This episode is an excerpt from a lesson inside the Paradigm Shift Program. I'm sharing it because the PDA lens is the foundation that all other skills in my work rest on, and it is not something most parents are going to hear explained anywhere else.

In this lesson I walk through exactly what the PDA lens is, why it has to be learned as a skill rather than just understood intellectually, and how to begin applying it. I also address the most common thought that comes up when I introduce the concept of deliberately signaling equality: am I training my child to be a bad adult? And why the answer, through the logic of this lens, is no.

• The PDA Lens Is a Skill, Not the Only Valid Lens | 00:00:00 The PDA lens is something I think of as a pair of glasses you can put on and take off. It does not invalidate the ADHD lens, the sensory lens, the OCD lens, or the anxiety lens. It teaches a different logic, one that most parents are not going to hear explained anywhere else because every professional encounter tends to frame the root cause through a different paradigm.

• Every Loss of Autonomy Is a Drop in a Bucket, Invisible Until the Tipping Point | 00:01:31 The PDA lens asks us to look at every behavior, even if it looks manipulative or intentional, and think: my child has been perceiving threat around not having autonomy or being below someone or something, over and over, and every time that happens, a drop goes into the cumulative nervous system activation bucket. Most of those drops are invisible because high masking, the internalization of the threat response rather than the behavioral expression of it, is a feature of PDA. The accumulation builds over days, months and years. By the time most families arrive at my work, the child is either very close to their threshold of tolerance or so far past it that they are existing in a near-constant state of threat.

• Equalization, Basic Needs, and Why Behavioral Strategies Cannot Work | 00:06:41 When cumulative activation reaches the tipping point, the nervous system tries to exert control and move above in order to get back to felt safety. This is equalizing. And control tends to coalesce around the one or two things a parent genuinely cannot force: eating, toileting, sleep, hygiene. Because this is subconscious, cumulative, and not under their conscious awareness, behavioral strategies do not work.

• Signaling Equality Without Removing All Boundaries | 00:11:39 The equality signal does not mean there are no limits in the home and the child runs everything. It means thinking creatively about how to deliberately, mindfully, and as an accommodation give a child or teen the felt experience of being above, of going first, of being more skilled in this moment, in order to offset years of subconsciously perceiving that they are below.

• You Will Know More Than the Professionals You Work With | 00:10:09 This is not a criticism of professionals. It is a reality of where the PDA research and understanding currently sits. Most clinicians, teachers, and therapists have been trained through a behavioral paradigm that assumes behavior is rational, conscious, and changeable through incentives and disincentives. The PDA lens is a fundamentally different paradigm and it is not (yet!) taught in most training programs.

Understanding PDA — Free class where I teach the nervous system disability framework and the root cause logic that the PDA lens described in this episode is built on.

Tracking Progress — Free class on how to observe the three outcome dimensions, nervous system activation, basic needs, and engagement, referenced in this episode as the data to watch rather than the behaviors to fix.

Paradigm Shift Program — My signature three-month program where the PDA lens introduced in this excerpt is practiced as an embodied skill across twelve weeks of live coaching, spot coaching, and community support.

When I first heard Jan Winhall speak about the intersection of the nervous system and addiction, I immediately thought of the PDA teens and adults in our community who are reaching for substances or engaging in self-harm.

In this episode she explains how addiction and self-harm function as nervous system state regulation strategies, what conventional models get wrong, and what it actually looks like to support someone through this from a place of safety rather than shame.

Winhall brings a wealth of knowledge to the conversation as a trauma and addiction psychotherapist, developer of the Felt Sense Polyvagal Model, and author of two books on treating trauma and addiction through embodied awareness. I hope her insights support you.

• Addiction as a Nervous System State Regulation Strategy | 00:06:52 The conventional model frames addiction as either a moral failure or a brain disease. Jan offers a third understanding grounded in polyvagal theory and neuroplasticity: addictive behaviors are strategies the body uses to shift nervous system states when there is not enough perceived safety. When someone is in a chronic sympathetic state, the wine bottle or the substance moves them into dorsal, into numbing and relief. When someone is in a chronic dorsal state, high-risk or stimulating behaviors move them back up into sympathetic mobilization. The body cycles between these states because it cannot stay in either extreme indefinitely. The behaviors become addictive because they work, at least in the moment, and because there is no other available path to felt safety.

