“Why does my child panic when asked to do something simple?”

This common question echoes in the minds of many parents and caregivers. It’s not always defiance—it may be pathological demand avoidance in autism, a lesser-known but increasingly recognized profile on the autism spectrum.

In Glenview, Illinois, and across the U.S., more families and professionals are learning to identify and respond to this distinct behavior pattern with empathy, knowledge, and the right support systems. At the Help and Healing Center, we believe that awareness is the first step toward creating a nurturing environment for individuals who exhibit traits of demand-avoidant autism.

What Is Pathological Demand Avoidance?

Pathological Demand Avoidance (PDA) is a behavioral profile that falls under the broader autism spectrum. It is characterized by an intense, often anxiety-driven resistance to everyday demands, even those that seem minor or routine. While all children resist demands occasionally, pathological demand avoidance in autism is persistent and extreme.

People with autism and pathological demand avoidance don’t simply say “no” to tasks—they often experience panic, distress, or even shutdowns when faced with expectations, regardless of how simple or familiar those demands may be.

This resistance stems not from stubbornness but from an overwhelming sense of losing control. The individual may go to great lengths—using distraction, excuses, negotiation, or aggression—to avoid demands and regain autonomy.

Autism and Pathological Demand Avoidance

There is a growing understanding that autistic pathological demand avoidance is not a separate condition but a behavioral profile seen in some individuals on the autism spectrum. Does this mean pathological demand avoidance is always a part of autism? This isn’t quite the right question. Instead, it’s better to ask: Is this a profile within autism that needs its understanding and approach?

The answer is yes.

Children and adults with autism with demand avoidance often present differently than what is typically expected in “classic” autism presentations. They may:

• Appear socially confident on the surface
• Use sophisticated social mimicry
• Have mood swings and extreme emotional responses
• Exhibit obsessive behavior (especially around control)
• Avoid demands with creative or manipulative tactics

Understanding this profile allows therapists, educators, and families to better support these individuals without using traditional behaviorist models, which may worsen anxiety.

What Causes Demand Avoidance in Autism?

The exact cause of demand avoidance in autism is not yet fully understood. Still, anxiety and a need for control appear to be key factors. In individuals with pervasive demand avoidance autism, the nervous system may interpret even basic requests as threats, triggering a fight-or-flight response.

Triggers can be as simple as:

• Being told to brush their teeth
• Transitioning between tasks
• Having to follow school routines
• Completing homework

This kind of autism demand avoidance is not intentional—it’s an involuntary, stress-driven reaction. The more pressure applied, the more resistance builds.

Recognizing Demand Avoidance Autism Symptoms

Parents and professionals should be aware of the following demand avoidance traits:

• Unusual or sudden changes in mood
• Refusal to comply with everyday tasks
• Use of distraction, excuses, or delaying tactics
• Extreme need for autonomy
• Role-playing or pretending to be someone else to avoid demands
• Difficulty with routine or authority figures
• Emotional outbursts when feeling cornered

When persistent behaviors interfere with everyday life, they may point toward extreme demand avoidance autism.

Autism Demand Avoidance in Adults

While often recognized in children, demand avoidance autism in adults may also struggle with responsibilities, relationships, or employment. Adults may appear charming or capable but experience internal stress when faced with obligations. This can lead to burnout, depression, and social isolation.

At Help and Healing Center in Glenview, we encourage adults facing these challenges to seek personalized counseling that respects their need for autonomy and reduces demand-based pressure.

Can You Have Pathological Demand Avoidance Without Autism?

This is a debated topic in the clinical world. Demand avoidance can occur with or without autism. At the current time, PDA is best understood within the context of autism. So, while you can have significant demand avoidance without autism, most professionals currently lean toward seeing PDA as a distinct profile within the autism spectrum.

However, regardless of diagnostic labels, the important thing is to understand the person’s lived experience and provide support accordingly.

