Need expert in Autism/Pathological Demand Avoidance for 20 yr. old (psychotherapist and psychiatrist

[Anonymous]

Anonymous wrote:Pathological Demand Avoidance isn't in the DSM or ICD. Getting upset when routines are disrupted (including by parents "demanding" things) is a pretty typical autism thing. Disruptive or defiant behavior is also commonly seen in autism and adhd, also sometimes characterized as ODD. These behaviors can be addressed through parent coaching/behavioral therapy. I wouldn't get caught up in the diagnosis of "Pathological Demand Avoidance" because it's not going to really give you any additional insight or guidance.

+1000

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is interesting and does describe my younger DC to an unnerving degree. Younger DC is very different from older DC, who seems to be a little bit Aspergers (very literal, sometimes rigid, anxious).

https://www.priorychildrensservices.co.uk/news-blogs/understanding-pathological-demand-avoidance-pda/

I had attributed the behavior to a combination of anxiety and potentially ADHD (which runs in the family). Younger DC is very social but uninhibited/without boundaries. Used to hide under chairs, will drop things or fall down dramatically. Etc.

^^^ Additionally, younger DC can be extremely oppositional and refuses everything. Although I never thought it was ODD because mostly just oppostional towards DH and me, not towards teachers.

My ODD kid was ok at school too. This was one of the reasons the diagnosis was delayed. Get help now - for you to learn the special parenting skills they require and for him to work on emotional regulation, impulse control, and relationships.

15:12 here. Sometimes younger DC is sweet and happy, but often enough our house is a warzone. DH and I have both gotten so worn down.

I'll keep following this thread for suggestions for a therapist/psychologist/psychiatrist for DC and/or for DH and me. We are also in Northern Virginia.

Ours is out of state but I found him on the Psychology Today website. Once I found someone who specifically mentioned ODD, I reviewed his site and bio then met with him first.

[Anonymous]

Oh. Wow. This is my 15 year old. It took me a long time to realize that a lot of his issues were due to anxiety but even that has not felt like the full story. This is it exactly. He’s in therapy although he hates it. But what to do. The parent tips are basically like have fewer expectations-which I’ve figured out on my own.

[Anonymous]

I don't have a kid with this profile, but the Tilt Parenting podcast has done two episodes on PDA which you might find helpful. It seems to be a more commonly accepted diagnosis in other countries (the UK particularly) so you may find better parenting resources from international sites. (Also, this is a great example of how "It's not in the DSM" isn't really helpful or answering the OPs question. There definitely are resources out there and as can be seen here, this profile rings true for a lot of people. But not everyone. I have an ASD kid and it doesn't fit at all.) Hope some of this helps, OP.

https://tiltparenting.com/2019/09/03/episode-173-a-conversation-with-dr-melissa-neff-about-pda-pathological-demand-avoidance/

https://tiltparenting.com/2020/01/14/episode-191-a-conversation-with-author-and-pda-emmisary-harry-thompson/

[Anonymous]

Anonymous wrote:I don't have a kid with this profile, but the Tilt Parenting podcast has done two episodes on PDA which you might find helpful. It seems to be a more commonly accepted diagnosis in other countries (the UK particularly) so you may find better parenting resources from international sites. (Also, this is a great example of how "It's not in the DSM" isn't really helpful or answering the OPs question. There definitely are resources out there and as can be seen here, this profile rings true for a lot of people. But not everyone. I have an ASD kid and it doesn't fit at all.) Hope some of this helps, OP.

https://tiltparenting.com/2019/09/03/episode-173-a-conversation-with-dr-melissa-neff-about-pda-pathological-demand-avoidance/

https://tiltparenting.com/2020/01/14/episode-191-a-conversation-with-author-and-pda-emmisary-harry-thompson/

"It's not in the DSM" provides information about whether professionals here in the US (and sometimes insurance companies) coalesce to provide useful evaluation and treatment. Although the DSM itself is of course a line-drawing exercise, where those lines are drawn in fact does have some meaning. What I think is a far more useful approach is focusing on the problem behaviors and evidence-based therapies. Generally researchers won't study something that's not in the DSM, especially if it fits within another DSM diagnosis, so focusing on a non-existent diagnosis isn't really going to help much.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don't have a kid with this profile, but the Tilt Parenting podcast has done two episodes on PDA which you might find helpful. It seems to be a more commonly accepted diagnosis in other countries (the UK particularly) so you may find better parenting resources from international sites. (Also, this is a great example of how "It's not in the DSM" isn't really helpful or answering the OPs question. There definitely are resources out there and as can be seen here, this profile rings true for a lot of people. But not everyone. I have an ASD kid and it doesn't fit at all.) Hope some of this helps, OP.

