Practice in Action: Understanding Pathological Demand Avoidance

In this episode, Paul and Ray sit down with psychologist Marie Hooper to break open one of the most misunderstood autism profiles: PDA (Pathological Demand Avoidance), or the pervasive drive for autonomy. Marie explains why these kids look oppositional on the surface but are actually responding to a nervous-system threat, why typical behavior plans often backfire, and how masking—especially among girls—keeps PDA hidden for years. She walks through the six core features clinicians should recognize, what burnout looks like in kids who stop attending school entirely, and how to shift from compliance-based approaches to safety-based, trauma-assumed care. Whether you’re a therapist, educator, or parent, this conversation reframes what “can’t, not won’t” truly means.

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