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This study looked at two boys whose parents thought they had PDA (pathological demand avoidance). Both boys were actually diagnosed with autism. The researchers found that the boys had been very stressed for years because they weren't getting the right support at school. The study suggests that what looks like PDA might actually be how some autistic children react when they're overwhelmed and not properly supported.

This case report examines two boys whose parents suspected pathological demand avoidance (PDA) but who received autism diagnoses. The authors argue that what appeared to be PDA behaviors may have resulted from prolonged stress due to inadequate school support. The study challenges the conceptualization of PDA as distinct from autism, suggesting that demand-avoidant behaviors might be stress responses in autistic children who lack appropriate educational accommodations. This perspective aligns with growing debate about whether PDA represents a separate condition or a manifestation of autism under adverse circumstances.

Suggests thorough environmental assessment is crucial when evaluating demand-avoidant behaviors. Emphasizes importance of adequate educational support for autistic children. Questions the utility of separate PDA diagnosis when behaviors may reflect autism under stress.

Case report design limits generalizability. Only two cases examined. No control group or systematic assessment tools used. Retrospective analysis may introduce bias. Causal relationship between inadequate support and behaviors not definitively established.

Requests for pathological demand avoidance (PDA) diagnoses have increased over recent years. However, PDA remains controversial. It was first coined by Elisabeth Newson who hypothesised that PDA differed from autism in specific areas. This case report presents two boys from different families whose parents have suggested PDA as the core problem.

But both boys were diagnosed with autism and when reviewing their history, it became clear that they had been subjected to great stress for years as they had not been supported sufficiently at school. PDA may be the resulting behaviour of this.