 10.13172/2052-7810-1-1-391 OpenAlex: https://openalex.org/W2314308466
    Crossref OpenAlex OpenCitations
  3. Margaret F. Gibson , Patty Douglas (2018). Disturbing Behaviours: Ole Ivar Lovaas and the Queer History of Autism Science . Catalyst: Feminism, Theory, Technoscience, 4(2), 1-28. University of Toronto Libraries - UOTL.
    Type: Article DOI: 10.28968/cftt.v4i2.29579 OpenAlex: https://openalex.org/W2897631587
    Crossref OpenAlex OpenCitations
  4. Martyn Hammersley , Peter Woods (1976). The process of schooling: A sociological reader .
    Type: Book OpenAlex: https://openalex.org/W145315925
    OpenAlex
  5. Jeroen Dewinter , H. De Graaf , Sander Begeer (2017). Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 47(9), 2927-2934. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3199-9 OpenAlex: https://openalex.org/W2624183778
    Crossref OpenAlex OpenCitations
  6. Carrie Paechter (2007). Being Boys, Being Girls: Learning Masculinities and Femininities .
    Type: Book OpenAlex: https://openalex.org/W165731900
    Crossref OpenAlex
  7. Kristin Bumiller (2008). Quirky Citizens: Autism, Gender, and Reimagining Disability . Signs: Journal of Women in Culture and Society, 33(4), 967-991. University of Chicago Press.
    Type: Article DOI: 10.1086/528848 OpenAlex: https://openalex.org/W1971010661
    Crossref OpenAlex OpenCitations
  8. Laura Pecora , Gary B. Mesibov , Mark A Stokes (2016). Sexuality in High-Functioning Autism: A Systematic Review and Meta-analysis . Journal of Autism and Developmental Disorders, 46(11), 3519-3556. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-016-2892-4 OpenAlex: https://openalex.org/W2509103032
    Crossref OpenAlex OpenCitations
  9. Elizabeth O'Nions , Judith Gould , Phil Christie , Christopher Gillberg , Essi Viding , Francesca Happé (2016). Identifying features of ‘pathological demand avoidance’ using the Diagnostic Interview for Social and Communication Disorders (DISCO) . European Child & Adolescent Psychiatry, 25(4), 407-419. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s00787-015-0740-2 OpenAlex: https://openalex.org/W1033651084
    Crossref OpenAlex OpenCitations
  10. Erica Burman (1994). Development Phallacies: Psychology, Gender and Childhood . Agenda, (22), 11. JSTOR.
    Type: Article DOI: 10.2307/4065729 OpenAlex: https://openalex.org/W4248140268
    Crossref OpenAlex OpenCitations
  11. Stuart Murray (2009). Autism Functions/The Function of Autism . Disability Studies Quarterly, 30(1). The Ohio State University Libraries.
    Type: Article DOI: 10.18061/dsq.v30i1.1048 OpenAlex: https://openalex.org/W1506834147
    Crossref OpenAlex OpenCitations
  12. Erica Burman (2016). Deconstructing developmental psychology . Routledge.
    Type: Book DOI: 10.4324/9781315727127 OpenAlex: https://openalex.org/W3020950746
    Crossref OpenAlex
  13. Emma Renold (2004). Girls, Boys and Junior Sexualities . Routledge.
    Type: Book DOI: 10.4324/9780203561584 OpenAlex: https://openalex.org/W4235486895
    Crossref OpenAlex OpenCitations
  14. Neil Thompson (2006). Anti-Discriminatory Practice . Macmillan Education UK.
    Type: Book DOI: 10.1007/978-1-137-28531-7 OpenAlex: https://openalex.org/W1534168633
    Crossref OpenAlex OpenCitations
  15. Butler J (1990). Gender Trouble Feminism and the Subversion of Identity . Gender Trouble Feminism and the Subversion of Identity.
    Type: Other
    Crossref
  16. Kirsi Pauliina Kallio (2007). Performative Bodies, Tactical Agents and Political Selves: Rethinking the Political Geographies of Childhood . Space and Polity, 11(2), 121-136. Informa UK Limited.
    Type: Article DOI: 10.1080/13562570701721990 OpenAlex: https://openalex.org/W1971609662
    Crossref OpenAlex OpenCitations
  17. Walkerdine V (1988). The Mastery of Reason: Cognitive Development and the Production of Rationality . Choice Reviews Online, 26(04), 26-2250-26-2250. American Library Association.
