Throwback: Is Pathological Demand Avoidance the Same as Autism, ADHD, or Anxiety? | Ep. 175

There is a lot of noise in the PDA space right now, and some of it is making parents doubt themselves and feel more confused rather than less. So I am re-airing this episode from May 2025 because I think it will help you feel more confident in the path you are on.

In this episode I share a story from a feeding support group that crystallized for me why PDA is a distinct experience, not one that can be folded into autism, ADHD, or anxiety strategies without losing something critical. I walk through two examples of content I have seen in the PDA space that would have sent me spiraling five years ago, and I close with a Buddhist concept called the near neighbor enemy that gave me the strength to say something I know is controversial.

• The Support Group Story and What It Clarified | 00:01:39 Shortly after moving to Michigan, my husband and I organized a babysitter and drove to a support group for families of Autistic children with feeding challenges. All the other children played in another room with their special interests. One non-speaking child sat calmly with a car magazine. Others played with trains and Legos while their parents talked. I wept on the way home, because I knew with certainty there was no version of that scenario that was possible for my son. He could not have gotten in the car. If he had come, he would have needed undivided attention the entire time and any lapse would have produced a meltdown or destruction of the other children's things. The behavioral feeding therapy that had worked beautifully for these families would have produced panic attacks for mine.

• PDA Becoming Trendy and What That Is Costing Families | 00:10:56 As PDA awareness has grown, I have noticed content that lumps PDA strategies in with ADHD or Autism approaches and presents them as interchangeable. Two examples I have seen recently: correcting behavior an hour after a meltdown once a child is regulated, and movement breaks every few minutes to help complete homework. Both of these may work beautifully for ADHD children. But for a PDA child who is still well past their threshold of tolerance, going back an hour later to discuss the behavior will most likely push them straight back into activation. A parent trying either of these strategies with a PDA child and seeing them fail is likely to conclude they are doing it wrong, when the issue is not implementation but neurotype fit.

• PDA Is Not an Anxiety-Driven Need for Control | 00:16:36 When PDA gets folded into the anxiety frame, it leads to recommendations about building frustration tolerance and increasing exposure. That is often exactly the right approach for anxious children. I have panic disorder myself and have worked hard on my own exposure and frustration tolerance. But PDA is not anxiety. It is a survival drive for autonomy rooted in the way the nervous system perceives safety and threat, and it can disable access to basic needs in a way that anxiety alone typically does not. Treating them as equivalent leads families toward strategies that do not fit and away from the ones that do.

• The Near Neighbor Enemy: Why Sameness Undermines Compassion | 00:18:14 A concept from Buddhist practice helped me find the courage to say something I knew was controversial. A near neighbor enemy is something that resembles a value but undermines it. The near neighbor of love is control. The near neighbor of fierce compassion is sameness, the idea that calling different things the same is itself a form of compassion. When we call PDA the same as Autism, ADHD, or anxiety in the name of inclusion, we erase the specific logic, the lived experience, and the sense of belonging that PDA families need and deserve. Difference is not division. It is precision.

• Why This Distinction Has Brought Peace to Thousands of Families | 00:19:31 The premise of my work is that PDA is a distinct neurotype with its own nervous system logic and its own approach to accommodation. That premise, not a technique or a strategy, is what has shifted things for my family and for the thousands of families I have worked with. When a parent finally has the right logic for their child's brain, they stop blaming themselves for strategies that were never going to work. They stop doubting their observations. And they start making decisions that actually fit the situation they are in.

Understanding PDA — Free class where I teach the nervous system disability framework and the unique logic of the PDA nervous system that distinguishes it from autism, ADHD, and anxiety.

Burnout — Free class with context for the burnout period I describe, and why strategies designed for other neurotypes can deepen rather than relieve burnout in PDA children.

Paradigm Shift Program — My signature program where the distinct logic of the PDA nervous system is practiced as an embodied skill across twelve weeks, with live coaching and a community of families who share the same experience.