• What Cutting and Self-Harm Do in the Nervous System | 00:10:05 Self-harm functions within the same trauma feedback loop. Cutting can release a sympathetic surge when the blood appears, which shifts a person out of dorsal numbness. It can also trigger the release of endogenous opioids that bring the body back down into dorsal relief. The person is not being manipulative or seeking attention. They are doing what their nervous system has learned will shift an unbearable state into something survivable. Jan describes working with women in her first job who were all self-harming, all addicted, and all diagnosed with borderline personality disorder. She did not accept that framing then and still does not. What she saw was a population of trauma survivors whose bodies were doing exactly what bodies are designed to do.

• Not Being Seen Is Traumatic | 00:37:30 Jan describes the privileged neurodivergent teenagers she saw in her clinical work who came to her saying I have everything, why am I like this? What they were experiencing, she explains, is the trauma of not being seen and fully delighted in for exactly who they are.

• What Healing Actually Looks Like With a Teen | 00:43:21 Jan describes her clinical work with teens as beginning with co-regulation and the building of a relationship where the teenager feels genuinely safe. That means meeting them where they are, including the sessions where they spend the entire hour talking about how much they did not want to come. It means creating an environment where they can say anything as long as they are respectful of the basic boundaries. It means finding something to fall in love with in the person sitting across from you, because that delight is the container in which a teen can begin to explore shame, identity, and the behaviors they have been hiding from everyone else.

• Neuroception, Interoception, and the Paradigm Shift | 00:22:55 Interoception is the body's capacity to sense what is happening from the inside: the tightness in the chest, the quickening of breath, the feeling of something that has not yet found words. Jan's Felt Sense Polyvagal Model combines polyvagal theory with a body-based practice to help people slow down enough to listen to what is already happening in the body rather than suppressing or bypassing it.

Felt Sense Polyvagal Model Institute — Jan Winhall's institute where she teaches the Felt Sense Polyvagal Model internationally, including graphic models of the nervous system that can be downloaded and used with children and families.

Somatic Mondays With Jan Winhall — Monthly community gathering focused on nervous system regulation for people navigating addiction and recovery, hosted by Jan Winhall and Recovery Reimagined.

Dr. Sean Inderbitzen on LinkedIn — Autistic therapist, parent, and author of two books on polyvagal theory and autism, referenced by Jan Winhall in this episode as a recommended resource for neurodivergent families.

Understanding PDA — Free class where I teach the nervous system disability framework and the polyvagal concepts that underlie the addiction and self-harm patterns Jan describes in this episode.

Burnout — Free class with context for the dorsal shutdown and burnout states that Jan's work helps illuminate, particularly for families whose teens are reaching for substances or engaging in self-harm.

Paradigm Shift Program — My signature program where the nervous system framework, felt safety, and the accommodation toolkit are taught live, creating the kind of co-regulated container Jan describes as foundational to all healing.

In this episode I share the definition of PDA I use: PDA is a survival drive for autonomy and equality that consistently overrides other survival instincts, including eating, sleeping, toileting, hygiene, and safety. I explain how this is different from older definitions that consider PDA to be anxiety driven, and why that distinction matters clinically and practically. I also I introduce the concept of equalizing - the behavioral expression of the disability that extends well beyond demand avoidance into physical, verbal, and relational patterns that can look like manipulation, control, or defiance but are actually a nervous system response.

• Why the Definition of PDA Matters: Survival Drive vs. Anxiety | 00:02:05 The original framing describes PDA as an anxiety-driven need for control. Anxiety is a future-oriented cognitive experience, and that framing points clinicians and parents toward exposure therapy, medication for anxiety, and pushing through avoidance. My definition is different. PDA is a survival drive for autonomy and equality that operates on a subconscious level, in the nervous system, before conscious thought. A child can love their grandparent, be emotionally attached to their therapist, and genuinely want to go to football practice, and still be accumulating nervous system activation from losses of autonomy throughout all of those experiences. The drive does not require cognitive anxiety to be present. That distinction changes what we do about it entirely.

• The Survival Drive That Overrides Everything Else | 00:07:35 What makes PDA neurologically distinct, in my conceptualization, is that the survival drive for autonomy and equality can override other basic survival instincts. I share an example from my own life: telling Cooper to stay away from the fire, gently at first, then with more urgency, and watching him move toward it instead of away, then try to jump in. I have also worked with families where a child accelerated into a body of water - without the ability to swim - after being told to stay back. These are extreme examples I use to illustrate the mechanism, not to suggest this is every family's experience, but they show that the PDA nervous system can prioritize autonomy above the instinct to stay safe, which is what can eventually produce the feeding tubes, the selective mutism, and the basic needs collapses that many families in this community have experienced.