    Type: Article DOI: 10.5860/choice.26-2250 OpenAlex: https://openalex.org/W1601477150
    Crossref OpenAlex
  18. Butler J (1993). Bodies That Matter: On the Discursive Limits of Sex . Bodies That Matter: On the Discursive Limits of Sex.
    Type: Other
    Crossref
  19. E Newson (2003). Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders . Archives of Disease in Childhood, 88(7), 595-600. BMJ.
    Type: Article DOI: 10.1136/adc.88.7.595 OpenAlex: https://openalex.org/W2162548254
    Crossref OpenAlex OpenCitations
  21. Christie P (2007) The distinctive clinical and educational needs of children with pathological demand avoidance syndrome: Guidelines for good practice (Originally published in Good Autism Practice). Available at: http://www.aettraininghubs.org.uk/wp-content/uploads/2012/05/5 . 2-strategies-forteaching-pupils-with-PDA.pdf (accessed 16 July 2019).
    Type: Other
    Crossref
  22. Sally Hester , Allison Moore * (2018). Understanding Children’s Participation through an Eliasian Lens: Habitus as a Barrier to Children’s Everyday Participation Rights . The International Journal of Children’s Rights, 26(3), 446-467. Walter de Gruyter GmbH.
    Type: Article DOI: 10.1163/15718182-02603002 OpenAlex: https://openalex.org/W2804926261
    Crossref OpenAlex OpenCitations
  23. J Davidson (2013). Worlds of Autism . University of Minnesota Press.
    Type: Book DOI: 10.5749/minnesota/9780816688883.001.0001 OpenAlex: https://openalex.org/W2478659999
    Crossref OpenAlex OpenCitations
  24. De Certeau M (1984). The Practice of Everyday Life . The Practice of Everyday Life.
    Type: Other
    Crossref
  25. Carol Lynn Martin , Diane Ruble (2004). Children's Search for Gender Cues . Current Directions in Psychological Science, 13(2), 67-70. SAGE Publications.
    Type: Article DOI: 10.1111/j.0963-7214.2004.00276.x OpenAlex: https://openalex.org/W2139536488
    Crossref OpenAlex OpenCitations
  26. F. Nowell Jones , B. F. Skinner (1939). The Behavior of Organisms: An Experimental Analysis . The American Journal of Psychology, 52(4), 659. University of Illinois Press.
    Type: Article DOI: 10.2307/1416495 OpenAlex: https://openalex.org/W1996847178
    OpenAlex
  27. CHINA MILLS , BRENDA A. LEFRANÇOIS (2018). Child As Metaphor: Colonialism, Psy-Governance, and Epistemicide . World Futures, 74(7-8), 503-524. Informa UK Limited.
    Type: Article DOI: 10.1080/02604027.2018.1485438 OpenAlex: https://openalex.org/W2905540795
    Crossref OpenAlex OpenCitations
  28. R. Danielle Egan , Gail Hawkes (2009). The problem with protection: Or, why we need to move towards recognition and the sexual agency of children . Continuum, 23(3), 389-400. Informa UK Limited.
    Type: Article DOI: 10.1080/10304310902842975 OpenAlex: https://openalex.org/W2023179962
    Crossref OpenAlex OpenCitations
  29. Jeroen Dewinter , Robert Vermeiren , Ine Vanwesenbeeck , Chijs van Nieuwenhuizen (2013). Autism and normative sexual development: a narrative review . Journal of Clinical Nursing, 22(23-24), 3467-3483. Wiley.
    Type: Article DOI: 10.1111/jocn.12397 OpenAlex: https://openalex.org/W2108090608
    Crossref OpenAlex OpenCitations
  30. Sally Hester , Allison Moore * (2016). Reflections from the classroom: Towards a radical pedagogy for early years practitioners . Global Studies of Childhood, 6(1), 155-166. SAGE Publications.
    Type: Article DOI: 10.1177/2043610615627924 OpenAlex: https://openalex.org/W2305858072
    Crossref OpenAlex OpenCitations
  31. Mary McIntosh , Judith Butler (1991). Gender Trouble: Feminism and the Subversion of Identity . Feminist Review, (38), 113. JSTOR.
    Type: Article DOI: 10.2307/1395391 OpenAlex: https://openalex.org/W2038600245
    OpenAlex
  32. Mitzi Waltz (2014). Worlds of autism: across the spectrum of neurological difference . Disability & Society, 29(8), 1337-1338. Informa UK Limited.
