It starts with small things.

“Get dressed, please.”
“In five more minutes we’re leaving.”
“Just turn off the screen.”

Not a big demand. Not a shout. Sometimes even with a smile. And then — something happens. An outburst. Crying. Absolute refusal. Running away. Freezing. Or an exhausting argument that feels like a battle with no end.

This experience — where every request, even the smallest one, triggers a big and disproportionate reaction — is a very lonely experience. Parents start walking on eggshells, weighing every word. Postponing requests. Avoiding asking for simple things, just to avoid igniting another round. And within all of this, a painful question also sneaks in:

What are we doing wrong?

Most parents who reach this stage have already tried almost everything: Parental guidance, clear boundaries, consistency, reinforcements, charts, talks and explanations. Sometimes tightening, sometimes softening. And still — the situation continues to worsen.

And this is a particularly hard moment. Because when effort doesn’t work, we start doubting ourselves and our parenting skills, and sometimes even believing that maybe the child is simply “doing it on purpose.”

Most of the parenting we know is based on clear principles: Boundaries, authority, reinforcements, and consistency. And these principles really do work — for a great many children.

But there are children for whom these tools, precisely because they are so clear and structured, increase distress. Not because they are difficult. Not because the parents aren’t good. But because their nervous system responds differently.

When we operate with a map that doesn’t fit the terrain — even devoted, caring parents can get lost. And this is exactly where the possibility opens to understand the difficulty from another angle: Not through the question of what the child is doing, but through what is happening to them.

There are children for whom the very fact that something is expected of them — anything — triggers internal distress. It can be something they don’t like, and it can also be something they themselves asked for. Their system does not distinguish between a “big” demand and a small one, between coercion and good intention. It identifies an expectation — and translates it into a threat.

What Is Pathological Demand Avoidance (PDA)?

When this threat is activated, we see reactions that look like refusal, resistance, escape, outbursts, or freezing. But beneath the surface — this is not a choice. It is a response of an overwhelmed nervous system trying to protect itself.

This pattern is now known as Pathological Demand Avoidance (PDA). It is not an official diagnosis, and you will not find it written in reports in Israel, but it is a profile that is being described more and more in the U.S. and Europe, mainly within the autistic spectrum.

The core of PDA is deep anxiety related to a sense of control. Not a desire to control others, but a need to hold control in order not to fall apart. In such children, even an open question, even a choice, and even a gentle request — can feel like an unbearably heavy demand.

In everyday life this can be expressed in an automatic “no,” in outbursts before leaving the house, in collapse דווקא during favorite activities, in many arguments and endless negotiation through words.

And when we respond to such a child as if he is trying to “defeat us,” we miss the fact that he is trying not to fall apart
And when we respond to such a child as if he is trying to “defeat us,” we miss the fact that he is trying not to fall apart (credit: SHUTTERSTOCK)

When the Ability Exists — but Is Not Accessible

Sometimes this happens mainly at home and less outside. And then the environment says: “But he can.”

And the truth is that outside, the child holds himself together. Makes an effort. Contracts. And at home — the safe place — he collapses.

This gap, between ability and functioning, is one of the most confusing things. The child is smart, verbal, understands situations and explanations — and then cannot manage to carry out a simple action.

And here the painful mistake is born: If he understands — then he is choosing not to. But in reality, the ability exists. Access to it — does not. When the nervous system is flooded, even high abilities are simply unavailable.

Why the Usual Tools Don’t Work — and What Does

At this stage, many children are labeled as “oppositional” or diagnosed with ODD (Oppositional Defiant Disorder). But despite the external similarity, the mechanism is completely different.

In ODD there is a struggle with authority.
In PDA there is a struggle with the demand itself.

And when we respond to such a child as if he is trying to “defeat us,” we miss the fact that he is trying not to fall apart.

The central principle: Regulation before functioning. Less load. Less pressure. Less measurement. More sense of control and safety.

Language that lowers threat (“maybe…”, “I wonder if…”, “let’s check”), use of play and imagination, genuine sharing of control, small and non-overwhelming choices — all of these allow the system to calm down, and then space opens up for cooperation.

This does not mean there are no boundaries. It means that boundaries do not pass through force. A calm, consistent boundary that does not enter into a struggle — can actually create safety.

So what do you do in real life? Because life is not sterile. There are showers, there are doctors, there are frameworks. The demands don’t disappear — but the path to them changes. We reduce load around the demand, choose one battle, don’t fight over everything, and try not to escalate.

Precisely children who receive adjustment now develop more flexibility and resilience later on. A child who feels safe — can learn to cope with demands. A child who feels threatened — learns only how to avoid them.

And the next time even a small request meets a wall of resistance, maybe it’s worth stopping and asking: Not what needs to be fixed — but what here feels too threatening.

This is not a promise of quiet, and not a magic solution. But it is another way to live daily life — with less struggle and burnout, and more moments in which it’s possible to simply be a family.

Libi Bagno-Simon, behavior analyst and treatment coordinator at “Tipuli” — the Child Development Company. Want to participate in a webinar on the topic? Register here