Dr. Taylor Day and I recently discussed Pathological Demand Avoidance (PDA) on the podcast. We dove into the unique drive for autonomy in children with PDA, the impact of the fight-or-flight response, and practical strategies for supporting these children both at home and in educational settings. Dr. Tay emphasizes the importance of a balanced approach to parenting and teaching—one that honors a child’s autonomy while still maintaining essential boundaries.
Dr. Taylor Day is a licensed psychologist who specializes in neuro affirming care for autistic children and their families, with a focus on early diagnosis and intervention. She holds a Ph.D. in clinical psychology and is the CEO and founder of Dr. Tay Concierge Clinical Care.
Her practice integrates The Whole Family Approach, a unique process she created using evidence-informed principles after recognizing a gap in autism care. Dr. Tay’s passion for child psychology and autism is deeply personal, rooted in her experience growing up with a brother diagnosed at just 23 months of age. Read our conversation below!
Meet Dr. Taylor Day
Tara: I know this is a topic so many people are interested in, but first, can you tell everyone a little bit about yourself?
Dr. Tay: Absolutely! I’m Dr. Taylor Day, but I go by Dr. Tay on social media and my podcast. I’m a licensed psychologist specializing in neurodiversity-affirming care for autistic children and their families. My clinical practice primarily serves children, but we’ve expanded to support adults as well. A big part of what we do is helping families feel seen and understood, especially when they suspect their child might have a PDA profile. Many times, these children get dismissed by the medical system, with professionals saying, “No, this can’t be autism.” But we provide second opinions and guide families through the diagnosis and, most importantly, what comes after.
Tara: Wow. The work you’re doing is so important. When it comes to challenging behaviors—whether we call them difficult behaviors, negative behaviors, or something else—it’s so emotional. It’s hard for families, schools, and therapists. Speaking from my own experience, my son had some challenges growing up. He was even given the EBD (Emotional Behavioral Disability) label at one point. Looking back, I sometimes wonder—if we knew then what we know now, would we have approached things differently? I imagine a lot of parents feel the same way.
Dr. Tay: Absolutely.
Tara: Many behaviors often get categorized under EBD, ODD (Oppositional Defiant Disorder), or something similar. And I think it’s easy to assume these behaviors are intentional or purposeful. But that’s why I wanted to talk about PDA—because it offers a different perspective. Can you explain what Pathological Demand Avoidance is? What are some key signs and behaviors that may indicate someone has this profile?
What is Pathological Demand Avoidance?
Dr. Tay: PDA is not well defined because it’s not an official diagnosis. There isn’t a lot of research on it yet, but that doesn’t mean it’s not real. What we do have is a lot of lived experience from families who feel like PDA perfectly describes what they see in their children.
At its core, PDA involves extreme demand avoidance. It can look like defiance or opposition, and it can seem as though the child is trying to control everything around them. Traditional parenting models assume a natural hierarchy where adults are in charge and children comply. But kids with a PDA profile don’t function that way. They have an intense drive for autonomy, and any perceived demand—no matter how small—can trigger a fight-or-flight response. It’s not just that they won’t do something; it’s that their nervous system is telling them they can’t.
Tara: That explanation really shifts the way we think about behavior. The term “persistent drive for autonomy” makes so much sense. Can you talk more about what that looks like in everyday life?
The Drive for Autonomy in Children with PDA
Dr. Tay: Kids with PDA want to be on an equal playing field with adults. They don’t respond well to rules that are based on “because I said so.” Instead, they challenge authority and seek ways to take control of situations. They may negotiate constantly, resist typical parenting structures, and struggle with transitions.
It’s interesting because, in our society, we expect kids to be compliant until they turn 18. Then, suddenly, we expect them to be independent and self-advocate. But if we don’t support autonomy along the way, that transition is incredibly difficult. For PDA individuals, this need for autonomy is much stronger and starts much earlier.
How the Fight-or-Flight Response Impacts PDA Behaviors
Tara: That fight-or-flight response piece is so critical. When someone is in that mode, they aren’t thinking clearly enough to be manipulative or defiant in the way people often assume. They’re just trying to survive.
Dr. Tay: Exactly. From a neurodiversity-affirming perspective, it’s essential to understand why a behavior is happening rather than just looking at the behavior itself. Parents and teachers often feel like a child is being manipulative, but what’s really happening is their nervous system is overwhelmed.