• What Equalizing Is and Why It Looks Like Manipulation | 00:12:31 Equalizing is a nervous system response to get back to a place of perceived equality - or above another - after a loss of autonomy has been registered. It can be physical: disorganizing something that was orderly, knocking things off tables, touching things impulsively, hovering near a sibling, controlling where a parent can sit or look. It can be verbal: correcting words, redirecting blame, pretending not to hear, changing the topic impulsively, lying about things that seem random. It can be directed at a safe person, at a sibling, at objects in the environment, or even at self.

• The Spices Example: PDA Versus Other Neurotypes | 00:17:11 I use a simple scenario - organizing kitchen spices - to distinguish PDA equalizing from behavior in other neurotypes, inclduing non-PDA autism, OCD, and anxiety.

• Equalizing Can Be Subtle Until It Escalates | 00:15:36 As cumulative activation builds and the environment continues to signal losses of autonomy without accommodation, these equalizing expressions can escalate toward the large nervous system responses and basic needs struggles I describe in this episode. The goal of everything I teach is to bring down that cumulative activation so families avoid these challenges, or get through them as quickly and smoothly as possible.

Understanding PDA — Free class where I teach the nervous system disability framework, the neuroception mechanism, and the cumulative activation logic introduced in this episode.

Burnout — Free class with context for how the survival drive overriding basic needs leads to the burnout state many families are already in when they find this work.

Paradigm Shift Program — My signature program where the full framework for understanding PDA, equalizing, and responding to both is taught across twelve weeks of live coaching.

If you are a parent who cannot unschool or homeschool your PDA child, or who needs practical support navigating the school system, this episode is for you. I am joined by Dr. Destiny Huff, a licensed professional counselor, non-attorney special education advocate, and neuro-affirming trainer who is also late-diagnosed autistic and ADHD and a mother of neurodivergent children.

Dr. Huff shares the most common patterns she sees as PDA families navigate schools, how she frames the nervous system lens in IEP meetings, the specific accommodations she advocates for most consistently, her approach to functional behavioral assessments, and practical steps parents can take right now.

• Two Patterns Dr. Huff Sees Advocating for PDA Families | 00:05:06 The first is families who have learned about PDA but are still defaulting to the demand avoidance frame when explaining it to schools, which makes it easy for administrators to push back by saying the child just needs to deal with demands. The second is schools latching onto the term PDA itself, either saying they do not recognize it or using it superficially, without understanding the nervous system mechanisms underneath it. Dr. Huff's approach is to move past the label entirely and focus on the root cause: what is happening in the nervous system, what does dysregulation look like for this specific learner, and what changes in the environment and approach can support access and safety.

• How to Frame the Conversation in an IEP Meeting | 00:13:53 Dr. Huff focuses on three areas that school staff are almost never formally trained on: sensory needs, communication access when regulated and dysregulated, and executive functioning, of which regulation is a component. She always starts with a profile letter that describes the whole learner before getting into accommodations or concerns, and she prefers working with teachers directly because they are often the most unheard people in the room and the most open to trying something new when asked what they are actually seeing.

• Accommodations Dr. Huff Advocates for Most Consistently | 00:29:43 The first is declarative language, documented with a concrete example of what it actually looks like in practice, because most teams have heard the term but are not using it correctly. The second is a nonverbal communication plan, for when the learner is dysregulated, that could include a designated safe space and trusted person, identified by the learner rather than assigned by the school, paired with a low-profile signal like a hand gesture or an email so the learner can access that space without drawing attention.

• Her Approach to Functional Behavioral Assessments | 00:40:11 Dr. Huff sees FBAs as useful primarily because they reveal the school's perception of the learner, even when the terminology reflects a behavioral lens she does not share. Once she understands what the school believes is driving the behavior, she goes into rewrite mode with her families: adjusting the language, shifting the approach toward relationship, safety and trust, and pushing back on behavior intervention plans that default to token economies and compliance strategies.

• What to Do When a Child Is Too Burned Out to Access School | 00:37:27 Dr. Huff has successfully advocated for truncated days and reduced schedules. Her consistent position is that a reduced schedule does not let the school off the hook for providing free and appropriate public education, but it does acknowledge where the child's nervous system is right now and creates a starting point that can be adjusted over time based on what is actually working.

Your FBA Is a Fantasy — Book by Rick and Doris Bowman on how to approach functional behavioral assessments through a trauma-informed, neuro-affirming lens rather than a behavior modification lens, recommended directly by Dr. Huff in this episode.

Collaborative & Proactive Solutions — Ross Greene's framework for addressing the root causes of challenging behavior through collaboration rather than compliance, referenced by Dr. Huff as a resource for reframing FBAs.

The Affirming Village Podcast — Podcast hosted by Dr. Destiny Huff and Lisa Baskin Wright on neuro-affirming approaches to education and parenting.

