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Is PDA Autism? Rethinking Diagnostic Boundaries in the Neurodivergent Landscape

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By PDA Insiders (Sally Cat and Brook Madera), plus guest quotes Illustrated by Sally Cat Introduction Pathological Demand Avoidance (PDA) remains one of the most contentious and confusing neurodivergent profiles. At the heart of this debate is one persistent question: should PDA be recognised as a subtype of autism—or does it demand a category of its own? To understand this, we need to trace the evolution of diagnostic systems and how PDA people became diagnostic refugees. From PDD to the Autism Spectrum: The Collapse of Diagnostic Diversity Under the DSM-IV, conditions such as autistic disorder, Asperger's syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS) existed as separate but related diagnoses.  PDA was first noted, and named by, Professor Elizabeth Newson who identified the profile in children referred to her during the 1980s who puzzled clinicians by seeming autistic in someways, but with marked differences. This classed PDA as slotting under t...
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Pathological demand avoidance or persistent drive for autonomy?

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Pathological Demand Avoidance (PDA) is a neurodivergent profile that is associated with high levels of anxiety, an intense need to avoid everyday demands, and a desire for personal control. The condition is complex, and its expression varies between individuals. However, there are common threads that unite those of us who identify with it. The term "pathological demand avoidance" (PDA) is not without controversy. The adjective "pathological" is  disliked by many in the PDA, and wider autism communities, because of its negative implications. The word is often associated with disease or dysfunction, which can be stigmatising. As a result, some prefer the alternative phrase “pervasive drive for autonomy”, which was proposed in 2019 by myself, Sally Cat, and fellow PDA individual T. Wilding. The phrase reframes our demand avoidance as a by product of seeking autonomy, and in many ways, it sounds much more positive, almost poetic. However, my personal view—and that of ot...
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PDA and Sleep

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Sleep issues are often talked about in PDA forums, with exhausted parents and carers desperate for their PDA kids to sleep through the night. Current folk wisdom is to restrict screen use and feed kids melatonin, both of which may be counter-productive. Most people will know about me because of my PDA, but I’m blessed with another invisible difference that makes me appear selfish and lazy: Delayed Sleep Phase Syndrome (DSPS), which forces me to be awake all night and sleep through the day. My sleep phase has been severely delayed since I was a small child. I’ll talk more about DSPS later in this article, but start off with a summary of other sleep issues associated with PDA, and look at what may help. Much of the first part of this article is taken from PDA Society’s 2018 booklet on sleep, produced in association with The Sleep Charity and me (Sally Cat)  LINK PDA Society’s 2021 sleep survey A survey conducted by PDA Society in November 2021 revealed that sleep is a significant...
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