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PDA or ADHD? Understanding the "Why" Behind Demand Avoidance

8/15/2025

 
Minimalist line art illustration of two abstract human figures drawn with continuous blue lines. The figure on the left stands against a pale yellow background, while the figure on the right stands against a pale turquoise background. Both figures have simple, curved outlines with no facial details, and their forms are elongated with stylized arcs representing arms or torsos. The background fades into a light blue gradient at the bottom, creating a soft, calm aesthetic.
If you’ve ever asked your neurodivergent child to do something, even something they usually enjoy, and been met with resistance, distraction, or complete shutdown, you are not alone. Parents often describe this as defiance or stubbornness, but for many kids, it’s something deeper: demand avoidance.

This is where it gets tricky. Demand avoidance can happen for very different reasons, especially in ADHD compared to Pathological Demand Avoidance (PDA).  The outward behaviors can look the same, which is why confusion is common. The difference is in why it happens and what's happening within.


Demand avoidance is not "stubbornness" or a chance to give adults a "hard time." It is the brain’s way of protecting itself when a task feels overwhelming, threatening, or simply impossible to start.

For ADHD, it often comes from the weight of executive functioning needs like initiation, planning, and working memory.  For PDA, it is more about the nervous system reacting to a perceived loss of autonomy. Even wanting to do something can trigger avoidance if it turns into a "must."


Some people show extreme demand avoidance in one environment, such as a busy, unpredictable home, but far less in another, such as a calmer, more predictable space.  If avoidance decreases significantly when distractions are fewer and routines are clear, ADHD is a likely factor.  If avoidance stays the same even in calm and consistent settings, PDA may be possible.


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How to Tell if a Therapist, Clinic, School, or Teacher is Truly Neurodiversity-Affirming... or Just Using the Label

8/7/2025

 
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It feels like everywhere you turn lately, someone is claiming to be “neurodiversity-affirming.” Therapy clinics, schools, even entire districts are adopting the language, but when you look closer, the practices don’t line up. As a parent or caregiver, it can be hard to know who actually gets it and who’s just using the terminology because it’s trendy. There are real, meaningful differences between performative neuro-affirming language and truly affirming support. If you’ve been burned before, you're not alone. Here are some ways to tell whether a therapy clinic, therapist, school, or teacher is genuinely neuro-affirming or just using it as a marketing label.

Red Flag
 RED FLAGS of Performative “Neuro-Affirming” Practices
They say the right things. But what they do tells a different story.

1. They still use compliance-based methods but call them "regulation" or "social skills"
  • ABA, "gentle ABA," "new ABA," or “relationship-based” compliance therapy gets a new name and an infinity symbol or two.
  • They talk about regulation, but the goal is “quiet hands,” eye contact, or sitting still.
  • They might say "it's not ABA" but still use token systems, sticker charts, behavior points, or clip-downs.
  • Affirming practices directly oppose the core beliefs and methods of ABA, so if someone claims to be neuro-affirming while operating an ABA clinic, they're either misrepresenting non-ABA services as ABA (which is unethical and outside their scope), or they're lying and rebranding compliance-based methods with prettier language.
  • NO ONE needs 40 hours of therapy a week...or 20 hours...or even 5 hours!
2. They treat stimming, scripting, or echolalia as a behavior to extinguish
  • Even if they call it “replacement behavior” or “functional communication training.”
  • They're more concerned with social acceptability than the individual’s comfort, communication, or nervous system.
3. They praise “high-functioning” behavior and pathologize “low-functioning” traits
  • Uses functioning labels at all.
  • Says things like “you’d never know they’re Autistic” and means it as a compliment.
  • Puts independence above interdependence.
4. They center adult expectations, not the client’s experience
  • “How can we make this easier for teachers?” vs. “What does the child need to feel safe and successful?”
  • “We just want to prepare them for the real world” = code for forcing masking.
5. They have a token Autistic or ND person on staff (or consult) but don’t structurally change anything
  • They quote lived experience online but ignore or override that input in practice.
  • Surface-level inclusion without giving that person any authority or leadership.
6. They rely heavily on outdated goals and assessments
  • Still using developmental norms and milestones as if they're prescriptive.
  • Still prioritizing age-typical communication styles and penalizing divergence.
7. They use affirming language but push ableist outcomes
  • "We celebrate neurodivergence!" — but therapy goals still focus on eliminating Autistic traits.
  • Their mission statement says “empower” but their IEPs say “reduce” or “correct.”
8. Parent coaching = compliance coaching
  • Coaching focuses on how to get kids to listen, follow directions, and do what adults say.
  • Doesn’t help parents understand their child’s sensory needs, cognitive processing, or autonomy.
9. Teachers say they support neurodivergence but won’t change their classroom structure
  • No sensory breaks allowed.
  • All assignments must be completed the same way.
  • Directions are not concrete and explicit. 
  • They are giving mandatory homework and not prioritizing recovery time at home.
  • Refusals are punished instead of investigated.
  • Insist on being called "Mrs." or "Mr."
  • Rules are only for children, not teachers/ adults.
10. They minimize or dismiss PDA (Pathological Demand Avoidance)
  • Say “all kids resist demands” or “that’s not in the DSM” as a reason to ignore PDA traits.
  • Push rigid strategies that escalate the nervous system.
  • Use "oppositional defiance" to describe demand avoidance.
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CLICK "Read More" for  GREEN FLAGS and for downloadable questions to ask teachers/therapists!

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Back to School: The Season of Stress (Help is here!)

8/5/2025

 
Let’s be honest. “Back to school” doesn’t just mean backpacks and fresh pencils. It often comes bundled with anxiety, sensory overload, and a whole lot of unknowns for kids and the grownups supporting them.

New teachers. New routines. New classmates. All of it can feel like too much too fast, especially for neurodivergent kids who thrive on predictability, familiarity, and feeling understood. And teachers are doing their best, but they’re walking into classrooms full of unique humans without always having the information they need to support each one well from day one.
That’s where we can change the game.

One of the most helpful things we can do, for both teachers and kids, is to proactively share the most important information before school starts. Things like sensory needs, communication styles, regulation strategies, or even what truly lights that child up. When teachers aren’t left guessing or learning everything by trial and error, it lowers their stress and sets up the entire year for smoother interactions.

At Therapy Center of Buda, we’ve seen how powerful this simple shift can be. That’s why we created personalized info sheets designed to highlight the things that matter most about your child. How they learn. What helps them feel safe. What works when things get hard.

We’re offering these sheets to our current families during sessions over the next two weeks. But we didn’t want to stop there. We know so many other families could benefit, so we’re making them available right here too, for anyone who needs them.
​
This school year can start with understanding instead of overwhelm.

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    A smiling woman with light skin, shoulder-length dark brown hair, and large dark-framed glasses. She is wearing a maroon top with a black cardigan and a delicate necklace. The background is white, and the image is cropped in a circular frame. Picture of Amy Grant

    Author

    Amy Grant is a licensed Speech-Language Pathologist and Clinic Director of Therapy Center of Buda. Special Focus: Autism/ ADHD

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WHAT OUR PARENTS SAY 

I am so happy with the care my daughter gets here. Everyone is helpful and patient. Amy took extra time 
with me and my wife to explain exactly what was happening with my daughter and explain how therapy was going to help. I love that she involves us in the sessions and we have seen major improvements. I would recommend this clinic to anyone!
-Paul S.
I can't say enough about how much my son has progressed and continues to progress in their care. The love and compassion, professional atmosphere, and top notch therapists make this place the best in central Texas. We are forever grateful to Amy Grant, Miss Angeli, Suzie and Brandi.


- Amy P.
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