Anyone have experience with Pathological Demand Avoidance (PDA)

[Anonymous]

I’ve gone down the TikTok rabbit hole on it, as a lot of it makes sense for my kid. She has an anxiety and ADHD diagnosis. Therapy helps a little. Meds help a lot. I’m waiting for maturity to kick in and praying that goes a long way to help. I found the videos helpful for ways to talk to her, being more flexible with her, being careful with my own tone.

[Anonymous]

Anonymous wrote:Raises hand. Yes, we have heard of it, we live it in our house. For years, our house was in crisis as was DC. After DC was diagnosed at 8 with ASD, ADHD, GAD, DCD, and pathological demand avoidance, we slowly made some changes and with time, maturity, stimulant meds, and tolerance + generally-the-same expectations, DC and our family are in a much much better place.

Same here! Exact same diagnosis for 7.5 yr old. Followed same as above. It is getting better!

PDA is a misnomer. It’s better defined as a Nervous System Disorder that cooccurs with certain AuDHD profiles. It’s a heightened response to sensory stimuli that causes nervous system activation. It’s constantly fight or flight with an extended cortisol surge. It could be as minor as an itchy sock that triggers a meltdown. My child describes it as her brain and skin being on fire and she’s trying to get the fire out. She can’t control it. She wants to control it. But “my brain won’t let me.”

Yes, it looks like behavior issues in children. This is where traditional special Ed/behaviorism makes it 10X worse. It's like saying “well, I know you are having a heart attack right now and losing consciousness, but you know the rules, toys must be put in the right bins when the whistle blows." It's a mismatch of cause and effect.

Avoidance is just one strategy that manifests when they perceive a threat. But once your child is mature enough to articulate the triggers and responses you can start to navigate ways around it to achieve closer to a balance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Raises hand. Yes, we have heard of it, we live it in our house. For years, our house was in crisis as was DC. After DC was diagnosed at 8 with ASD, ADHD, GAD, DCD, and pathological demand avoidance, we slowly made some changes and with time, maturity, stimulant meds, and tolerance + generally-the-same expectations, DC and our family are in a much much better place.

Same here! Exact same diagnosis for 7.5 yr old. Followed same as above. It is getting better!

PDA is a misnomer. It’s better defined as a Nervous System Disorder that cooccurs with certain AuDHD profiles. It’s a heightened response to sensory stimuli that causes nervous system activation. It’s constantly fight or flight with an extended cortisol surge. It could be as minor as an itchy sock that triggers a meltdown. My child describes it as her brain and skin being on fire and she’s trying to get the fire out. She can’t control it. She wants to control it. But “my brain won’t let me.”

Yes, it looks like behavior issues in children. This is where traditional special Ed/behaviorism makes it 10X worse. It's like saying “well, I know you are having a heart attack right now and losing consciousness, but you know the rules, toys must be put in the right bins when the whistle blows." It's a mismatch of cause and effect.

Avoidance is just one strategy that manifests when they perceive a threat. But once your child is mature enough to articulate the triggers and responses you can start to navigate ways around it to achieve closer to a balance.

You’re an idiot if you think this is the approach “behaviorism” would take for addressing avoidant behavior.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Raises hand. Yes, we have heard of it, we live it in our house. For years, our house was in crisis as was DC. After DC was diagnosed at 8 with ASD, ADHD, GAD, DCD, and pathological demand avoidance, we slowly made some changes and with time, maturity, stimulant meds, and tolerance + generally-the-same expectations, DC and our family are in a much much better place.

Same here! Exact same diagnosis for 7.5 yr old. Followed same as above. It is getting better!

PDA is a misnomer. It’s better defined as a Nervous System Disorder that cooccurs with certain AuDHD profiles. It’s a heightened response to sensory stimuli that causes nervous system activation. It’s constantly fight or flight with an extended cortisol surge. It could be as minor as an itchy sock that triggers a meltdown. My child describes it as her brain and skin being on fire and she’s trying to get the fire out. She can’t control it. She wants to control it. But “my brain won’t let me.”

Yes, it looks like behavior issues in children. This is where traditional special Ed/behaviorism makes it 10X worse. It's like saying “well, I know you are having a heart attack right now and losing consciousness, but you know the rules, toys must be put in the right bins when the whistle blows." It's a mismatch of cause and effect.

Avoidance is just one strategy that manifests when they perceive a threat. But once your child is mature enough to articulate the triggers and responses you can start to navigate ways around it to achieve closer to a balance.

You’re an idiot if you think this is the approach “behaviorism” would take for addressing avoidant behavior.

Hyperbole. And yes, we had this type of response from a behavioral specialist at school in response to an asthma attack (not pda related). The kid needed her inhaler - not a sticker chart, point system or behavior correction.

I would advocate that PDA be reclassified outside of the autism spectrum. It really requires a different type of care. The autism label makes everyone jump to ABA which isn’t appropriate for PDAers. Even CBT is discouraged for PDA.


Demand avoidance is not PDA. Demand Avoidance implies willfully not doing something. PDAers its a medical response.

[Anonymous]

The adult PDA community has renamed it "Persistent Drive for Autonomy" which is helpful in understanding the underlying triggers (lack of autonomy as the primary one). For PDA, I really like the book Low Demand Parenting by Amanda Dieckman. Also Kristy Forbes is a great resource -- she has PDA herself and is parent to kids with it as well, and she has great insights.
Also, finding a parenting group (support group or class) with parents who may have kids with similar or relatable profiles may be really helpful.