Neuro-Affirming Special Education Handbook — Dr. Huff's book on navigating special education in the US from a neuro-affirming standpoint, including guidance on IEPs, FBAs, and supporting PDA learners.

Advocacy and Consultation With Dr. Destiny Huff — Dr. Huff's direct services for families, including IEP meeting attendance, drafting parent input statements, and consultation on supporting PDA and neurodivergent learners in schools.

Dr. Destiny Huff on Instagram — Follow Dr. Huff for ongoing content on neuro-affirming special education advocacy, IEP navigation, and supporting neurodivergent learners in schools.

PDANA - Dr. Destiny Huff is board member of PDA North America.

Paradigm Shift Program — My signature program for parents of PDA children and teens taught across twelve weeks of live coaching.

When he was young, it seemed like my son Cooper was almost always active and agitated. I tried everything I was told to try - bubble blowing for deep breathing, emotion naming, zones of regulation, nature walks with candy as incentives - but nothing worked. Maybe the activity would occupy him once, but then he'd be agitated all over again afterwards. I thought I must be going it wrong, or just a bad mom.

What I know now is that I wasn't and I'm not - and neither are you. The logic underneath those approaches just does not match how a pathologically demand avoidant nervous system actually works.

In this episode I discuss the 4-S Framework I developed to help my PDA son - and the children of the many families I was working with - stay regulated. The four S's are: safe nervous system, sensory intense experience with novelty and dopamine, screens, and special interests. I talk through what each one means for a PDA brain specifically, why children in burnout can often only access some of the four, and how to use this framework to structure unstructured time so it feels less like chaos and more like a plan.

• Why the Approaches I Was Given Kept Making Things Worse | 00:02:06 I walk through the regulation strategies I tried with Cooper before I understood PDA: sensory integration activities like bubble blowing and glitter shaker bottles, naming emotions and using the zones of regulation stoplight, and nature walks I would incentivize with sweets. Each one followed the same pattern: novelty made the first attempt work, and the second produced refusal, avoidance, or escalating behavior. But then I had an "aha" moment and made a shift that changed everything.

• S1: What Actually Makes a Nervous System Safe for a PDA Brain | 00:21:43 A safe nervous system for a pathologically demand avoidant child is not simply a kind or emotionally attuned person. In my work with thousands of families, I have seen loving, competent, well-trained adults be deeply unsafe nervous systems for PDA children, not because they are unkind but because they arrive with an agenda. They want to teach, engage, improve, or modify. The safest nervous system is the one that is not trying to change the child at all. I use the example of a grandma who arrives with activities and baking plans versus a grandpa who sits on the couch reading his phone with zero agenda. The PDA child will reliably gravitate toward grandpa. This is also why you may notice your child feels safer with your partner on certain days, or with a teenage neighbor who just wants to jump on the trampoline without any goal. The lower the agenda, the safer the nervous system.

• S2: Sensory Intense Experience, Novelty, Dopamine, and the Modern Day Alchemist | 00:26:48 The second S covers three overlapping things: physical sensory intensity like roughhousing; novelty, which is why the first time at an ice skating rink produces full regulation and the second visit produces a meltdown; and dopamine, which can show up as a fixation on sugar, screens, or the drive to transform things from one material state to another. I call this last pattern the modern day alchemist, and I see it consistently across PDA children and adults I work with.

• S3: Screens, Books, Podcasts, and Journaling as Regulation Tools | 00:40:02 I view screens neutrally, and I want to be clear that this S is not only about screens. For PDA children and teens who are older, or for PDA adults who grew up before constant access to devices, this S may have looked like always having a book in hand, listening to podcasts, or journaling compulsively. What all of these have in common is that they provide autonomy, allow engagement with special interests and learning without an agenda, and offer relief from the intense sensory input that comes both from the outside world and from inside a nervous system that is chronically activated. For Cooper during burnout, screens were one of only two things that kept him regulated enough to eat and exist. Now that his activation has come down, he tracks his own screen time and averages around two hours a day, half the national average for American children. That shift was not something I imposed. It happened naturally as his window of tolerance expanded. I share this because I know how much shame parents carry around screen time, and I want to offer a different frame: screens in the right season can be what keeps your child accessible to life.

• S4: Special Interest and How to Use the Full Framework in Practice | 00:43:45 Special interest for a PDA brain involves what researchers call monotropic focus: sustained attention toward an interest that is deeply regulating, and dysregulation when pulled away from it. For Cooper right now the three special interests are football, fishing, and friends. When I need to help him out of the "I'm bored" loop, I use the framework to identify which S's are available and stack them. In the episode I also name what this looks like in burnout: during the hardest years, Cooper could only access safe nervous system and screens. The other S's returned as his activation came down, and I want parents to hold that as evidence that things can shift.

