Pathological Demand Avoidance (PDA) Is a Junk Diagnosis

A triptych titled 'This Autistic Boy's Life' depicts a journey from birth to adulthood. The left frame shows an X-ray-like, monochrome visage of a boy with an innate, fragmented essence. In the center, the boy's vivid expression mirrors childhood frustration against societal demands. The right frame, in a more somber tone, extends this overwhelm into adulthood, his face distorting into a stark office setting, illustrating the enduring struggle and its intensified impact on life.

Prove me wrong… Double-dog-dare ya. Hell, make it a triple…


🚨Content Warning: Discusses the controversial proposed PDA diagnosis. Opinionated. A tad passionate…


Too-Long;Didn’t-Read

  1. Pathological Demand Avoidance” (PDA). Some call it “junk” science. No standard diagnostic tool, DSM or ICD, recognizes it. Why?
  2. Critics argue the label, “PDA,” stigmatizes rather than helps. We can better support autistic kids. How?
  3. Researchers working with adult Neurodivergents reevaluate PDA, suggesting more authentic approaches. Where?

Pathological Demand Avoidance is a fringe, PROPOSED diagnosis. Backed up by little… replicated… research.

Not recognized by DSM or ICD, the two standard diagnostic manuals used by doctors and therapits.

In fact, PDA is what’s known in the trade as a “junk” diagnosis.

Cage an animal? It will go crazy.

Unnaturally restrain ANY natural impulse of a child? They will freak out. Once you pass their individual tolerance level.

A triptych titled 'This Autistic Boy's Life' depicts a journey from birth to adulthood. The left frame shows an X-ray-like, monochrome visage of a boy with an innate, fragmented essence. In the center, the boy’s vivid expression mirrors childhood frustration against societal demands. The right frame, in a more somber tone, extends this overwhelm into adulthood, his face distorting into a stark office setting, illustrating the enduring struggle and its intensified impact on life.
“This Autistic Boy’s Life,” digital image by author. Digital tools included AI.

Any child. With ANY neurology.

PDA is an insulting,
denigrating,
dehumanizing diagnosis,
invented by “pros,”
hired by frustrated parents
who restrain
their own autistic kids’ natures…

Cuz they didn’t understand how to meet their kids’ needs.

My feelings.

Prove me wrong…👇


Inspired by an interesting conversation on LinkedIn:

Replying to @🌶️ Navin Israni

I think I will bow out of this sub conversation.

I’ve spent the better part of 5 years of writing & podcasting about not pathologizing neurodivergent thinking. Rather accepting it as intrinsically different… a difference that has become increasingly unwelcome in a modern consumer capitalist “society.”

Not interested in another “conversation.” I’ve had literally a dozen pathological labels tossed at me by confident pros. Some pretty severe.

This in hindsight and the knowledge of my intrinsic differences… seems ludicrous.

Substituting my links for another back & forth.

  1. How to Get Diagnosed #ActuallyAutistic… in Just 26 Years! – Podcast s1e8
  2. CBT…? Never Worked for Me. Why? An Adult Autistic Perspective
  3. This Autistic’s Fantasy: So, He Asks about My History… What I told My Doctor
  4. “Look Doc… You Just Don’t GET #AutisticJoy”
  5. Reply to @Navan Israini


Further Reading (not comprehensive)

  1. A relatively balanced article about the debate around the proposed PDA diagnosis: Demand Avoidance
  2. A relatively balanced summation of the state of current research on PDA: Pathological Demand Avoidance: Current State of Research and Critical Discussion (english abstract, German text)
  3. A relatively favorable conversation with a neuropsychologist, redefining PDA in a more postive light: Questioning the Pathological Part of PDA: A Talk with Dr. Deborah Budding
  4. A relatively balanced article on PDA from neurodivergent pscyhologist: Emerging Neurodivergent Identities: A Lesson On Pathological Demand Avoidance From Kristy Forbes

Understanding Autism and Neurodiversity

Autistic Self Advocacy Network (ASAN): ASAN is an organization run by and for autistic people, advocating for the rights of people with autism. They focus on promoting self-advocacy, public policy advocacy, and efforts to improve the lives of autistic individuals through a neurodiversity framework.

Autistic Women & Nonbinary Network (AWN): AWN provides community, support, and resources for autistic women, girls, nonbinary people, and all others of marginalized genders. Their work includes raising awareness about the intersectionality of gender and autism.

Thinking Person’s Guide to Autism: This organization provides valuable insights and resources related to autism. They offer a thoughtful perspective on various aspects of autism and aim to provide a nuanced understanding of neurodiversity.


Key Takeaways

  1. Challenging PDA’s Validity: The article criticizes Pathological Demand Avoidance (PDA) as a “junk” diagnosis, noting its lack of empirical support and absence from recognized diagnostic manuals like DSM and ICD.
  2. Impact on Neurodivergent Individuals: PDA is described as stigmatizing and harmful, pathologizing behaviors natural to autistic children in response to misunderstanding overwhelm. Highlights the need for better support tailored to neurodivergent needs.
  3. Personal Insights and Advocacy: Leveraging personal experiences and advocacy discussions, such as those with Navin Israni, the author advocates for recognizing neurodivergent thinking as inherently valid rather than disordered, urging a societal shift towards acceptance.
  4. Call for Rethinking Neurodiversity: The article invites readers to challenge pathological labels and consider more authentic approaches to neurodivergence, supported by expert dialogues like those with Dr. Deborah Budding.
  5. Resources for Deeper Understanding: It provides links to balanced discussions and research on PDA and neurodivergence, offering resources for those seeking to understand these concepts without stigma.
  6. Engagement and Support: The conclusion calls for reader engagement with the #AutisticAF Out Loud Newsletter, promoting a community dialogue that supports open discussions on neurodivergence.


All images in 4K available for paid subStack subscribers.

#AutismAwareness #AuDHD #Autism #Neurodiversity #Neurodivergent #ADHD #ActuallyAutistic #AutismAppreciation

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