Why Is My Child Refusing Everything? Burnout, PDA, and ODD Explained

Your kid is refusing everything. School refusal, homework battles, meltdowns over things they used to enjoy. You're exhausted, they're exhausted, and someone's throwing around terms like "Your child has PDA," "They seem burned out!" or bringing up things like "ODD" or, worst of all, they dismiss your child and blame you, saying your kid just needs more discipline.

Maybe you've heard all of these in the same week from different people. The teacher thinks it's behavioral. The pediatrician mentions ODD. Your therapist wonders about burnout. Someone online suggests PDA. Meanwhile, you're standing in the middle of this mess trying to figure out what the hell is actually happening and what you're supposed to do about it.

Here's what you need to know: ADHD/autistic burnout, Pathological Demand Avoidance (PDA), and Oppositional Defiant Disorder (ODD) can all look similar on the surface, but they're fundamentally different things that need different approaches. Misidentifying what you're dealing with means applying the wrong strategies, which makes everything worse for your kid and for you.

Let's break down what each of these actually is, how to tell them apart, and what to do about them.

What Is ADHD/Autistic Burnout?

Burnout happens when a neurodivergent person has been pushing beyond their capacity for too long. Research defines autistic burnout as "a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports." Personally speaking,  I've always referred to burnout as the broken bone of the mind, the treatment is the same. Rest and time to heal, which isn't always easy.

For kids, this often means they've been masking at school, managing sensory overload, forcing executive function tasks their brain isn't ready for, and holding it together in environments that demand constant regulation. Then they get home and completely fall apart. This burnout is often a result of prolonged issues with After School Restraint Collapse that goes unmanaged. I talk about that more in this blog: Why Does Your Child Fall Apart the Moment They Get Home From School?

Burnout shows up as withdrawal, refusal to do things they normally enjoy, increased meltdowns or shutdowns, and needing more recovery time. Everything feels like too much. The key thing about burnout is that it's cumulative, it builds over time from sustained pressure that exceeds their capacity. Research on autistic burnout describes it as chronic exhaustion, loss of skills, and reduced tolerance to stimulus affecting every part of life and lasting for long periods.

A burned-out kid isn't choosing to be difficult. Their nervous system has hit its limit. They've spent all their energy just getting through the day, and there's nothing left for homework, chores, or even fun activities. What looks like defiance or laziness is actually a nervous system desperately trying to protect itself.

What Is PDA (Pathological Demand Avoidance)?

PDA describes a behavioral profile where the nervous system perceives everyday demands as threats. It's most commonly discussed in relation to autism, though research on this is still developing and the concept itself remains debated within both clinical and autistic communities.

The key feature of PDA is an anxiety-driven response where even things the child wants to do can trigger an overwhelming need to avoid because the demand itself feels threatening. A kid with this profile might desperately want to do something, go to a birthday party, play their favorite game, eat their favorite food, but the moment it becomes a demand or expectation, their nervous system treats it as a threat.

Parents often hear "we don't see this behavior at school," which makes them feel like they're doing something wrong. You're not. The demand-avoidant response is rooted in anxiety about autonomy and control—your kid's nervous system is genuinely perceiving the demand as a threat, not choosing to be difficult.

PDA is not currently a standalone diagnosis and there's no standardized assessment for it. Some clinicians note demand-avoidant traits in autism evaluations, while others question whether PDA represents a distinct profile at all. Research suggests demand avoidance can appear across different neurodivergent presentations, not exclusively with autism. If you're seeing extreme demand avoidance in your child, a comprehensive neurodevelopmental evaluation, including assessment for autism, ADHD, anxiety, and other conditions, is the starting point.

What Is ODD (Oppositional Defiant Disorder)?

ODD is defined in the DSM-5 as a pattern of angry or irritable mood, argumentative or defiant behavior, or vindictiveness lasting at least six months. To meet diagnostic criteria, a child must have at least four symptoms from three categories: angry or irritable mood (losing temper frequently, being easily annoyed, being angry and resentful), argumentative or defiant behavior (arguing with authority figures, actively defying requests or rules, deliberately annoying others, blaming others for mistakes), or vindictiveness (being spiteful or vindictive).

These behaviors need to be severe and disruptive enough to cause significant distress or negatively impact functioning at home, school, or with peers. For kids younger than 5, the behavior must occur most days for at least six months. For kids 5 and older, it must occur at least once per week for at least six months.

Here's the thing about ODD: it's often a surface diagnosis that misses what's actually happening underneath. Kids don't wake up deciding to be oppositional for fun. There's almost always an underlying cause, unaddressed ADHD, autism, anxiety, trauma, sensory processing issues, or chronic stress.

ODD is what it looks like when a kid has been struggling with something for so long that opposition and defiance have become their primary coping strategy. It's the behavior that emerges when a child's needs aren't being met and they don't have other tools to communicate that.

Some kids genuinely do have ODD as a standalone diagnosis, but it's far less common than many people think. Before accepting an ODD diagnosis, you need to rule out or address ADHD, autism, anxiety, sensory processing disorder, trauma, and learning disabilities. If those are present and untreated, the oppositional behavior is often a symptom of those conditions, not a separate disorder.

How to Tell Them Apart

This is where it gets tricky because burnout, PDA-type demand avoidance, and ODD can all cause refusal, meltdowns, and what looks like defiance. If you're looking at me like "those sound the same," I get it. The thing is, all of them can cause what many of you are experiencing. But the why behind the behavior is different, and that why determines what actually helps.

Burnout vs. Demand Avoidance

The key difference is what's driving the refusal. With burnout, the refusal is connected to exhaustion and overwhelm from sustained effort beyond capacity. They're depleted, there's nothing left in the tank. They might refuse things they normally enjoy simply because everything requires energy they don't have. It doesn't matter how you phrase it or present it; they just don't have the reserves.