Responding to Autism and Demand Avoidance

Traditional reward and consequence-based systems often fail for those with autism and demand avoidance. Instead, practical approaches include:

• Reducing pressure and offering choices
• Using indirect language (e.g., “I wonder if…” instead of “You must…”)
• Building trust and predictability
• Empowering the individual to lead
• Encouraging interest-based activities

For parents and teachers, shifting the mindset from obedience to understanding is key. Recognizing that behavior is communication helps create a more positive environment.

At Help and Healing Center – Support Starts With Understanding

Located in Glenview, Illinois, Help and Healing Center works with families navigating autism demand avoidance vs PDA confusion. It helps them identify the right strategies for their loved ones. Our team focuses on neurodiversity-affirming practices, trauma-informed care, and individualized support.

Whether you’re a parent, educator, or adult seeking guidance, we offer evaluations, behavior planning, and therapy that prioritize connection over compliance.

FAQs

1. What is the difference between autism and PDA?

PDA is not a separate condition but a profile seen in some people with autism. It involves high levels of anxiety-driven demand avoidance that require unique strategies.

2. How is pathological demand avoidance diagnosed?

There is no formal diagnosis for PDA in the DSM-5. Still, clinicians may identify it as a behavioral profile within autism based on observation, history, and psychological assessments.

3. Can adults have pathological demand avoidance?

Yes. Demand avoidance in adults often results in similar stress responses to those triggered by demands. They may benefit from customized support and understanding from family and workplaces.

4. Is demand avoidance the same as oppositional behavior?

No. Unlike oppositional behavior, demand-avoidant autism is driven by anxiety and fear of losing control, not by a desire to be defiant or disruptive.

5. How can I support a child with autism and demand avoidance?

Focus on emotional safety, ease pressure, and speak flexibly. Collaborate with experts who can customize a plan to meet your child’s requirements and who are knowledgeable about autistic pathological demand avoidance.

Conclusion

Understanding pathological demand avoidance and autism is crucial for establishing safe and respectful environments for neurodivergent individuals. Whether it’s a child resisting bedtime or an adult feeling overwhelmed by workplace expectations, demand avoidance is a genuine and valid experience that stems from anxiety and a need for control.

By educating ourselves and others about autism demand avoidance, we open the door to compassionate support, not just in Glenview, Illinois, but in every home, school, and community.

At Help and Healing Center, we guide that journey with heart, science, and understanding.

Support as You Need It: Introducing Follow-Up Consultations for Families

Psychological evaluations are powerful tools. They help clarify a child’s strengths, needs, and neurodevelopmental profile, and they offer direction for what to do next. But even the most thorough evaluation cannot fully prepare families for the day-to-day reality of implementing recommendations, advocating in school settings, or navigating new information about their child. Many parents describe the weeks after receiving a report as both validating and overwhelming—there is guidance, but translating that guidance into concrete steps can be harder than expected.

To better support families through this process, we are now offering follow-up consultation sessions designed to bridge the gap between evaluation and real-world application. These sessions give families a dedicated space to ask questions, review recommendations, and develop strategies that genuinely fit their child and their lifestyle.

Why Follow-Up Support Matters

An evaluation is not the end of a journey; it’s often the beginning of a new phase. Once families start implementing recommendations—at home, at school, in therapy—it’s common to discover areas where they need additional clarity or practical help. A recommendation that sounds straightforward in a report may feel more complex when it comes to daily routines, emotional dynamics, or navigating school systems. Some strategies work immediately; others require adjustment. And sometimes children’s needs shift over time, especially during developmental transitions.

Also Read: 4 Takeaways from a PDA Clinical Consultation Group

Follow-up consultations create space to process these experiences with a psychologist who already understands the child’s profile and context. They allow families to return to the evaluation material with new insight, new questions, and a clearer sense of what’s working and what isn’t.

How do Families Use These Sessions?

