PDA and attachment disorder aren’t the same

I recently came across a blog post where the writer was stating that PDA doesn’t exist and these individuals are actually children who have been mistreated and abused, that they actually have attachment disorder.

This made me rather angry. Firstly the person has no experience of PDA children and secondly their perception of autism was shaky at best. What worries me is that someone who knows a PDA child may come across that post and actually believe the misinformation that is on it and end up doing more harm to a vulnerable child or adult than good. It’s bad enough that there is very little help available for autistic and PDA people and getting an accurate diagnosis is akin to winning the lottery in terms of likeliness to happen, but for those parents to be accused on harming their children when they go looking for help for their children is abhorrent.

One of the points mentioned in the offensive post I read was that PDA obviously doesn’t exist because it’s not included in the DSM. I’m sorry but when did the DSM become infallible? Sensory Process Disorder isn’t in the DSM either, are we now to accept that doesn’t exist either? The DSM doesn’t cover every condition, it couldn’t possibly do that as every day we are still uncovering new differences in the human autonomy. There are still so many physical problems which don’t have a name or a diagnosis because they are the first of their type seen. It took till the third edition of the DSM for autism to even be added and it was placed under schizophrenia. Even now the DSM doesn’t include a fully accurate description of autism, and Asperger’s has been removed completely. So just because something isn’t in the DSM doesn’t mean it doesn’t exist, it’s a guide, not the Bible.

The person also stated that the diagnosis traits described for PDA by Elizabeth Newson (the person who first recognised PDA and named it) are vague. Really? What and the original autism traits weren’t? They still are now. Newson does give some examples alongside the traits described to help but PDA is like Autism in that it is a spectrum. No two people are the same so if the traits were to be described in exact terms then, like Kanner’s pure autism, it would exclude most of the individuals who have PDA. And what good would that be.

PDA is a relatively new diagnosis. It will take ages for awareness and acceptance of it to spread enough for it to be included in the DSM. And it’s not like they produce a new one every year either.

Now, the assumption that PDA is actually a description of attachment disorder is rather insulting and very inaccurate. Of course there are parents and guardians of children who mistreat and abuse their charges, sadly. But I think people would have noticed if every abused child all had the exact same traits, similar to that of autism. People in the past have already (and still do) tried to pin autism on the parents ‘bad’ parenting. The rise of the refrigerator mothers planted false seeds of neglect in the public eye. Despite evidence of parents who also had autistic traits and evidence of amazingly good parenting disputing those claims. If autism was a product of bad upbringing then those placed in institutions where they were so badly treated would have become more autistic. And if what this person is saying is true then would we not have seen every child develop PDA traits. Alas we didn’t, because PDA and autism are not products of bad upbringing but are actually a neurological difference which these individuals are born with.

I highly doubt that thousands of children and adults have all been mistreated and have developed the exact same traits, including autistic traits, that present in a similar way and yet are completely different to that of knowingly abused and mistreated people. There are plenty of autistic individuals who have had bad upbringings who haven’t developed PDA traits. There are lots of mistreated and abused NT people who haven’t developed autistic and/or PDA traits. It seems the person who wrote the misleading and inaccurate post can’t actually tell the difference between signs of mistreatment and abuse and that of a very real and present neurological difference. And that’s without getting into the families who have one PDA child and one NT child who have been brought up the exact same way but yet were very different from birth.

It seems to me that anyone who would abuse a child wouldn’t go to the effort of having professionals and the potential of social services prying into their personal lives if there wasn’t something actually wrong. I’m sure neglectful and abusive parents would actually try to hide the damage they have done rather than try to get their child the help they need.

Looking at the diagnostic criteria for attachment disorder, it says AD cannot be considered when an autism spectrum disorder are present. So by that reasoning PDA people cannot have AD anyway, unless you ignore the evident ASD signs that are present in PDA people. I’d be wary of anyone trying to push that. It seems that neglect and abuse must show up differently in autistic people. Based on my experiences, autistic people who have suffered abuse/neglect are even more rigid in their thinking and behaviour. They retreat more into themselves to try to protect themselves. So how would that fit with the PDA traits of appearing sociable and the Jekyll and Hyde behaviour? I highly doubt abused and neglected individuals would randomly show positive emotional responses, I doubt they would become hyper and silly and give everyone hugs at random if they had been mistreated. I doubt they would show more autistic traits when their anxiety is low. They wouldn’t be able to switch between caring and polite to anxious and demand avoidance and back at the blink of an eye. They wouldn’t be highly sociable, more so than most autistic individuals.

Sure PDA people are always anxious and will actively avoid demands. This has nothing to do with their upbringing but everything to do with the neurological differences of PDA. Why else would they all have the same traits, why else would there be genetic links, why else would some children not have the same diagnosis and traits if they had the same upbringing. We are still trying to figure out PDA, whether it is a sub-type of autism or a condition in it’s own right. Why do these traits all link with known autistic traits but with their own spin. What we do know is that every PDA individual also has autistic traits. There won’t be many who have evidence of abuse or neglect, although it would be unwise to say that no PDA experience negative upbringings, but to say every PDA person has is wrong and misleading, especially when you actually meet some of these parents and their children. There are parents of PDA children and adults who have been brought up with so much love and care that you can tell immediately how much they value them. And yet the PDA traits are still there.

Maybe instead of reaching for the nearest cheap option, people like the writer of the post would bother to see the child before them and go through every diagnosis until they get the correct one. Regardless of the cost to mental health services. It may be cheaper to plaster a diagnosis of attachment disorder on every PDA child who comes in rather than getting them the best help and the correct diagnosis even if it does cost more. Sadly it seems blaming the parents is a cheaper and easier option for some professionals than going through the process of gaining the correct diagnosis and admitting that these people will need life long help to manage the very real condition that is PDA.

For anyone interested, here is the blog post which sparked this post and the anger of many loving parents who have been wrongly accused of hurting their children because it’s an easier diagnosis for the so called experts.

Pathological Demand Avoidance: does it exist, and if so what is it?

4 thoughts on “PDA and attachment disorder aren’t the same”

  1. It’s interesting reading the article which prompted you to write this, as it’s premised on an ill-founded, somewhat ignorant, and out of date, view of autism itself! I’m still not sure where I think PDA fits but I do accept it as very real. My son doesn’t fit the PDA profile, but is very demand avoidant, and my parenting is mostly PDA-style.

    There’s a lot of work to be done.

    1. Yes, it’s worrying how those out of date views are still being spread around, they are very damaging. I’m glad the PDA strategies work for your son, it’s important to match our parenting techniques to suit the individual child as they are all different. Whatever works 🙂

  2. “Attachment disorder” was mentioned several times in connection with my daughter’s problems with school. No-one ever answered my question of how we could raise 4 relatively normal, high-achieving kids then become disastrous parents with the 5th – the closest anyone came was to suggest we’d just been “lucky” with the other 4!

    1. It’s so insulting. When you try your hardest to bring up your kids and someone comes along as throws everything you’ve done into doubt. I’m sorry you had to put up with such ignorance.

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