Understanding PDA — Free class where I teach the nervous system disability framework and the threat perception mechanism that explains why standard regulation approaches tend to backfire for PDA children

Burnout — Free class with context for the burnout period I describe in this episode, when only two of the four S's are typically accessible

School, Screens and Siblings — Free class directly relevant to the screens S and how I think about screen time as a neutral tool within the Four S Framework

Monotropism: Understanding Autistic Ways of Being — Background reading on the monotropic focus I describe in the S4 section and how it shapes regulation and learning in autistic and PDA brains

Monotropic Split and Burnout — Explains what happens when monotropic focus is repeatedly fractured, directly relevant to why pulling a PDA child away from a special interest contributes to cumulative activation and burnout

Me and Monotropism: A Unified Theory of Autism — Deeper academic context for the monotropism framework I reference when explaining the fourth S

I sit down with Dr. Jennifer Huffman, a board-certified pediatric neuropsychologist, PDA woman with lived experience, and creator of the Neurodynamic Navigator System and the Neurodynamic Quotient. After twenty-five years working with children whose profiles were called often called ODD (Oppositional Defiant Disorder), she developed a framework to make the dynamic, fluctuating nature of the PDA brain visible and usable for parents, teachers, and clinicians.

We talk about her childhood as an undiagnosed PDA autistic person, why ODD as a diagnosis isn't helpful, how she assesses children who cannot come into an office, and the app she is building to help families. After all that great insight, just her closing message for parents of PDA kids in burnout makes this episode worth a listen.

• Growing Up as an Undiagnosed PDA Autistic Neuropsychologist | 00:02:48 Dr. Huffman describes a childhood marked by academic failure in math from third grade, severe bullying that led her parents to drive her thirty minutes each way to attend school in a different town, and the recurring experience of being told she was not living up to her potential. She names the specific mechanism she now recognizes in herself: she cannot process on demand. If someone tells her to do something, or if it feels redundant, her brain shuts off. This is not willfulness. It is the same mechanism she has spent twenty-five years helping children and families understand. She describes finding neuropsychology in her third year of undergraduate study as a light bulb moment, not because she wanted a career but because she was trying to figure out her own brain.

• The ODD Buster: Why Oppositional Defiant Disorder Is So Often the Wrong Label | 00:12:39 Dr. Huffman describes spending twenty-five years working with the complex cases other clinicians could not crack, children who had been given ODD diagnoses and whom nobody wanted to work with. She calls herself the ODD buster and states directly that in her clinical experience, she has rarely seen a child who actually had ODD. What she consistently found underneath that label was high empathy, anxiety, sensory differences, social communication differences, and learning differences, often in combination. She names ODD as an example of a DSM category built by non-neurodivergent clinicians describing externalized behavior without curiosity about what is underneath it.

• How She Assesses Children Who Cannot Come Into an Office | 00:17:38 Dr. Huffman explains that when a child is in burnout and cannot access evaluation, the work does not begin with the child. It begins with the parent: helping them advocate with the school, coordinating with medical providers who may not understand why the child cannot leave the house, and slowly building a relationship with the child themselves. She describes spending six months to a year playing Minecraft with a child before any formal assessment data is collected, and names this as genuinely valuable clinical time. She also holds PSYPACT certification, which allows her to work with families across most of the United States without the family ever entering her office.

• The Neurodynamic Quotient: Making the Dynamic Nature of the PDA Brain Visible | 00:36:57 Dr. Huffman introduces the Neurodynamic Quotient, her framework for understanding why PDA children can do something one day and appear to lose the skill the next. The formula combines dynamic safety, which includes felt safety, connection, information, and autonomy, with dynamic capacity, which includes the battery, sensory load, and executive functioning scaffolding, plus motivation. She explains why autonomy functions as a multiplier: if it reaches zero, the entire product is zero regardless of how much skill or capability is present. She also names motivation as the variable parents and teachers most often misuse, pushing past natural capacity because the child demonstrated what they were capable of once.

• Do Not Get in Front of Your Child | 00:55:03 Dr. Huffman closes with a message for parents whose children are in burnout. She names never assuming the child is not capable as the most important thing a parent can hold onto, and shares her own story as evidence: her parents could not have predicted she would become a neuropsychologist. She uses the phrase "do not get in front of your child" to mean: if they have something they want to do, let them fly. The child who is in their room with the lights off on Minecraft is telling you what they need. Meeting that need and staying regulated yourself is what moves them through burnout faster than fighting against it.

