Thread by @Richard_Autism

That moment when you realise, you need to define what you consider to be in all its glory and not.

First one, so this is what I consider PDA traits criteria to be (on the right hand side).

The wording is mainly based on Newson's clinical descriptions, except where Newson's assumptions are wrong. E.g. panic attacks being attributed to Surface Sociability trait.

Main reasons for this, is that if PDA is a common mental disorder, the predicted PDA populations are based off her descriptions which we know to be clinically different to autism & Newson saying PDA is NOT autism.

So logically, I am not saying PDA belongs to any diagnostic grouping, as we do not how PDA fully manifests in all its populations. PDA probably presents differently outside of autism, as most autism co-occurring conditions do.

So, I.e. PDA is not part of the autism spectrum.

If one accepts should be diagnosed, than all persons who its profile are entitled to research, support & diagnosis, irrespective of if they are autistic or not.

Also people can transition into PDA, as this is inline with clinical descriptions of PDA, both Newson and others.

Also inline with modern transactional understandings of PDA, persons should be able to present PDA when sufficiently distressed.

Clinical threshold for a PDA diagnosis. I will accept the one given from Gillberg et al (2015), which is used to make many of predicted PDA populations on. So this is a LOW diagnosis threshold.

"“Classic PDA” was defined as Total PDA score of 5
or more and including the presence of socially manipulative
or shocking behaviour to avoid demands." Gillberg et al (2015, p981). On original PDA DISCO questions.

This is a lower diagnosis threshold than Newson, as she required all her persons with PDA to have socially manipulative demand avoidance, it was not an "OR" to shocking behaviour to avoid demands.

So this means I am throwing out the "Pervasive" and "Developmental" definitions Christie & others use in their PDA interpretations.

I think this is representative of the PDA literature.

That broadly, is my interpretation of PDA.

@threadreaderapp Please can you unroll this in its all splendor?

Thank you in advance.

To clarify, I would move around some PDA features to other PDA traits, so panic attacks should go into the Lability of Mood trait.

@threadreaderapp please can you unroll this one?

I need to point out that it is not a whim discarding "Pervasive" & "Developmental" wordings as underpinning PDA.

For one, there are concerns if PDA is developmentally stable and thus actually is pervasive. We know that PDA has a higer drop-off rate in CYP meeting clinical threshold for a diagnosis compared to autism.
acamh.onlinelibrary.wiley.com/doi/abs/10.111…

Second point, I have already covered that clinicians, mainly Wing, Newson, Gould & Gillberg have said people can transition into PDA. I provide where they say this elsewhere.

I would also point out that certain clinical populations probably require persons to display PDA after infancy. Especially as most disorders are diagnosed in teenage years, Off the top of my head the average age of a dx is 14.

Next point is that persons developing into PDA, so it is not necessarily developmental is data from the EDA-Q. The tool is known for detecting PDA outside of autism, so called "false-positives" because the person is not autistic...

If one accepts that PDA is seen outside of autism, then many of these "false positives" are going to correct positive identifications. I also include "Rational Demand Avoidance" group as PDA.
network.autism.org.uk/sites/default/…

If one accepts many of these "false positives" are actually PDA, then it no longer is necessarily "Pervasive".

It is scientific to reject outdated assumptions when presented with new information, such as EDA-Q commonly detecting PDA outside of autism.

The important thing about this EDA-Q data, is that the EDA-Q is currently only validated to detect PDA in autistic CYP. It will likely detect PDA more commonly outside of autism when validated on predicted populations.

Which just highlights the absurdity of basing PDA diagnoses on "Pervasive" and "Developmental" descriptors.

@threadreaderapp Please could you unroll this?

Thank you in advance.