In this episode I’m bringing a new topic to this show—pathological demand avoidance or PDA, which is typically defined as a pervasive developmental disorder that falls under the autism spectrum. It’s a label that’s frequently used in the United Kingdom, and it’s often defined as a complicated and misunderstood condition wherein some people have a heightened anxiety response to demands being placed on them. I should note that like oppositional defiance disorder, PDA isn’t universally recognized as a diagnosis, and it’s also a label rooted in controversy. 

To talk with us about all of this is friend of the podcast Dr. Melissa Neff, a licensed clinical psychologist who specializes in the assessment of ADHD, depression, anxiety, trauma, nonverbal learning disorder, and autism spectrum disorders, about the diagnostic process. Melissa has been on the show several times before, talking about working with recently diagnosed adults and assessing differently wired kids. You can find links to those episodes below.

I definitely had a different understanding of and awareness about pathological demand avoidance before this conversation, and my hunch is that the way Melissa talks about PDA is differently from preconceived notions you may have, unless it’s something you’ve researched extensively. I’m grateful to share Melissa’s insights and I hope this conversation generates more dialogue that can lead to deeper awareness of the experiences of some of our children so we can better support who they inherently are. 


About Melissa: Melissa Neff, Ph.D. is a clinical psychologist in private practice in Missoula, MT. She conducts psychological evaluations for children and adults. She specializes in the assessment of giftedness, ADHD, depression, anxiety, trauma, nonverbal learning disorder, and typical and atypical autism spectrum disorders.

Dr. Neff received her BA with honors from The University Professors Program at Boston University. She received her MA and Ph.D. in Clinical Psychology from The University of Montana and completed her pre-doctoral internship at Spokane Mental Health Center in Spokane, WA. She is the head psychologist at Shodair Hospital in Helena, MT, and a faculty affiliate at University of Montana, where she has taught graduate-level courses on assessment and therapy for the Clinical and School Psychology Ph.D.programs. She has consulted for a range of community agencies in Montana, including the Child Development Center, Full Circle Counseling/Consumer Direct Services, and the FIRST STEP Counseling Center at St. Patrick Hospital. She has recently participated in grant research aimed at equipping schools to treat children with trauma, and in the creation of a video game to help survivors of domestic violence learn coping skills and gain the strength to leave their abusers.



  • How pathological demand avoidance (PDA) is defined
  • Whether or not PDA is a real thing
  • How PDA is differentiated from ODD
  • What it means that PDA is “within and beyond” ASD
  • What demand avoidance behaviors look like in children and how parents can assess them
  • The connection between school refusal and PDA
  • How to support kids who are struggling with demand avoidant behaviors






Read through the whole episode!






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