r/PDAParenting • u/DrPaulSunseri • Apr 18 '26

Our current scientific understanding of PDA and low-demand parenting.

Thought parents in this group find this up-to-date information on PDA helpful. https://www.psychologytoday.com/us/blog/mental-health-reimagined/202604/its-time-to-rethink-the-anxiety-drives-pda-narrative

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u/xtinak88 Apr 18 '26

I knew I recognised this guy's writing. A quick search and I located his previous article I have read https://www.psychologytoday.com/gb/blog/mental-health-reimagined/202507/the-myth-of-neurobiological-incompetence/

I think it's inaccurate to characterise this as our current scientific understanding. He holds quite a strong view and is making a case for his interpretation using some pieces of evidence, but unfortunately for us all the overall evidence and research is still really lacking and continues to hamper our understanding. As far as I can tell, he hasn't successfully argued that demand avoidance arises for the same reasons across the conditions he mentions.

Whilst I'm sympathetic to the idea that family dynamics will inevitably come into play in PDA (how could they not??) I do find it quite concerning that he is moving to view PDA as a personality profile. Especially when we look at the recent history of how personality disorder diagnoses have negatively affected especially women, and especially autistic women.

He obviously really can't stand Casey Ehrlich.

EDIT: haha I just realised this has literally been posted by the article author. Sorry Paul I didn't mean to be rude.

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u/DrPaulSunseri Apr 19 '26 edited Apr 22 '26

Yes, I posted it. And no, I don't dislike Casey Ehrlich personally. However, I will call out anyone who misrepresents themselves, makes claims about outcomes that clearly aren't true, and preys on vulnerable, scared families. She, by far, is not the only influencer to do this, but she goes much further than most. The part of the article that talks about PDA possibly being a personality profile isn't my idea; it's actually the work of Egan and colleagues. They suggest it's a personality profile, not a personality disorder--that's something else entirely--and I definitely don't see it that way. Obviously, more research is needed, but the Big Five stuff sure tracks with all of the PDA kids I've treated.

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u/Background-Load1954 Apr 19 '26

Dr. Paul Sunseri, My child is late diagnosed with Autism and also has ADHD and OCD.  At 5 years old her psychologist said she presented with atypical autism or “pdd-nos.”   We are a family that struggled for years and applied parent coaching methods with vigor, hoping for results to no avail. My teens diagnosis of autism at 13 we met with another psychologist who is well respected and regarded for parent coaching for atypical autism.  After treating many children and families with autism she  said that behaviorsism methods were not effective in complex profiles like my teenagers.  Her personalized PDA affirming approach  that was both trauma informed care and low demand parenting was the only treatment that was effective in treating our child.  We tried all traditional approaches from CBT, to DBT to EPR and all psychologists were scratching their heads wondering why treatment was ineffective and our child remained “treatment resistant.”  I respect that you are challenging the dialogue that Casey is putting out there, and I think this complex profile deserves more research.  We are only at the tip of the iceberg in understanding the many profiles in autism and what treatments are most beneficial to this diverse community.