    Type: Article DOI: 10.1080/09687599.2014.934064 OpenAlex: https://openalex.org/W2047908406
    Crossref OpenAlex OpenCitations
  33. Ruth Fidler (2019). Girls who ‘can’t help won’t’ . In Girls and Autism (pp. 93-102). Routledge.
    Type: Book chapter DOI: 10.4324/9781351234429-12 OpenAlex: https://openalex.org/W2939709912
    Crossref OpenAlex OpenCitations
  34. Rosemarie Garland-Thomson (2014). Disability and social theory: new developments and directions . Disability & Society, 29(4), 664-666. Informa UK Limited.
    Type: Article DOI: 10.1080/09687599.2013.875260 OpenAlex: https://openalex.org/W2076246851
    OpenAlex
  35. Flackhill C (2017). bibr15-2043610619890070 Good Autism Practice, 18(1), 62.
    Type: Other
    Crossref
  36. Jordynn Jack (2012). Gender Copia: Feminist Rhetorical Perspectives on an Autistic Concept of Sex/Gender . Women's Studies in Communication, 35(1), 1-17. Informa UK Limited.
    Type: Article DOI: 10.1080/07491409.2012.667519 OpenAlex: https://openalex.org/W2094406607
    Crossref OpenAlex OpenCitations
  37. Foucault M (1977). Discipline and Punish . Discipline and Punish.
    Type: Other
    Crossref
  38. Kirsi Pauliina Kallio (2008). The body as a battlefield: approaching children's politics . Geografiska Annaler: Series B, Human Geography, 90(3), 285-297. Informa UK Limited.
    Type: Article DOI: 10.1111/j.1468-0467.2008.293.x OpenAlex: https://openalex.org/W2151916696
    Crossref OpenAlex OpenCitations
  39. Rua M. Williams * (2018). Autonomously Autistic . Canadian Journal of Disability Studies, 7(2), 60-82. University of Waterloo.
    Type: Article DOI: 10.15353/cjds.v7i2.423 OpenAlex: https://openalex.org/W3146972156
    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
  41. Julia Gruson-Wood (2016). Autism, Expert Discourses, and Subjectification: A Critical Examination of Applied Behavioural Therapies . Studies in Social Justice, 10(1), 38-58. Brock University Library.
    Type: Article DOI: 10.26522/ssj.v10i1.1331 OpenAlex: https://openalex.org/W2523317672
    Crossref OpenAlex OpenCitations
  42. Ian Hacking (2009). Autistic autobiography . Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1522), 1467-1473. The Royal Society.
    Type: Article DOI: 10.1098/rstb.2008.0329 OpenAlex: https://openalex.org/W4244526978
    Crossref OpenAlex OpenCitations
  45. Chris Jenks (1996). Childhood . Routledge.
    Type: Book DOI: 10.4324/9780203129241 OpenAlex: https://openalex.org/W4249670341
    Crossref OpenAlex OpenCitations
  46. Elizabeth O'Nions , Essi Viding , Caroline Floyd , Emma Quinlan , Connie Pidgeon , Judith Gould et al. (2018). Dimensions of difficulty in children reported to have an autism spectrum diagnosis and features of extreme/‘pathological’ demand avoidance . Child and Adolescent Mental Health, 23(3), 220-227. Wiley.
    Type: Article DOI: 10.1111/camh.12242 OpenAlex: https://openalex.org/W2761580303
    Crossref OpenAlex OpenCitations
  48. Milton D (2013) ‘Natures answer to over-conformity’: Deconstructing pathological demand avoidance. Autism Experts. Available at: https://kar.kent.ac.uk/62694/431/Natures%20answer%20to%20over%20conformity.pdf (accessed 15 July 2019).
    Type: Other
    Crossref
  49. John B. Watson (1913). Psychology as the behaviorist views it. Psychological Review, 20(2), 158-177. American Psychological Association (APA).
    Type: Article DOI: 10.1037/h0074428 OpenAlex: https://openalex.org/W4213283813
    Crossref OpenAlex OpenCitations
  50. Milton D (2018a) Pathological Demand Avoidance (PDA) and alternative explanations: A critical overview (Conference Paper). Available at: https://kar.kent.ac.uk/67064/1/PDA%20and%20alternative%20explanations.pdf (accessed 15 July 2019).
    Type: Other
    Crossref
  51. Amanda Ptolomey (2018). The Palgrave handbook of disabled children’s childhood studies . Disability & Society, 33(7), 1177-1179. Informa UK Limited.
