If you’re a parent searching for autism services, you may feel overwhelmed by choices. Some programs promise to “fix” behaviour, while others focus on strict compliance. But more and more families — and research — are pointing to a different approach: neurodiversity-affirming care. Support and understanding from a family member, such as a parent, guardian, or close relative, play a crucial role in building trust and fostering a safe environment for children with PDA.
This way of supporting children doesn’t try to change who they are. Instead, it focuses on mental wellness, belonging, and skills that grow from safety and connection.
What the research tells us about autism spectrum disorder
For many years, Applied Behaviour Analysis (ABA) has been the most widely promoted therapy. In Ontario, most of the government funding for autism services has been directed toward ABA, and families often hear it described as the “gold standard” or “evidence-based” approach.
While ABA has been studied extensively, newer reviews raise important cautions:
Conflicts of interest: A 2021 review found that most ABA studies were written by people with professional or financial ties to ABA, making claims of effectiveness harder to evaluate independently (Bottema-Beutel & Crowley, 2021).
Mental health risks: Research shows that focusing only on compliance can contribute to masking (hiding true feelings to “pass”), which is linked to higher anxiety and depression in autistic youth (Cage & Troxell-Whitman, 2019). Individuals with PDA may use masking, role play, or making excuses as social strategies to avoid demands and manage anxiety.
Quality of life: Experts now recommend that outcome measures for autism services prioritize wellbeing and relationships, not just behaviour reduction (Schuck et al., 2022).
At the same time, emerging research is helping us understand why neurodiversity-affirming approaches are so effective:
Double Empathy Problem.Recent studies confirm that social struggles are two-way. Autistic people often understand each other well, but both autistic and non-autistic people can miss each other’s cues (Cheang et al., 2024). Social communication and social boundaries can be particularly challenging for individuals with PDA, who may use unique strategies to navigate social situations.
For parents, this means when your child doesn’t pick up on a teacher’s facial expression, it isn’t because they “lack empathy.” And when adults miss your child’s signs of stress, that’s not your child’s fault either. Everyone has to learn to meet in the middle.
Monotropism & deep interests.Autistic children often have a strong focus on favourite topics — dinosaurs, Minecraft, art. Instead of seeing this as “rigid,” researchers now view it as a strength that can drive learning and connection (Brosnan & Camilleri, 2025).
For parents, this means it’s okay — even powerful — to let your child’s passions lead. When teachers or peers join in (“Tell me about your favourite dinosaur”), kids open up, regulate, and build trust more easily.
These findings highlight why compliance-heavy approaches often backfire for kids with PDA profiles or school avoidance: pushing harder on demands usually fuels anxiety, whereas affirming their needs and interests builds cooperation and resilience.
What does “neurodiversity-affirming” mean?
The neurodiversity movement views autism, ADHD, and other brain differences as natural parts of human diversity — not problems to cure. A neurodiversity-affirming therapist or program:
Respects identity. Many autistic people prefer identity-first language (e.g., “autistic child”), but we always follow your family’s preference.
Adapts the environment. Instead of forcing a child to fit in, we reduce sensory stressors and make spaces feel safe.
Prioritizes mental health. Anxiety, shutdowns, and meltdowns are signals of distress, not misbehaviour.
Supports connection. Therapy should help adults and peers meet children halfway — not put all the responsibility on the child.
PDA and school avoidance: understanding the bigger picture
Some children experience what’s often called a PDA profile. PDA usually stands for Pathological Demand Avoidance, but many families and advocates are moving toward alternatives like Persistent Drive for Autonomy or Extreme Demand Avoidance because these names feel more respectful and less stigmatizing.
It’s important to know that:
PDA is not yet formally recognized in most Canadian diagnostic manuals, so you may not hear your doctor or school team use the term.
However, it is increasingly researched and supported in the UK and Australia, where clinicians and schools are building strategies around PDA profiles. There is a need for extensive research to better understand PDA and its differentiation from autism, as current gaps in scientific understanding contribute to ongoing debates about its legitimacy. Regardless of the name, what matters most is recognizing the pattern: children who feel extreme stress and anxiety when faced with demands, even ones that seem small or everyday.
This can show up as school avoidance. Instead of laziness or defiance, school avoidance is usually a mental health response to overwhelm — sensory overload, social stress, or constant demands without relief.
Neurodiversity-affirming care helps by:
Lowering pressure and offering choices.
Building safety and trust before demands.
Using interests as a pathway into learning.
Prioritizing emotional regulation alongside academics.
When children feel safe and understood, they are more likely to re-engage with learning and relationships.
Why this matters for families
When therapy respects your child’s neurodivergence, you’re not fighting against who they are. You’re building skills with them. Families often notice:
Reduced anxiety and fewer meltdowns.
Stronger connection and trust.
More engagement in learning and play.
Hope — because their child is thriving, not just “performing.”
Neurodiversity-affirming care also helps build caregivers’ capacity by providing support and strategies that empower parents and caregivers to effectively support their child’s development and manage their needs.
Further Reading for Parents and Professionals
If you’d like to learn more about PDA (sometimes called demand-avoidant profile or Persistent Drive for Autonomy), here are some trusted resources from the UK and Australia, where much of the current research is happening:
National Autistic Society (UK) – Demand Avoidance
Explains why some people prefer terms like “demand-avoidant profile” instead of “Pathological Demand Avoidance.”
👉 Read herePDA Society (UK) – Research Overviews
A hub of research summaries, including studies on school experiences and the EDA-8 questionnaire (a tool for identifying demand-avoidant traits).
👉 Explore researchAutism Awareness Australia – The Latest on PDA (2025)
Confirms that PDA is acknowledged in Australia as a behavioural profile within autism, even if it isn’t a stand-alone diagnosis.
👉 Read article
Developmental Disability WA – Recognition of PDA in Australia (2025)
Outlines how Australia’s national autism strategy now formally recognizes PDA as a profile that requires tailored supports.
👉 Download PDF
References
Bottema-Beutel, K., & Crowley, S. (2021). Research review: Conflicts of interest in autism early intervention research. Autism, 25(7), 1876–1889.
Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. JADD, 49(5), 1899–1911.
Schuck, R. K., et al. (2022). Neurodiversity and Autism Intervention: Reconciling Perspectives. JADD, 52, 4620–4636.
Cheang, R. T. S., et al. (2024). Do you feel me? Autism, empathic accuracy and the Double Empathy Problem. PMC.
Schuck, R. K., et al. (2022). Neurodiversity and Autism Intervention: Reconciling Perspectives. JADD, 52, 4620–4636.