Understanding PDA — Free class with context on the nervous system disability framework and the dynamic, cumulative nature of activation Dr. Huffman builds on throughout this conversation

Burnout — Free class with context for the red zone experience Dr. Huffman describes and the burnout recovery process for both children and parents

Paradigm Shift Program — Our signature program where parenting for autonomy, safety, and connection is taught in full

Unlocking the PDA Brain by Dr. Jennifer Huffman — Dr. Huffman's book introducing the Neurodynamic Navigator System, written as a manual for understanding and supporting the PDA brain

The Able Center — Dr. Huffman's private neuropsychology practice in Illinois

The Baby Fold — The Illinois nonprofit where Dr. Huffman serves as Vice President of Clinical Operations, specializing in trauma and higher support needs neurodivergent children

Beyond Behaviors by Mona Delahooke — Mentioned by Dr. Huffman for understanding what is happening beneath the behavior in neurodivergent children

Dr. Huffman is also a board member of PDA North America.

This episode is an interview with my husband, Jake, about his path from well-founded skepticism of Pathological Demand Avoidance to fully changing his parenting to support our two PDA sons, and how that has helped all three of them.

This conversation is for parents who aren't sure about PDA, their partners who are, and everyone who has wondered what it actually looks like to shift the paradigm as the "non-lead" parent. Jake talks about the enforcer role he played, dreading coming home from work, what brought him to shift his perspective, and how he took action to change his relationships with his sons.

• Why Non-Lead Parents Lag and Why That Is Not a Deficiency | 00:10:01 Jake explains that his skepticism about pathological demand avoidance came from the same place as his desire to be a good father: wanting his son to be okay long after he was gone. He names the specific experience of not being present enough during the day to witness what Casey was witnessing, the cognitive dissonance of a child who could race through Halloween trick-or-treating and then suddenly be unable to walk, and the ease with which behaviors that look manipulative can be written off as such. He is clear that lagging does not make a parent deficient. It makes them human.

• What the Enforcer Role Actually Felt Like | 00:24:12 Jake describes placing himself in the role of the disciplinarian and enforcer when Cooper was young, trying strict and punitive approaches consistently enough to know they were not working. He reflects on the moments when Cooper would submit, and how even those felt awful because he was a grown adult overpowering a four-year-old. He names the specific appeal of the pathological demand avoidance approach as not just intellectual but personal: he did not want to be that kind of dad, and the relational damage it was doing to his connection with Cooper was undeniable.

• Dreading 5PM and the Second Arrow | 00:43:44 Jake describes a period when he went from counting down the hours to the end of the workday to dreading them, knowing he was walking back into a home where the kids were dysregulated, Casey was stretched to her limit, and there was no joy. He names the second arrow clearly: feeling like a dad who dreads his own family, and then feeling guilty for that. He offers this not as a confession but as something he suspects many non-lead parents are sitting with quietly.

• The Trampoline Commitment and What It Built | 00:44:23 Jake shares a concrete example of how he found a way into connection with Cooper during burnout: committing to saying yes every time Cooper asked to go on the trampoline, even though the activity involved Cooper lying there while Jake jumped for twenty minutes. He frames it honestly as work, not fun fatherhood. But he also describes how, when his legs gave out and he lay down next to his son and started pointing at clouds, the small moments of connection began to accumulate. This type of commitment, he says, may be available to other parents who work full days and only have evenings.

• Vulnerability With Other Dads and the Masculinity Frame | 00:29:46 Jake reflects on coaching Cooper's tackle football team and the specific difficulty of needing other coaches to understand that Cooper's meltdowns were not a measure of his commitment or character, while knowing that a full explanation of Pathological Demand Avoidance would not land. He names the fear of judgment, and the discomfort of demonstrating vulnerability in a context that did not historically make space for it. He frames the masculine enforcer archetype as a stereotype that most men do not actually identify with but feel bound by because breaking it is a risk.

Understanding PDA — Free class with the foundational context that Jake describes eventually coming to through lived experience

Burnout — Free class relevant to the burnout phases with both Cooper and William that Jake discusses throughout

Paradigm Shift Program — Our signature program where Jake hosts three live sessions specifically for non-lead parents

In this episode I talk about how I understand my autistic brain, my internalized pathological demand avoidance, and why it took me six years of working in this space before I felt certain enough to say this publicly. I also walk through my life, from childhood to the present, with renewed understanding, in the hope of sharing insights that can help you.

This episode is for parents of high-achieving young adults who burn out, for women exploring whether they might be autistic or pathologically demand avoidant, and for anyone who just wants to know more about the person behind this work (me!).