Tara: That’s such an important shift in perspective. I get so many questions from parents and teachers asking, “What should I do? My child is kicking, spitting, hitting—how do I stop it?” But that’s surface-level thinking. If there were a quick fix, we wouldn’t see these ongoing challenges in schools and homes. We need to dig deeper.
Dr. Tay: Exactly. But that’s hard because many behavioral approaches focus on eliminating the behavior itself. They can appear to “work” in the short term, but they don’t address the underlying reason the child is struggling. Strategies like planned ignoring, for example, might actually make things worse for a child with PDA because they need co-regulation.
Effective Strategies for Supporting Children with PDA
Tara: I think back to my years in the classroom—so many of us were trained in behavior strategies that we later realized didn’t serve all kids. Ignoring behaviors, enforcing compliance—it didn’t work for some students, and in hindsight, we can see why. But I love that new approaches, especially those informed by autistic voices, are giving us better ways to support these kids.
Dr. Tay: Absolutely. And that’s why conversations like this are so important. PDA isn’t officially recognized in diagnostic manuals, but the experiences of families and autistic individuals tell us that it’s very real. Right now, the leading theory is that PDA is a profile of autism, but we also see overlaps with ADHD, anxiety, and even trauma. The more we understand, the better we can support these individuals in ways that truly help them thrive.
Tara: That really resonates with me! Years ago, we used a similar approach with an elementary student who had frequent behavioral challenges. Different teachers had varying expectations, so we had to align our approach. I drew from Dr. Ross Greene’s book and used a ‘basket’ strategy. Does that sound similar?
Dr. Tay: Yes! I wanted to merge collaborative problem-solving with a low-demand approach in a structured way for families. Many struggle with knowing which demands to drop or feel resistance—sometimes due to a needed mindset shift or missing accommodations.
Prioritizing What Truly Matters in the Classroom
Tara: In schools, getting adults on the same page is key. For example, a student always turned off the lights when leaving the room, and one teacher saw it as a big issue—but it really wasn’t. We had to decide what truly mattered: safety issues like running in the street required intervention, while minor behaviors weren’t worth addressing. Prioritizing just a few key skills at a time helped everyone focus and ease up on unnecessary battles.
Dr. Tay: As adults, we often enforce rules without questioning them. Helping parents shift their mindset first—before engaging in collaborative problem-solving with their child—can give kids more autonomy and respect their individuality. For example, why must kids sit still if they learn better while moving? Why insist on pencils over pens? In classrooms, focusing on mastery over repetition can reduce unnecessary demands—if a student demonstrates understanding after a few problems, why assign 20? Giving kids choices, like deciding how many problems they need to feel confident, fosters collaboration and reduces stress.
Shifting Mindsets to Foster Autonomy and Reduce Unnecessary Battles
Tara: Even without labels like EDA or ODD, what you're saying is deeply validating. As a mom, I struggled watching my son clash with authority at school. It’s easy to lose confidence and wonder if you're just being biased. I remember when he aced a pre-test on microscope parts—yet he still had to sit through a week of lessons and take the same test again. I knew he'd struggle, but there was no flexibility from the school. No one considered why he couldn’t engage when he had already mastered the material.
Dr. Tay: That's the issue, right? It’s a rule that doesn’t make sense, and it’s frustrating for him because he's being forced into something illogical. It also doesn’t respect him as a person. Often, we focus on the behavior without seeing the child as a human first. Imagine an adult being forced into something they don’t understand—it's frustrating, and we have better emotional regulation skills than kids. The idea that kids should just learn to tolerate it like adults is unrealistic. Instead, we can support them through it. Without that, they escalate and get punished, creating a vicious cycle.
PDA in Educational Settings: Practical Approaches for Teachers
Tara: This is why IEPs are important—they help personalize support when issues arise. Yes, people need to learn to tolerate boring moments, but spending an entire week waiting for a test you’ve already passed doesn’t seem like the best use of time. Talking with you has reminded me of my son, who’s always been detail-oriented. I remember when he was three, we went to see the Easter bunny, and he asked, “Is that the real Easter bunny?” after noticing a zipper on his back. He’s still the same curious person at 30.
Dr. Tay: Absolutely. Two key points: First, this is a major mindset shift—it’s not just about what we do for kids, but how we think about behavior. Give yourself grace, as this shift can benefit your entire classroom. Second, parents' voices matter. Too often, parents of high-masking kids are dismissed by schools, especially when their children hide stress at school but show it at home. Schools might say, “This is a home problem” or “We don't see this behavior here,” invalidating parents. Schools may also resist new approaches. Recognizing parents as collaborators is crucial—it can make a huge difference.