    Type: Article DOI: 10.1080/09687599.2018.1471813 OpenAlex: https://openalex.org/W2804814912
    OpenAlex
  52. Milton D (2018b) The double empathy problem. Available at: https://network.autism.org.uk/knowledge/insight-opinion/double-empathy-problem (accessed 12 July 2019).
    Type: Other
    Crossref
  53. Milton D (2013). bibr33-2043610619890070 Medical Sociology Online, 7(2), 61.
    Type: Other
    Crossref
  54. Milton D, Moon L (2012) The normalisation agenda and the psycho-emotional disablement of autistic people. Autonomy: The Critical Journal of Interdisciplinary Autism Studies 1(1). Available at: https://kar.kent.ac.uk/62638/1/Normalisation%20agenda.pdf (accessed 15 July 2019).
    Type: Other
    Crossref
  55. Larry R. Arnold * (2020). Autonomy, the Critical Journal of Interdisciplinary Autism Studies . In Autistic community and the Neurodiversity movement (pp. 211-220). Springer Singapore.
    Type: Book chapter DOI: 10.1007/978-981-13-8437-0_15 OpenAlex: https://openalex.org/W2983661291
    AutiHub · Autistic Autism Scholarship Project OpenAlex
  56. Lindsay O’Dell (2018). Different Childhoods Non/Normative Development and Transgressive Trajectories . Different Childhoods Non/Normative Development and Transgressive Trajectories.
    Type: Other
    Crossref
  57. (2018). THE PRACTICE OF EVERYDAY LIFE . In Collected Fictions (pp. 469-471). OR Books.
    Type: Book chapter DOI: 10.2307/j.ctt1bkm5kc.100 OpenAlex: https://openalex.org/W4234233476
    OpenAlex
  58. PDA Society (2016) Pathological demand avoidance syndrome: A reference booklet for health, education and social care practitioners. Available at: https://www.pdasociety.org.uk/professionals/awareness-matters-booklet (accessed 16 July 2019).
    Type: Other
    Crossref
  59. Rose N (1998). Inventing Our Selves: Psychology, Power and Personhood . Inventing Our Selves: Psychology, Power and Personhood.
    Type: Other
    Crossref
  60. Runswick-Cole K (2014). Disability and Social Theory New Developments and Directions . Disability and Social Theory New Developments and Directions, 33.
    Type: Other
    Crossref
  61. Jonathan Simon , Nikolas Rose (1998). Inventing Ourselves: Psychology, Power, and Personhood . Contemporary Sociology, 27(3), 267. SAGE Publications.
    Type: Article DOI: 10.2307/2655187 OpenAlex: https://openalex.org/W4250563439
    OpenAlex
  62. Runswick-Cole K (2017). The Palgrave Handbook of Disabled Children’s Childhood Studies . The Palgrave Handbook of Disabled Children’s Childhood Studies.
    Type: Other
    Crossref
  63. Bryan S. Turner , Judith Butler (1995). Bodies That Matter: On the Discursive Limits of "Sex". Contemporary Sociology, 24(3), 331. SAGE Publications.
    Type: Article DOI: 10.2307/2076481 OpenAlex: https://openalex.org/W4253106724
    OpenAlex
  64. Runswick-Cole K (2016). Re-Thinking Autism: Diagnosis Identity and Equality . Re-Thinking Autism: Diagnosis Identity and Equality.
    Type: Other
    Crossref
  65. Skinner BF (1991). The Behavior of Organisms: An Experimental Analysis . The Behavior of Organisms: An Experimental Analysis.
    Type: Other
    Crossref
  66. Speier M (1976). The Process of Schooling: A Sociological Reader . The Process of Schooling: A Sociological Reader, 98.
    Type: Other
    Crossref
  67. Thompson H (2019). The PDA Paradox: The Highs and Lows of Life on a Little-Known Part of the Autism Spectrum . The PDA Paradox: The Highs and Lows of Life on a Little-Known Part of the Autism Spectrum.
    Type: Other
    Crossref
  68. Waksler FC (1991). Studying the Social Worlds of Children: Sociological Readings . Studying the Social Worlds of Children: Sociological Readings.
    Type: Other
    Crossref
  69. Woods R (2018) Rational (pathological) demand avoidance: What it is not, what it could be and what it does (Conference Paper). Available at: http://shura.shu.ac.uk/21414/ (accessed 16 July 2019).
    Type: Other
    Crossref