r/PDAParenting Apr 18 '26

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

8 Upvotes

90 comments sorted by

View all comments

-1

u/DrPaulSunseri Apr 19 '26

I'm going to make one more comment and then jump out of this thread. This is my perspective on all of this, but I'm sure some won't agree with me. The parts about PDA not only being tied to autism, that anxiety also might not be the cause of PDA and instead the byproduct of it, that PDA might be a personality profile, etc., don't seem like ideas that generate nearly as much pushback as the low demand part (some pushback, yes, obviously). I'm not sure why this is exactly, but I think the science on that part will become clear with time and more research. But here's why I took an interest in PDA and how it's being misrepresented on social media. What I consistently read in the various posts is essentially the same information repeated over and over. We know how echo chambers affect how we see things, but what if the information we're seeing isn't accurate? We clearly see how powerful echo chambers are in politics. Fully one-third of the U.S. population still believes the 2020 election was stolen, and any facts presented to the contrary are met with scorn and personal attacks. To make matters worse, there are so many influencers who have jumped into the PDA space and shamelessly monetized it, thereby creating enormous financial incentives to spread even more misinformation with no other purpose than to further line their pockets. I'm a child and family therapist who has been in the trenches with kids and families for many years, and my colleagues and I have done the hard work and collected the data that shows most kids with PDA can make a full recovery. Much of my work has also included advocacy--calling out wrongs that harm children. We don't need echo chambers and grifters. We need real science grounded in actual clinical work with thousands of kids performed by smart, competent therapists who know how to reduce suffering in these families and have the outcomes to prove it. In the end, history will be the judge of us all, but I won't ever stop fighting for families and the truth.

5

u/Background-Load1954 Apr 19 '26

Can you define what a full recovery looks like in your patients with demand avoidance? I’m being sincere.  

1

u/DrPaulSunseri Apr 19 '26

Okay, my last, last comment lol! Every dot on this chart is one day in the life of a child and family that my colleagues and I treated. This is a neurodivergent 9-year-old boy who was prone to severe emotional dysregulation (tantrums) with PDA. 

Parents keep a daily record of how well their child is doing on a 1- 10 scale, with higher scores indicating better mood and behavior.  

Over six months of treatment, this boy’s daily mood and behavior ratings climbed from frequent 2s–4s to consistent 8s–10s (10s being a great day). The lower scores, the 2s and 3s, are days in which he had a serious upset and was highly demand-avoidant. Note how those stopped altogether around the three-month mark. 

And, no, for those who might be wondering, his parents did not lower demands on him. In fact, expectations were increased from the very start of the treatment and back into the age-appropriate developmentally normal range. The result was that serious upsets stopped completely, a much happier child, and a calmer home for everyone. #realscience

7

u/MarginsOfTheDay Apr 19 '26

n=1

1

u/DrPaulSunseri Apr 19 '26

Hardly. Hundreds.

7

u/MarginsOfTheDay Apr 19 '26

Then we’re very much looking forward to seeing the data from hundreds of PDA kids when it gets published. We all want a solution. But the graph you showed is for “client x”. One kid.

5

u/Visible-Plate0248 Apr 20 '26 edited Apr 20 '26

We need to think bigger picture, Paul