Diagnosing PDA Within The Guidelines

The following post is reproduced with kind permission of Graeme Storey from within the Facebook PDA – USA Group and originated on thePDAresource.com at this link:

DIAGNOSING PDA within the guidelines!!

I have posted this in a comment on an existing thread, but it is important enough to give it its own thread… The following is on The PDA Resource website, in PDF form, but here it is in text form for everyone.

Never mind the clinicians’ reluctance to diagnose PDA, they CAN do so, within the guidelines, and it is simply the way they write it down:-

November 2016 (original version in January 2015)

PDA does not appear in the diagnostic manuals published by the World Health Organisation or the American Psychiatric Association. In fact, it only just gets a footnote in an appendix of the guidance produced by the UK National Institute for Health and Clinical Excellence.

It will be a while before it gets into any of those manuals because you need research studies involving thousands of diagnosed patients before the editorial boards will even start to notice it.

However, clinicians who are aware of the diagnostic criteria are free, in both the US and the UK, to diagnose PDA as a sub‐type of an existing diagnosable condition.

Indeed, the latest versions of the diagnostic manuals positively encourage clinicians diagnosing ASD to go on and describe the individual presentation in narrative detail.

The wording now being promoted by NAS, the Lorna Wing centre, and professionals such as Phil Christie is “ASD with a profile of [pathological] demand avoidance”. This fits in with their recommendations for other subtypes of autism such as “ASD with a profile of Aspergers”, “ASD with a female profile” etc.

It is also worth noting this paragraph from the NAS website about the use of the word “pathological”:-
“Demand avoidance can be seen in the development of many children, including others on the autism spectrum. It is the extent and extreme nature of this avoidance that causes such difficulties, which is why it has been described as ‘pathological’.”

For this reason, a diagnosis of “ASD with a profile of [pathological] demand avoidance” (with or without the word pathological) is a perfectly valid means of diagnosing PDA and remaining firmly within the letter and spirit of the American diagnostic manuals.

Thanks to Tom Crellin for the explanation above 🙂

3 thoughts on “Diagnosing PDA Within The Guidelines”

  1. Graeme, thanks for bringing this up. It is indeed noteworthy as the UK’s National Autistic Society (NAS) is a world leader in PDA recognition. We referenced NAS in our recent letter to a household name autism charity in the US, try to gain their attention to PDA.

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