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

[lg1965]

HI everyone, my 20 yr. old stepson has been diagnosed with Autism (very high functioning=old "Aspberger's"), with the Pathological Demand Avoidance profile--a VERY difficult type to control/interact/live with. Are there any psychiatrists (need anti-anxiety meds) and psychotherapists you know of in Northern VA who may be experts in this area? Thank you!

[Anonymous]

Following because I think this is my child too. I’ve only heard of PDA from a British book. Is it a recognized diagnosis in the US?

[lg1965]

It appears that it was too early (i.e., not enough research to satisfy the DSM board, etc) to get it into DSM V. But if you go onto the PDA Society website, it's a real eye opener. There is SOO much information for parents, adults with PDA, professionals, all kinds of things. I just read the self-help section of the Adult page and it's eye opening. It will give you more patience, tolerance and understanding. For your son too.

[Anonymous]

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

[Anonymous]

This sounds very similar to ODD. What are the differences?

I feel that if you can find a therapist skilled with ODD, there would be a big skill base there.

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

Anonymous wrote:This sounds very similar to ODD. What are the differences?

I feel that if you can find a therapist skilled with ODD, there would be a big skill base there.

This discusses some differences.

https://hes-extraordinary.com/pathological-demand-avoidance

[Anonymous]

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.

[Anonymous]

Empoweringparents .com is extremely helpful for ODD

[Anonymous]

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?

[Anonymous]

Wow. I always suspected my husband had a tinge of Asperger's, but I didn't know he had THAT. He always has a fit whenever we have an important event with a deadline that messes up his routine, like a wedding or trip. I understood that it was anxiety related to time management and presenting oneself socially in a novel situation, but I didn't have a name for the disorder. He will become utterly unreasonable, to the point of accepting significant discomfort or even danger to himself when he gets overwhelmed. And of course he blames me for everything. It's very difficult.

Thanks, OP.

[Anonymous]

The Explosive Child by Ross Greene is good for those of you with young kids.

[Anonymous]

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.

[Anonymous]

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.