Thread by @Richard_Autism

Oh crikey. Looking briefly at OCD again. Notice this in its DSM criteria:
"Young children may not be able to articulate the aims of these behaviors or mental acts."

Applying the same logic to PDA debate. If we do not expect non-autistic children to not always be able to understand/ rationalise their behaviours. Why are we expecting autistic CYP to be able to do the same to have a "Rational Demand Avoidance" group?

As I state elsewhere are good reasons to expect many autistic CYP being labelled with "Rational Demand Avoidance" who CAN NOT rationalise their behaviours, their demand avoidance.
…emandavoidancecom.files.wordpress.com/2020/08/01-aug…

This supports my point that the differences between "Extreme Demand Avoidance" and "Rational Demand Avoidance" are arbitrary.

Going back to OCD DSM criteria:

"B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."

Note the part to causing significant distress or impairment in social, occupational, or other important areas of functioning. If any child is school refusing that would seem to meet definition "important areas of functioning".

Again supporting the view that "Rational Demand Avoidance" by Help4Psychology, is arbitrary definition, if PDA is viewed akin to OCD, the "Rational Demand Avoidance" group, should be getting PDA diagnsoses.

I am increasingly thinking that a lot people's opinions on PDA are shaped by their background and ideological preferences.

I actively acknowledge my views are informed by seeking scientific-method, inclusive research & practice.

I mean we know that O'Nions and others have been approaching PDA from their understanding of autism:
discovery.ucl.ac.uk/id/eprint/1493…

This just raises more questions than answers, as my understanding of autism tells me it is blatantly obvious PDA is not autism. This is point is relevant to the thread.

So O'Nions is proposing a mechanism in PDA for is almost identical to OCD cycle given earlier. More importantly, if one is associating avoidance behaviours to anxiety/ aversive experience to demands, this different to accepted reasons for RRBIs in autism.

I make often make this point in my demand avoidance behaviours are caused by anxiety, it is not associated to autism, but to comorbids.

Part of OCD category A DSM-5 criteria.
"Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress."

Now I accept would argue there maybe clinical differences between obsessions in PDA & demands. Demands in PDA are often caused from the environment, not necessarily internal.

What I am getting to here, effects of the obsession are distressing to the person, mainly causes anxiety in both OCD & PDA. Again both aversive experiences are relieved through a compulsive act, for PDA, avoidance. Avoidance can be a compulsive act for OCD.

I am not impressed with referring to PDA as a subgroup. This is playing the facts, Newson was clear she thought PDA was a syndrome, as it represented a clustering of symptoms.
linkinghub.elsevier.com/retrieve/pii/S…

adc.bmj.com/content/archdi…

Something has been nagging about this passage of text:
"Therefore, her data may over-estimate the degree to
which PDA separates as a sub-group within the autism spectrum as we now know it." (O'Nions & Eaton, 2020, p1)

This sentence is within a section trying to explain PDA as subgroup of autism. As part of a paragraph trying to establish their is a collider bias within Newson's work. I establish elsewhere, this suggestion is nonsense, & not applicable.

rationaldemandavoidance.com/2020/10/17/wha…

What has been nagging me about the previous quoted sentence, it just feels like an attempt to explain away the differences between PDA and autism, without critically engaging with PDA. Without considering that PDA might not be autism.

Following sentence.
"This does not imply that the profile Newson described does not exist, but rather there is likely a broader range of profiles: varying in severity of both ASD and PDA features." (O'Nions & Eaton, 2020, p1).

I support the aspect that there is likely to a broader range of profiles, varying in PDA features. There will be some overlap of autism features, that is because autistic features exist within a continuum within the human population.

This then begs the question why they are trying to separate PDA out from "Rational Demand Avoidance" definitions?

*Help4Psychology definitions*

It is also claims making by Eaton and Weaver for their being a "Rational Demand Avoidance" group, as at Judy Eaton is aware of autistic scholarship on Rational Demand Avoidance, which is not referenced.
autism.org.uk/what-we-do/pro…

Looking at their justification for "Rational Demand Avoidance" it does seem to be partly inspired by @milton_damian & my work.

O'Nions & Weaver describe PDA behaviours as being having specific causes, often from school.

Eaton & Weaver also describe PDA as having different developmental aspects to Rational Demand Avoidance.

My issue here is, that many PDA experts & literature say PDA is not developmental in nature; contradicting their approach of diagnosing PDA in those who have developmental features. Those with "Rational Demand Avoidance" would not receive a PDA dx.

The point here is that Help4Pscyhology are unlikely to look for similarities in their "Rational Demand Avoidance" and their PDA, when they do not dx PDA in said persons.

"Rational Demand Avoidance" seems to be defined as a PDA-like autistic group, but it is not PDA. Almost, a PDA-NOS; Pathological Demand Avoidance- Not Otherwise Specified. So people not meeting their PDA threshold.

Which feeds back into my point about why are they trying to separate out different PDA profiles?

Maybe it is a case of splitters will be splitters? They will divide PDA, like they are trying to divide autism?

Fundamentally, if core PDA features present at lower frequencies, but still produce same relationships (especially predictive relationships), RDA, would still be PDA (Help4Psychology definitions).

Demand avoidance in "Rational Demand Avoidance" should still follow same process:
Demand
Anxiety (rational or not).
Avoidance.
Temporary Relief.

Even Help4Psychology "Rational Demand Avoidance" would appear to be fundamentally the same as their PDA, on its defining OCD-Like aspect.

@threadreaderapp Please can you unroll?