https://tiltparenting.com/2019/09/03/episode-173-a-conversation-with-dr-melissa-neff-about-pda-pathological-demand-avoidance/

https://tiltparenting.com/2020/01/14/episode-191-a-conversation-with-author-and-pda-emmisary-harry-thompson/

"It's not in the DSM" provides information about whether professionals here in the US (and sometimes insurance companies) coalesce to provide useful evaluation and treatment. Although the DSM itself is of course a line-drawing exercise, where those lines are drawn in fact does have some meaning. What I think is a far more useful approach is focusing on the problem behaviors and evidence-based therapies. Generally researchers won't study something that's not in the DSM, especially if it fits within another DSM diagnosis, so focusing on a non-existent diagnosis isn't really going to help much.

(forgot to add: since OP's question is specifically about where to find an expert, it's definitely relevant to explain that evidence-based US therapists probably won't have a speciality in "Pathological Demand Avoidance," but finding someone who specializes in behavioral therapy/ODD would be more likely to help.)

[lg1965]

I understand your skepticism; however, it absolutely will if you're a parent or someone close to someone with the condition. It's not in the DSM because the process for a diagnosis to be accepted usually takes years, and this is fairly new. Your points are acknowledged throughout the information on PDA. The best two websites I've found are: https://www.pdasociety.org.uk and https://www.autismwestmidlands.org.uk/wp-content/uploads/2017/11/PDA-1.pdf

If anyone needs a diagnostician , Dr. Donna Henderson at Stixrud and Associates is outstanding.

[lg1965]

SOOO... back to my original question does anyone know a good clinician for Adults with ASD/PDA in No. Va?

[Anonymous]

lg1965 wrote:SOOO... back to my original question does anyone know a good clinician for Adults with ASD/PDA in No. Va?

Maybe you could ask Dr. Henderson?

[Anonymous]

Thanks, she had a couple a bit too far away for now

[Anonymous]

Anonymous wrote:

Anonymous wrote:NP. Hmmm, I just read the pamphlet at the link below and recognize my 4.5 year old son in it. Are some of these just normal behaviors for the age? He is often contrarian (if I point to something and say that it is white, he will literally say it is not white) and role plays all the time. He sometimes gets upset when we praise him. And unexpected demands make him freak out. I didn't think he was special needs in any way but this has me thinking...

https://www.autismwestmidlands.org.uk/wp-content/uploads/2017/11/PDA-1.pdf

Does he meltdown when he’s disciplined/receives consequences?

Actually usually we ask him to go sit somewhere until he cools down and he welcomes that and goes and tries to calm himself down. Typically that works to an extent until one of us goes in and helps him calm down fully with distractions. He is lso definitely motivated by rewards (having mango after his green beans for example).

[Anonymous]

Thanks! Our therapist sent a pdf on this, as well. She believes our son has this and we are looking for more outlets. Thanks for the post.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP. Hmmm, I just read the pamphlet at the link below and recognize my 4.5 year old son in it. Are some of these just normal behaviors for the age? He is often contrarian (if I point to something and say that it is white, he will literally say it is not white) and role plays all the time. He sometimes gets upset when we praise him. And unexpected demands make him freak out. I didn't think he was special needs in any way but this has me thinking...

https://www.autismwestmidlands.org.uk/wp-content/uploads/2017/11/PDA-1.pdf

Does he meltdown when he’s disciplined/receives consequences?

Actually usually we ask him to go sit somewhere until he cools down and he welcomes that and goes and tries to calm himself down. Typically that works to an extent until one of us goes in and helps him calm down fully with distractions. He is lso definitely motivated by rewards (having mango after his green beans for example).

if your 4 year old will eat green beans and mango, and considers the mango a reward, I would not be super concerned TBH.

[Anonymous]

I had never heard of this until this post, but it matches my child to a T. I found this podcast transcript if anyone is interested.

https://www.tiltparenting.com/wp-content/uploads/2019/09/173-Melissa-Neff-PDA.pdf

[Anonymous]

lg1965 wrote:SOOO... back to my original question does anyone know a good clinician for Adults with ASD/PDA in No. Va?

If you need a psychiatrist for medication, try Lance Clawson. He’s actually in MD, but not too far from nova.

For a therapist, ivymount’s resource fair will be in March. You can call the outreach office for information about past presenters or recommendations.