Pathological Demand Avoidance Test (EDA-Q-24)

Extreme/Pathological demand avoidance test is also available in the following languages:

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Basic information

Statements:24
Duration:5–6 minutes
Type:Self-assessment Questionnaire
Dimensions:Resistance – Reactivity – Control – Anxiety – Social Influence – Imagination
Publishing year:2019
Seminal paper:O’Nions, E., Happé, F., Viding, E. et al. Extreme Demand Avoidance in Children with Autism Spectrum Disorder (EDA-QA) [Research Paper]
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Pathological demand avoidance self-test has been adopted from the Extreme Demand Avoidance Questionnaire’ (EDA-Q) which is the 24 item questionnaire designed to measure behaviours related to Extreme/pathological demand avoidance (PDA). EDA-Q is not designed to make a self-diagnose and this self-assessment questionnaire is NOT a diagnostic test. EDA-24 can help identify patterns of behavior that look like Pathological/Extreme Demand Avoidance traits but remember PDA traits overlap with anxiety, oppositional behavior, and autism features. [1] Extreme demand avoidance in children with autism spectrum disorder: Refinement of a caregiver-report measure. O’Nions, Elizabeth, et al.

PDA was proposed by British psychologist Elizabeth Newson in the 1980s. She found some children showing autism-like features but also showing an unusual pattern of resisting demands. The research by Newson on these autistic children with this type of syndrome gained attention from other psychologists, and the research was expanded by Francesca Happé, Essi Viding, and Liz O’Nions, who developed the EDA-Q to study demand avoidance traits. The EDA-Q is a parental questionnaire in which parents observe their children for signs of extreme demand avoidance syndrome. In modern times, a need for a self-report screening tool for EDA has been observed, so the EDA-24 was developed, and it is designed to look for EDA traits on the spectrum.

Six Dimensions of EDA

People with Pathological Demand Avoidance (PDA) often show their difficulties through different patterns of behavior. The EDA-24 groups these into six main areas, which help us understand how and why a person avoids everyday demands.

Resistance means not wanting to do things when asked. A child may say “no,” ignore instructions, or try to get out of a task. This is not just stubbornness but often linked to feeling pressured or anxious.

Reactivity describes strong or extreme reactions when demands are placed. Instead of calmly saying no, a child may shout, run away, or become very upset. These responses happen quickly and can seem “bigger” than the situation.

Control refers to the child’s strong need to be in charge. They may want to decide what games to play, make rules for others, or refuse to follow directions unless it is their choice.

Anxiety is often at the root of demand avoidance. Children may worry, feel panicked, or become distressed when told to do something. Their avoidance is often driven more by fear than by simple defiance.

Social Influence is how children use social strategies to avoid demands. They may distract, joke, negotiate, or pretend not to hear. Sometimes, they even use role-play or pretend characters to escape pressure.

Imagination highlights how creative or pretend play can be used as an avoidance tool. A child may say, “I can’t do this because I’m a superhero today,” using imagination to delay or refuse tasks.

PDA-24 Score Interpretation

Score RangeLevelInterpretation
0 – 4 (per trait)LowMinimal signs of demand avoidance in this area.
5 – 8 (per trait)ModerateSome traits of demand avoidance are present, but not consistent.
9 – 12 (per trait)HighStrong expression of avoidance behaviors, clear patterns in daily life.
13 – 16 (per trait)Very HighIntense or pervasive avoidance, demands often trigger resistance.
0 – 32 (overall)Low PDA likelihoodUnlikely to show a persistent PDA profile.
33 – 64 (overall)Moderate PDA likelihoodSome PDA traits may be present and noticeable in daily life.
65 – 96 (overall)High PDA likelihoodStrong PDA profile; demand avoidance likely to impact functioning significantly.

Trait-Specific Interpretations

TraitWhat a High Score Suggests
ResistanceAvoids direct demands, frequent refusal, or use of avoidance strategies.
ReactivityEmotional volatility; quick, intense responses to stress or frustration.
ControlStrong need to be in charge; struggles when others make decisions.
AnxietyUnderlying worries drive avoidance; demands may trigger fear or overwhelm.
Social InfluencePersuasion, distraction, or charm used to manage pressure.
ImaginationFantasy, role-play, or creativity used to escape demands.

References

  1. O’Nions, Elizabeth, et al. “Extreme demand avoidance in children with autism spectrum disorder: Refinement of a caregiver-report measure.” Advances in Neurodevelopmental Disorders 5.3 (2021): 269-281. DOI: https://doi.org/10.1007/s41252-021-00203-z