What is the

Persistent Drive For Autonomy (PDA)?

PDA: A Neuroaffirmative Perspective

A Persistent Drive for Autonomy is a strong need for independence, control, and self-determination in daily life. It’s not being “defiant” or “oppositional” but about protecting one’s sense of agency in a world that often feels unpredictable, overwhelming and threatening.

Using a Low-Demand Approach to Therapy

A Persistent Need for Autonomy is often self-protective. Forcing compliance can increase distress and the fight-or-flight response.

OT Strategy:

  • Respect No: if the child or teen says “no”, respect it and explore why

  • Use a Collaborative Approach: collaborate with the child or teen to problem-solve

  • Recognise Autonomy-Driven Burnout: recognise the cumulative impact of demands and reduce expectations.

  • Support Self-Advocacy Skills: Help individuals communicate their eneds clearing (using AAC, “I need” statements, scripts).

  • Create Exit Strategies: Give a way out of Dysregulating situations and honour the exit strategy

  • Normalise Autonomy Needs: Help children and teens recognise that wanting autonomy is valid.