How is PDA diagnosed in children?

PDA is not a diagnosis used in the United States; it’s not in the Diagnostic and Statistical Manual (DSM-V) or the international medical manual, the ICD-11. Rather, PDA is a cluster or profile of behaviors and characteristics. Although research on PDA is in its infancy and many questions about it remain, learning about PDA can still give parents new ways to understand and support their child.

There is no standard clinical assessment for PDA. However, if you suspect that your child might have PDA, you may come across the Extreme Demand Avoidance Questionnaire (EDA-Q), now called the EDA-8. While it can provide insights, which can be a helpful aid for practitioners exploring a PDA profile, it’s important to remember that the EDA-8 was created for research purposes and hasn't been tested in clinical settings.

Parents can seek a neuropsychological assessment from a provider who is familiar with PDA. If applicable, the provider may note that a child has “demand avoidance features” or “a PDA profile” in the assessment. This would be distinct from the child's primary diagnosis, which is most often autism or ADHD.

If you request an assessment, think about why you want an assessment and whether the potential benefits outweigh the costs, including time, money, and the challenges of the process itself. Having this label is of limited usefulness when dealing with schools, insurance, and public benefits programs.

It’s important to get an assessment from a seasoned psychologist or psychiatrist who understands autism as well as other disabilities and mental health conditions, and not just PDA. This is crucial so that they can compare different conditions with similar symptoms to make the most accurate assessment.

For more information, see our full article Pathological Demand Avoidance (PDA) 101.