Key Takeaways

Why Casey Resisted Identifying Publicly for Seven Years | 00:06:29 Casey names three reasons she held back. First, she genuinely was not sure, because her experience did not feel like the veil-lifting moment many autistic adults describe, and she had other diagnoses that made the picture muddy. Second, her early experiences engaging with the autistic and PDA online community involved sustained harassment and cancellation attempts, which made that space feel unsafe rather than affirming. Third, her resistance to being labeled by others mirrored exactly what she teaches about pathologically demand avoidant children who reject diagnoses: it is a survival drive for autonomy, and that include identity.

What Her Internalized Profile Looked Like in Childhood and School | 00:18:25 Casey describes herself as an extraordinarily compliant and academically gifted child whose two special interests were academics and people. She explains that school functioned as a natural accommodation: it was predictable, she was consistently above her peers, and cause and effect was clear. At home, her parents' divorce introduced chaos, and her nervous system defaulted to freeze, fawn, and shutdown rather than fight or flight. She started writing in journals for hours as a way of processing social interactions and exerting control over her environment, which she now sees as the same mechanism as a child spending hours on a screen.

Burnout at 26 and the Panic Disorder Years | 00:27:55 Casey describes her first panic attack during a graduate economics exam at Columbia, followed by a full dissociative episode in the law library weeks later. She lost 20 pounds, could not eat or sleep, and could only function when physically close to safe nervous systems. She was prescribed medication, but she refused to take it for fear of addiction. She frames this period as a burnout triggered by the first situation in her life where she was not the best at something, in an environment where the rules of the game were no longer ones she could win.

Postpartum Burnout and What Cooper's Birth Revealed | 00:38:40 Casey describes going off her medication during pregnancy, an emergency C-section after 48 hours of labor where she felt she lost control of her body, and the 18 months of suicidal ideation and intensive outpatient psychiatric care that followed. She was diagnosed with postpartum OCD, anxiety, and depression. She now understands this as a profound loss of bodily autonomy compounding a nervous system that was already primed for that response.

Acceptance as the Shift That Therapy Alone Could Not Produce | 00:42:15 Casey describes reaching a point after years of EMDR, somatic experiencing, safe and sound protocol, havening, and meditation where she recognized that some of what she was experiencing was not going to be "fixed" by more therapy. It was brain wiring. She shares how she now applies to herself the same accommodation framework she teaches parents, including using the 4S's of regulation, attending hot yoga for sensory regulation, and protecting her close relationships as her primary nervous system resource. The intrusive self-critical thoughts, she explains, are her version of self-equalizing: a nervous system response to perceived loss of control that she is learning to accept.

Relevant Resources

What Is PDA — Foundation for understanding the internalized pathological demand avoidance profile Casey describes in this episode.

Burnout — Free class with context for the burnout patterns Casey traces across her own life.

Finding Meaning — Free class relevant for parents and adults exploring acceptance and long-term perspective.

I speak with Stephanie Harrigan, a certified speech language pathologist with nearly fifteen years of experience working with the neurodiverse population, to talk about selective mutism, feeding therapy and more.

Stephanie brings a regulation-first, child-led approach to all of her work, and this conversation is full of concrete examples from her practice, including what feeding therapy actually looks like when it follows the child's lead, how she has worked with selectively mute children, and what she has seen happen to communication when behavioral pressure is removed.

We also talk about how to advocate effectively with a school team and what research Stephanie uses when making the case for a non-behavioral approach.

Stephanie can be reached at Inclusive Minds Educational Consulting via [email protected].

She also shared some links to research and resources:

https://scerts.com/

https://www.ted.com/talks/amy_laurent_compliance_is_not_the_goal_letting_go_of_control_and_rethinking_support_for_autistic_individuals

https://tiltparenting.com/2025/01/21/episode-424-creating-neurodiversity-affirming-schools-with-amanda-morin-emily-kircher-morris/

https://pmc.ncbi.nlm.nih.gov/articles/PMC9601143/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4515208/

https://aane.org/autism-info-faqs/library/restoring-the-autistic-nervous-system-a-gentle-path-to-regulation/

• Regulation Before Skills, Always | 00:07:00 Stephanie describes how her approach across all of her work, whether feeding, Augmentative and Alternative Communication (AAC) speech therapy, or selective mutism, starts with regulation. She references her time at the Center for Discovery, where the entire program was built on the belief that sensory and emotional regulation is the foundation. Without it, she says, everything else crumbles. She uses the analogy of a house: regulation is the foundation, and speech and communication goals sit on top of it.

