Pathological demand avoidance and schooling experiences: A scoping review examining the experiences of children and their families

Pathological Demand Avoidance (PDA) is widely depicted to be a profile that lies within the autistic spectrum; its salient feature being a strong resistance to demands due to heightened anxiety or an intolerance to uncertainty, which arguably creates a significant conflict with a schooling environment. There are also some researchers and academics who argue that there is growing evidence that a PDA profile can be observed outside of the autistic spectrum (Woods, 2022). This scoping review’s objective was to explore the current available research pertaining to PDA and schooling experiences. Thirteen databases including Scopus, PsycInfo, Child Developmental & Adolescent Studies and the Social Science Citation Index were searched, and nine articles were selected for review based on the inclusion criteria. Analysis of the extracted data found three main themes; barriers that exist within the education system, characteristics of the PDA profile that prevent engagement in education and characteristics, approaches and interventions that help to improve schooling experiences. The findings of this review indicate that a substantial number of children and young people who present with the profile are experiencing extreme distress within their schooling environment, which is impacting their ability to learn, and contributing to exclusion and poor mental health. There are major gaps and methodological flaws that exist within the PDA literature; further research is urgently needed to address these and to help advance knowledge of the profile and assist in improving outcomes for this group of children and young people (CYP) within education. Recommendations for support to help these young people have been included.