Our mascot Rash (left) is used as a pseudonym for the real child in this case study. We’ve simply changed his name to protect him and his family, but everything else is true.

Rash is nine years old and lives in the US. His father, describing his own experience as “terrifying”, says:

My son has jumped out of a moving vehicle twice, eloped from school numerous times, eloped with his younger sister in a store, eloped through a neighborhood, attempted to crash my car, bitten me, attempted to harm himself and caused me to be removed from my vehicle by police as they thought I was abducting him due to his extreme ‘flight’ reactions to seemingly benign requests [such as] “Please put that back on the shelf.”

He’s been admitted five times in six months to a locked ward of a psychiatric hospital for a total of 50 nights.

Rash’s current diagnoses are: autism, ADHD, OCD and generalized anxiety. His father goes on:

In the last four years, we have seen numerous reputable medical doctors, psychiatrists and psychologists as well as counselors and clinical social workers. Sometimes we have been advised to try to treat the ASD; sometimes we have been advised to treat OCD; sometimes we have been advised to treat ADHD; sometimes we have been advised to treat the anxiety. My son has been put on a myriad of drugs [including] stimulants, anti-psychotics, anti-depressants, sedatives and alpha-2 receptor agonists. There has been no solution from any of these sources.

Rash does not have a diagnosis of PDA. Even so, we are convinced – through observation, wide reading and off-the-record conversations with knowledgeable professionals in the UK and the US – that Rash has PDA. We believe the main reason for the lack of a PDA diagnosis is that the condition is not recognized in the US.

This matters, for two main reasons. First, Rash’s parents would be vastly relieved if reputable professionals were to tell them officially that:

• their son has a recognized condition which tallies closely with their experiences;
• they are not alone;
• the problems are not the result of bad parenting.

Second, a PDA diagnosis might lead to more appropriate and effective treatment.