With demand avoidance, the issue is the demand itself feeling threatening, regardless of energy levels. How you present something matters enormously. Direct demands trigger the response, but offering choices or collaborating on solutions might work. The demand is the problem, not the exhaustion.

Both can show up as masking at school and falling apart at home. Sometimes it's both, a kid can be burned out and have a demand-avoidant profile. Burnout can make demand avoidance worse because when you're already depleted, your nervous system has even less capacity to handle perceived threats.

ODD vs. Demand Avoidance or Burnout

ODD tends to show up as anger and vindictiveness across multiple settings and relationships. There's often a pattern of deliberately annoying others or being spiteful. It's more about interpersonal conflict and power struggles than about specific triggers.

Demand avoidance shows up specifically around demands and expectations. The behavior isn't about anger or spite, it's about anxiety and autonomy. A kid with this profile isn't trying to make your life difficult; their nervous system is genuinely perceiving the demand as a threat. Remove the demand, and the behavior often shifts.

Burnout shows up as withdrawal and depletion. There's less anger and more shutdown. The kid might want to comply but literally doesn't have the energy. Push them harder, and you'll see more shutdowns, more withdrawal, and eventually more meltdowns because they've got nothing left.

If your kid is getting an ODD diagnosis but you're seeing significant ADHD or autism traits, anxiety, sensory issues, or patterns that suggest they're overwhelmed rather than deliberately defiant, push back. Ask what's being ruled out before accepting ODD as the primary explanation.

What to Do About It

If It's Burnout

Real recovery time is essential. Burnout doesn't get better by pushing through it, that makes it worse. Your kid needs rest and reduced pressure. I know that sounds impossible when you've got school, homework, activities, and life happening, but if you don't address burnout, it gets deeper and takes longer to recover from.

Pull back on demands where you can. Less pressure to perform socially, fewer transitions, more predictability. Prioritize what actually matters and let go of what doesn't. If homework is causing daily meltdowns and your kid is barely functioning, talk to the school about modifications or temporary reduction. Their mental health matters more than finishing every assignment.

Create more downtime and reduce stimulation. Let them decompress in whatever way works for them, whether that's screen time, being alone, sensory activities, or just doing nothing. Don't fill their schedule with "helpful" activities that require more energy. They need actual rest, not different demands.

If It's Demand Avoidance

Reduce the feeling of demands by offering choices, collaborating on solutions instead of directing, and giving your kid as much autonomy as possible. Instead of "go do your homework," try "what do you think would be a good time to work on homework today?" Instead of "put on your shoes," try "we need to leave in five minutes, what do you need to do to be ready?"

Use indirect language and remove the sense of pressure. Sometimes just changing how you phrase things can make an enormous difference. This approach isn't about being manipulative or giving in to everything your kid wants, it's about presenting necessary things in ways that don't trigger their threat response.

Therapy can help, particularly approaches that focus on anxiety management and building flexibility without adding more pressure. Make sure any therapist understands demand avoidance and doesn't rely on traditional behavioral approaches that emphasize compliance, as those can make things worse.

If It's ODD (or Looks Like ODD)

First, make sure you're addressing underlying causes. If ADHD, autism, anxiety, sensory processing issues, or trauma are present, those need to be treated first. You can't address ODD effectively if you're not addressing what's driving it.

Work with a therapist who understands neurodivergence and can help your kid develop regulation skills, communication tools, and healthier ways to express frustration. Parent-Child Interaction Therapy (PCIT) or collaborative problem-solving approaches like Collaborative & Proactive Solutions (CPS) are often more effective than traditional behavioral modification for neurodivergent kids.

Focus on connection before correction. A kid who's constantly in conflict needs to feel understood and supported, not constantly disciplined. That doesn't mean there are no boundaries, it means the boundaries come from a place of collaboration and understanding rather than power struggle.

Document What You're Seeing

The thing is, determining what it is can be complicated, but if you want doctors, therapists, or teachers to understand what you're seeing at home, you need to document it. Write down when the refusals happen, what led up to them, what you tried, and how your kid responded. Look for patterns, does it happen more after school days? After transitions? When there are multiple demands in a row?

Approach it with curiosity rather than frustration. You're trying to figure out what your kid's nervous system is actually responding to. That documentation becomes critical when you're explaining to professionals what's happening, especially if they're not seeing the same behaviors at school or in appointments.

Track things like: time of day, what was happening before the refusal, how you responded, how your kid responded to your response, how long it lasted, and what eventually helped (if anything). Over time, you'll start seeing patterns that help you understand whether you're dealing with burnout, demand avoidance, ODD, or something else entirely. These patterns of what you see when the child is at their most unfiltered will inform your medical care team about how to support your child.. 

Why This Matters

Getting this right matters because applying the wrong approach can make things significantly worse. Treating burnout like defiance and adding more pressure deepens the burnout. Treating demand avoidance with traditional behavioral approaches that focus on compliance escalates anxiety. Treating ADHD or autism as ODD without addressing the underlying conditions means your kid never gets the support they actually need.

Your kid isn't trying to make your life difficult. Their nervous system is overwhelmed, anxious, or depleted, and the behaviors you're seeing are how that shows up. Once you understand what you're actually dealing with, you can respond in ways that actually help instead of accidentally making things worse.

And if professionals are dismissing what you're seeing or blaming you for needing better discipline, that's not on you. You know your kid. Trust what you're observing, document it, and keep advocating until you find providers who take you seriously and help you figure out what's really going on.

If you're looking for support in helping your child navigate these challenges and building strategies that actually fit your family's needs, I work with parents to develop personalized approaches grounded in real-world experience and evidence-based practices. Schedule a Free Discovery Call to see if we're a good fit!