The Bylund Clinic

Episode 15: A Parent's Guide to Pathological Demand Avoidance (PDA)


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A Parent's Guide to Pathological Demand Avoidance (PDA)

In this episode, we sit down with Maria Gregory, LEP and Guy Hernandez, LMFT of TheraTree Community for a nuanced, clinically grounded conversation about Pathological Demand Avoidance (PDA)—also referred to as Pervasive Drive for Autonomy—and what this profile can look like in real children, families, and schools.
For parents who may be encountering PDA for the first time, Maria and Guy break down how a PDA profile differs from more familiar presentations of anxiety, oppositional behavior, or behavioral noncompliance. They explore why PDA is not currently recognized as a standalone diagnosis in the DSM or ICD, and how this lack of formal classification can create confusion for families seeking answers and appropriate support.
Maria and Guy share how clinicians can thoughtfully identify PDA traits without relying on a formal diagnostic label, including the professional frameworks, theories, and clinical patterns that tend to emerge during evaluation. They also address an ongoing debate in the field: whether PDA is exclusive to autism or whether it can exist outside of an ASD diagnosis.
Throughout the episode, the conversation highlights common misconceptions and misdiagnoses, including ways children with a PDA profile are often misunderstood by well-meaning adults and systems that rely on traditional behavior management approaches.
Maria and Guy explain how recognizing PDA traits shapes therapeutic goals and strategies, emphasizing approaches that prioritize safety, autonomy, and nervous system regulation. 
Finally, the episode explores the school context, including common barriers within educational systems, frequent misunderstandings by teams, and accommodations or approaches that can meaningfully reduce conflict and support engagement for students with PDA traits.
This episode is especially relevant for parents, clinicians, and educators seeking a deeper, more compassionate understanding of PDA—and practical guidance for supporting children whose needs do not fit neatly into traditional diagnostic or intervention frameworks.


You can learn more about TheraTree's services at:

theratreecommunity.com

(925) 378-9456


Learn more about the Bylund Clinic at:

bylundclinic.com

(925) 418-4661


Disclaimer: This podcast is for informational purposes only and is not a substitute for professional mental health treatment, diagnosis, or therapy. Listening does not create a therapist-client relationship. If you have concerns about your child's or your own mental health, please consult a qualified professional.

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The Bylund ClinicBy James Bylund