Demand Avoidance ADHD: A Practical Guide for Australians

What demand avoidance ADHD means

The phrase is used when a child or adult with ADHD seems to refuse ordinary requests, such as getting dressed, starting homework or leaving the house.

• A description, not a diagnosis: naming the pattern can help you describe it to a GP, but a qualified professional assesses what is going on.
• More than one possible explanation: a clinician considers ADHD itself and any co-occurring conditions, such as autism, anxiety or ODD.
• Look at the whole picture: an ADHD diagnosis needs symptoms causing impairment in at least two settings, so note where and when the avoidance happens.

PDA and ADHD: how they are linked

PDA is discussed mainly in relation to autism, and autism often occurs alongside ADHD.

• The Australian ADHD Guideline states that among people with ADHD, autism spectrum disorder co-occurs in 20–50% of cases (AADPA).
• PDA is not listed as a separate diagnosis in the DSM-5, so ask the assessor to explain any term used in a report.
• A specialist can help work out which explanations fit a particular person.
• Our guide to ADHD vs autism spectrum disorder sets out where the two overlap and where they differ.

PDA ADHD meaning: terms explained

The vocabulary around this topic is confusing, so here is a plain-language guide to the terms you will hear.

ADHD and ODD: what is the difference

ADHD and ODD can both involve conflict at home and school, yet they are different conditions, each with its own assessment.

• ADHD involves patterns of inattention and hyperactivity-impulsivity; under DSM-5 there are 9 inattentive and 9 hyperactive-impulsive symptoms.
• ODD involves a persistent pattern of angry, argumentative or defiant behaviour toward authority, and it is assessed separately.
• Both together: a person can have ADHD, ODD, both or neither, and only a qualified clinician can assess which applies.
• Support for each: a clinician plans support for each condition that is present.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

ADHD and ODD in children: symptoms and signs

Signs of ADHD and ODD can look similar from the outside, so a list of behaviours cannot tell you which condition, if any, is present. Only a qualified professional can assess whether a child has ADHD, ODD, both or neither.

For ADHD, the AADPA diagnosis checklist asks for evidence of symptoms before age 12, symptoms present for at least 6 months, and impairment in at least two settings such as home, school, work or community (AADPA). For children, 6 of the 9 symptoms in a group must be present to reach the diagnostic threshold.

• Write down what you notice at home, and ask the school what they see.
• Bring school reports and your notes to the GP appointment.
• Ask the clinician to explain how they tell ADHD, ODD and other conditions apart.

ADHD and ODD symptoms in adults and teens

The same checklist applies to teens and adults, including evidence that symptoms began before age 12.

• For people aged over 17 years, 5 of the 9 symptoms in a group are required to reach the diagnostic threshold, while for children it is 6 of the 9 (AADPA).
• Around 3-5% of adults in Australia have ADHD.
• If avoidance or conflict is affecting work, study or relationships, talk to your GP about an assessment.

ADHD defiance and authority defiance: what a clinician considers

Behaviour that looks like defiance can have more than one explanation, so a clinician looks beyond the behaviour itself.

• ADHD symptoms: whether inattentive or hyperactive-impulsive symptoms are present across settings.
• ODD: whether there is a persistent pattern of angry, argumentative or defiant behaviour.
• Co-occurring conditions: autism, anxiety, trauma or a learning difference may also need assessment. See our guides on ADHD and trauma and ADHD and dyslexia.

How to discipline a child with ADHD and ODD

Plan discipline approaches with a qualified professional who knows your child.

1. 1Book a GP appointment. Ask for a referral to a paediatrician, psychiatrist or psychologist.
2. 2Bring your notes. Write down what happened before, during and after difficult moments.
3. 3Ask about parenting programs. A paediatrician or psychologist can tell you what is suitable for your child.
4. 4Agree on priorities. Work out with the clinician which behaviours matter most for safety and daily life.
5. 5Review the plan. Go back to the clinician if a strategy is not working.

How to deal with a child with ODD and ADHD at home and school

Sharing what works with the people around your child helps everyone use the same approach.

• Keep a short diary of what happened before, during and after a blow-up and bring it to your GP appointment.
• Ask the school about a learning or behaviour support plan that names the strategies teachers will use.
• Share the clinician’s advice with the school and other carers.
• Look after yourself too; healthdirect’s nurse helpline on 1800 022 222 is available 24 hours a day, 7 days a week (healthdirect).

Demand avoidance ADHD support and NDIS funding

Support is built around what the person needs day to day, and NDIS funding applies only if you meet the NDIS access requirements.

• A GP can refer you to a paediatrician or psychiatrist for assessment.
• Therapies, parent training and school supports are discussed with your treating team, and medicines, if used, are decisions for your doctor and pharmacist.
• Check the NDIS access requirements before applying, and ask your treating team for evidence you may need.
• The ADHD Foundation on 1300 39 39 19 offers ADHD support, and our NDIS services page explains the practical help available at home.
• Related reading: ADHD avoidance and ADHD task avoidance.

When to talk to a GP or specialist

Reach out when the pattern is persistent and affecting daily life, even if you are unsure what is behind it.

• Refusals or meltdowns happen most days and are stopping the child or adult from attending school, work or activities.
• You suspect ADHD, ODD, autism or anxiety could be involved and want a proper assessment rather than guesses.
• Strategies that worked before have stopped working, or family relationships are under strain.
• The person is withdrawn, very low in mood or talks about hurting themselves; call Lifeline on 13 11 14, and call 000 if someone is in immediate danger.
• Carers are burning out and need respite or practical help at home.

Call 000 in an emergency.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Your next step

If you are supporting someone with ADHD, autism or a similar need, the right assessment comes first and practical help comes alongside it. At TQN Care, we provide NDIS support workers who help with routines, community access, respite and help around the home. See our NDIS services or send a referral and we will talk through what would help.