• What Child-Led Feeding Therapy Looks Like | 00:18:32 Stephanie gives two concrete examples from her feeding therapy work. One student only ate hot dogs at age sixteen. Rather than introducing new foods directly, she used the student's interest in small figurines to interact playfully with food. Another student loved baking but would not eat what they made, so they baked together and delivered food across campus. Stephanie explains that child-led feeding therapy means finding the child's special interest and embedding it into the work, with no timeline for progress and no pressure toward any specific outcome.

• Selective Mutism and the Role of Safety | 00:24:28 Stephanie describes working with a kindergarten student who was described by staff as someone who never spoke. In her first session with him, he spoke immediately. She attributes this to the felt safety she worked to establish before anything else. She describes how she uses a total communication approach, honors every form of communication including grunting and hissing, and matches the child's energy rather than bringing high excitement.

• AAC Is Not a Last Resort | 00:30:29 Stephanie explains what AAC is and pushes back on the common concern that using a device will prevent a child from learning to speak. She draws a parallel to what Casey describes with PDA children more broadly: the issue is often not that the child lacks the ability, but that at times stress and sensory dysregulation are blocking access to that ability. She describes seeing communication expand when sensory needs were addressed first, and frames AAC as one tool in a total communication approach rather than a replacement for speech.

• How to Work With a School Team as a PDA Parent | 00:48:57 Stephanie's advice for parents trying to collaborate with a school team is to not be afraid to advocate. She says she has never viewed a parent as challenging, and that strong advocacy is not only a parent's right but something she personally appreciates. She suggests sharing resources from a place of curiosity rather than confrontation, asking for the team's expertise, and framing questions as "I found this and I'm curious what you think" rather than leading with disagreement.

What Is PDA — Foundation for understanding the nervous system lens Stephanie and Casey share

School, Screens and Siblings — A free class relevant for families navigating school-based challenges discussed in this episode

Understanding PDA — A free class for deeper context on regulation and autonomy

This is the fourth episode in my series on PDA and restrictive eating, and this one is for therapists.

If you are an occupational therapist, a speech language pathologist, or another type of therapist working with a child who isn't responding to gentle, play-based, sensory-based, or exposure-based feeding approaches the way you'd expect, this episode designed to help you.

I share the full arc of my older son Cooper's journey with extremely restrictive eating, from the time he was four and a half years old and eating primarily three processed foods, through five years of occupational therapy, to where he is today. I walk through how we adapted the SOS feeding protocol over time to incorporate autonomy, equality, lower demands, play, and connection to special interests. I also share five specific strategies you can bring into your sessions.

Key Takeaways

The Sensory Lens Is Not Enough | 00:02:04 I share how Cooper's restrictive eating was initially understood through a sensory lens, and how, for about a year and a half, that framing guided his therapy. But the sensory lens alone was not sufficient to explain the patterns I was seeing or to help him expand his eating. What I came to understand was that his survival drive for autonomy was also a major factor, and that the two had to be held together rather than treated separately.

What Was and Was Not Working | 00:11:56 I walk through what was working in the early stages of occupational therapy, specifically the therapist's focus on establishing relationship and rapport before moving to skill acquisition, and the role that dopamine, novelty, and sensory-intense experiences played in Cooper's initial engagement. I also describe what was not working: visual schedules and laminated choice boards, pressure to describe sensory experiences verbally, and structured home-based feeding protocols. For a PDA child, I explain, even chosen structure can become an internal demand.

Autonomy and Equality as Accommodations | 00:16:37 I describe two specific accommodations that became central to how we approached feeding therapy over five years: autonomy and equality. Autonomy meant shifting away from scheduled, structured feeding time and toward strewing, declarative language, and following Cooper's lead. Equality meant deliberately allowing him to win, be above the therapist and me in games, direct the session, and have the last word. I explain how these accommodations address the root cause of nervous system activation rather than managing the surface behavior.

Lowering Demands in the Session | 00:29:35 I describe what it looked like to lower demands in the occupational therapy session itself, meaning doing things for Cooper that he was cognitively or physically capable of doing himself, so that his available capacity could go toward tolerating and engaging with food. I give specific examples and I address the common concern that this approach enables children rather than building independence, and explain why the logic is different for PDA.

Special Interests as a Turning Point | 00:37:06 I describe the turning point in Cooper's feeding therapy, which came when eating became connected to his special interest in football. I explain how this connection made it possible to revisit things he had previously rejected, including the laminated food charts, but this time entirely on his terms. I also offer five specific strategies for therapists at the end of the episode.

Relevant Resources

Free Therapist Masterclass — Free class for OTs and therapists on PDA.

What Is PDA? — Overview of PDA as a nervous system disability.

Paradigm Shift Program —Our signature live coaching program where we walk families as they implement accommodations and move forward.