Why PDA is Often Misunderstood and Overlooked
Tara: Parents know their kids best—that’s the biggest takeaway from my years in the classroom. If I could tell my younger self anything, it would be to listen to parents' insights. As for PDA, it’s often misunderstood or overlooked in the broader autism context because it doesn’t always fit typical behavior expectations. To improve awareness, we need to educate teams on how PDA presents and emphasize the importance of recognizing it as part of the spectrum.
Dr. Tay: One of the main reasons PDA is misunderstood is that it’s not officially recognized as a diagnosis. This leads to misconceptions, with some people dismissing it as a social media trend. While it’s not yet part of the medical or educational systems, that shouldn't invalidate the experience. We don’t need to wait for extensive research to validate it.
The Importance of Trying Supportive Strategies—Even Without Official Recognition
Dr. Tay: The challenge is meeting individuals where they are and providing the right accommodations. Resources do exist, but they’re not widely known. Many school systems still struggle with this concept, often focusing on what it is instead of understanding how to support it. There’s also a gap in how neurodiversity-affirming approaches have reached social media but not yet the broader medical or educational systems. This lack of understanding causes PDA to be dismissed as something that needs fixing instead of something to better understand. Lastly, the masking behavior seen in schools can make it harder to recognize.
Tara: Masking can definitely hide PDA at school. While PDA isn’t officially recognized in the DSM or IEPs, the label itself doesn’t matter if the strategies help kids and respect them as individuals. Trying these strategies won’t hurt and may help. Change takes time to evolve into evidence-based practices, but thinking outside the box is essential. For example, in the 1960s, Bruno Bettelheim thought kids were autistic because of their cold, uncaring mothers. If no one challenged that, we wouldn’t have the understanding of autism we do today. Keeping an open, growth mindset allows us to try approaches that may benefit children.
Why Connection Matters More Than Strict Behavioral Methods
Dr. Tay: The concern is often that being too permissive will prevent kids from learning boundaries or skills. I understand that fear, but after being trained in highly evidence-based programs like CBT, I realized that meeting a child on a human level is more important. I’d rather be wrong for focusing on connection and respect, even if the approach isn’t always perfect, than stick strictly to behavioral methods and risk overlooking the child as a person. Building rapport and understanding matters, and that connection can be therapeutic in itself.
Tara: I love that perspective—it’s so important for parents to feel supported and know that others genuinely want to connect with their kids. For families or educators wondering if a child has a PDA profile, my advice would be to start by reaching out to professionals who specialize in neurodiversity or autism. Look for those who are open to alternative strategies and understand the value of connection and trust. It’s key to advocate for the child’s needs and explore resources that can offer insight and support.
How to Approach a Possible PDA Diagnosis
Dr. Tay: For parents, pursuing a diagnostic evaluation with a provider familiar with PDA can be helpful. If that's not possible, learning about PDA and exploring resources like Low Demand Parenting by Amanda Deekman, The Explosive Child by Dr. Ross Green, or Brain Behavior Connection by Mona Delahooke can provide valuable strategies.
For educators, it's important to approach the topic gently with parents. Start by asking what works at home and how you can collaborate, rather than directly mentioning PDA. Using curious language like “I wonder if this might fit” can open the conversation without causing defensiveness, helping parents explore the idea and potentially validating their experience.
Tara: By gently suggesting it, you allow parents to decide or plant a seed for future consideration. This has been so great—thank you, Dr. Tay! Everyone, be sure to check out her Instagram. Where can they find you?
Where to Find More Support: Dr. Tay’s Resources and Membership
Dr. Tay: You can find me on Instagram @theDrTay. I also have a podcast, Involved with Dr. Tay, for parents of autistic or suspected autistic children. For more about our clinical services and upcoming membership, visit DrTaylorDay.com. We currently serve 40 states, and the membership will be a non-clinical service.
Tara: I'm excited about your membership! Thank you so much for being here.
Listent to the Podcast Episode #113
Autism & Behavior: A Compassionate Approach To Stress Responses
Mindfulness & Regulation For Preschoolers With Sarah Habib
If you use visual supports in your classroom or home, you are going to want to sign up for this free Visual Supports Starter Set ASAP! Click here to have one sent to your inbox. Also, be sure to read more about visual supports and how they can help autistic children here.
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