Shift away from oppositional defiant disorder reflects changing views on child noncompliance

Lawrence Diller, a behavioral pediatrician, writes about a noticeable shift in how clinicians label children who resist authority. He recounts a recent call from a mother who asked whether her son could be evaluated for PDA, a term she said stood for "pathological demand avoidance."\n\nDiller explains that PDA is being used to describe extreme non‑compliance, a label that has emerged as parents and professionals seek newer explanations for challenging behavior. The term contrasts with older diagnostic categories and reflects a broader trend toward re‑framing child conduct.\n\nAccording to Diller, the once‑common diagnosis of oppositional defiant disorder is fading from practice, suggesting that the field is moving away from that label in favor of newer concepts like PDA.

He argues that this disappearance signals a shift in how society and clinicians understand and respond to children who "won't listen."