PDA is an extremely complex condition that has behavioural overlaps with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), a typical presentation of Autism Spectrum Condition (ASC) and Reactive Attachment Disorder (RAD).
Therefore, PDA can easily be mistaken for one of these conditions and some individuals may receive a mix and match of labels in order for clinicians to try to adequately describe the child by rigidly following the labels currently available in the DSMV.
If the child actually has PDA the mix and match of these labels may do little to support the child or to signpost others to the most efficient strategies.
‘A diagnosis of ASD defines the underlying developmental condition, but does little to signpost towards the specific needs and most effective interventions for a person with PDA.’ Dr Judith Gould, Director of the NAS Lorna Wing Centre for Autism:
‘Diagnostically the PDA sub-group is recognisable and has implications for management and support.’ Dr Judith Gould, Director of the NAS Lorna Wing Centre for Autism:
‘Those with PDA share areas of difficulty with other autism spectrum disorders, but strategies and approaches found to be effective are quite different. Differential diagnosis is therefore important to signpost towards appropriate educational and handling interventions.’ PDA Society
‘Since the diagnosis is not currently in the diagnostic manuals, a diagnosis may have to come under the term Autism Spectrum Disorder but should be qualified by something along the lines of ‘resembles the profile described as Pathological Demand Avoidance’ as this is what signposts teachers, parents and other professionals to the understanding and better management of the condition.’ PDA Society
The author and colleagues at Sutherland House, as well as those working with children who had been referred for specialist assessment, were describing how many of the generally accepted strategies that are advocated for working for children with autism and Asperger’s syndrome were not proving successful for children with PDA; an altogether different emphasis was required.’ Phil Christie, The Distinctive Clinical and Educational Needs of Children with Pathological Demand Avoidance Syndrome: Guidelines for Good Practice. Taken from the Good Autism Practice Journal published by BILD, 2007, by kind permission.
‘There is little available research evidence about what kind of long-term outcome is likely for children with PDA. However, without appropriate diagnosis and support, both for the child and his or her family, this has the potential to be very poor.’ Dr Judy Eaton (Dr Judy Eaton wrote the first and only published research paper about PDA in Adults)
Therefore, an assessment and potential diagnosis of PDA needs to be carried out by a highly experienced clinician.
‘These areas of overlap, and the potential for behavioural profiles being interpreted in different ways, underline the importance of a detailed and comprehensive assessment being carried out by experienced practitioners.’ Phil Chrisite, 2014, p.g 14, PDA Society’s Clinician’s Booklet.’ What are the differences between PDA, ODD and Attachment Disorder?
Services that Diagnose PDA Using a Multi-Disciplinary Approach in Accordance with National Institute for Care and Excellence (NICE) Guidelines. Some local health authorities prefer a multi-disciplinary approach and so these may be the preferred option.
The Elizabeth Newson Centre (ENC) are highly experienced but waiting times can be long due to the high demand for this service. http://www.norsaca.org.uk/diagnosis-and-assessment
The Lorna Wing Centre (LWC) are highly experienced in diagnosing complex presentations of ASC including PDA. They also have particular experience in the female profile of ASC. http://www.autism.org.uk/lornawingcentre
Dr Judy Eaton and Dr Jo Jones are both highly experienced in the assessment and diagnosis of PDA.
Dr Judy Eaton http://www.help4psychology.co.uk/
Dr Jo Jones http://www.healthcare4kids.co.uk/index.html
Dr Joanne Douglas is also extremely experienced and offers a diagnostic service in Northern Ireland The Spectrum Centre
Other Services That May Be Able To Offer A Multi Disciplinary Assessment for PDA
Libby Hill who we saw diagnose the little girl named Honey on the channel 4 TV show also offers a diagnostic service. Libby is an experienced speech and language therapist who works in conjunction with a clinical psychologist for ASC/PDA assessments. Small Talk
Dr Jonathan Middleton http://www.middletonpsychology.co.uk/ (sometimes offer a multi-disciplinary assessment depending on the individual case)