Extreme Demand Avoidance in Children with Autism Spectrum Disorder: Refinement of a Caregiver-Report Measure

Abstract Objectives Extreme/“pathological” demand avoidance (PDA) describes a presentation found in some children on the autism spectrum, characterized by obsessive resistance to everyday demands and requests. Demands often trigger behavior (e.g., distraction, excuses, withdrawal into role play). Pressure comply can lead escalation emotional reactivity that challenges. Methods Previously, Extreme Demand Avoidance Questionnaire (EDA-Q) was developed quantify resemblance clinical accounts of PDA from caregiver reports. The aim this study refine EDA-Q using principal components analysis (PCA) item response theory (IRT) parent/caregiver-report data 334 with ASD aged 5–17 years. Results PCA IRT analyses identified eight items are discriminating indices EDA traits, behave similarly respect quantifying irrespective child age, gender, reported academic level, or independence daily living activities. “EDA-8” showed good internal consistency (Cronbach’s alpha = .90) convergent divergent validity other measures (some which were only available for subsample 233 respondents). EDA-8 scores not related parental reports severity. Conclusions Inspection test information function suggests may be useful tool identify spectrum who show an extreme demands, as starting point more in-depth assessment.