Families use follow-up consultations in a variety of ways, depending on what they need at a given moment. These sessions are intentionally flexible and can focus on anything from immediate problem-solving to longer-term planning. Some of the most common uses include:

Troubleshooting Specific Areas of Difficulty

Maybe a strategy recommended in the evaluation isn’t landing as expected. Maybe school accommodations aren’t being implemented the way you hoped, or a particular behavior is becoming more challenging. These sessions allow us to talk through what you’re experiencing, identify barriers, and work together to find adjustments that better meet your child’s needs.

Refining Recommendations and Making a Support Plan

The list of recommendations in an evaluation is often extensive. Families may feel unsure where to start or how to prioritize. During a follow-up session, we can break the recommendations down into manageable pieces, choose a realistic starting point, and create a step-by-step plan that fits your family’s schedule, resources, and goals.

Checking In on Progress and Maintaining Accountability

Some families benefit from periodic check-ins—monthly, quarterly, or as needed—to help maintain momentum. These sessions can focus on what’s improving, what still feels stuck, and where additional support might be helpful. It can be grounding to revisit a recommendation after you’ve had time to try it, reflect on the outcome, and adjust based on your child’s evolving needs.

Revisiting the Report and Clarifying Questions

Evaluation reports contain a great deal of information. The first read often feels dense, and families naturally focus on the sections most immediately relevant. Weeks or months later, new sections may feel more important, or the meaning of a recommendation may become clearer. Follow-up sessions give families time to revisit the report, ask additional questions, and deepen their understanding of both the findings and the rationale behind them.

Support That Meets You Where You Are

Every family’s needs are different. Some want immediate support to address a specific challenge. Others prefer ongoing guidance as they implement recommendations, navigate school decisions, or move through periods of transition. Follow-up consultations are designed to be responsive and individualized—support as you need it, when you need it.

Whether you’re seeking a single session to troubleshoot a current concern or recurring consultations to help keep you on track, these appointments offer a focused and collaborative way to continue the work that began with the evaluation.

School Collaboration and Virtual Participation

Families often need support beyond the home environment, especially when navigating school-based services and accommodations. We are able to participate virtually in school meetings to help clarify evaluation findings, explain recommendations in an accessible language, and support families in advocating for their child. Having a clinician present can make discussions more productive and ensure that everyone understands the student’s needs and the recommended supports.

Also Read: Neurodiversity Affirming Mental Health Assessments

Schools appreciate having clear, clinically grounded information; families appreciate not having to translate technical testing results on their own. Virtual participation also keeps this support accessible regardless of schedules or geography.

Moving Forward With Confidence

Evaluations provide essential insight, but the true impact comes from what happens afterward—how families use that information, how strategies are adapted, and how supports evolve. Our follow-up consultation services are designed to help families move from understanding to action, from recommendations on paper to meaningful change in daily life.

If you’ve recently completed an evaluation or if months have passed and new questions have emerged, you are welcome to schedule a follow-up consultation at any time. We are here to support you as you take the next steps.

Getting Started

If you’re curious about the Safe and Sound Protocol, I’d love to connect. Whether you’re seeking more calm, a better connection, or simply a softer baseline for daily life, SSP can be a powerful step forward. Reach out now for more details.

Dr. Jessica Myszak, Dr. Jaime Long are performing psychological evaluations with children and adults. They offer both in-person and telehealth evaluations for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! Dr. Long is also now available to see clients in California. If you are interested in learning more about potentially working with them, you can visit their website here to get the process started

The Safe and Sound Protocol: A Gentle, Science-Based Approach to Regulating the Nervous System

Many of the people I work with—whether they’re autistic, living with anxiety, recovering from trauma, or simply feeling “stuck” in a state of stress—describe the same experience:
“I know I should be able to calm down, but my body just won’t let me.” When this happens, it means your nervous system is doing its best to keep you safe, even when that “protection” shows up as stress, shutdown, or overwhelm.

The Safe and Sound Protocol (SSP) is a gentle, evidence-based tool designed to help your nervous system shift out of chronic defence mode and into a state where connection, safety, and growth become possible. I’m excited to offer SSP in my practice now because I’ve seen how life-changing it can be for people—especially those who have tried traditional strategies but still feel “on edge” or disconnected.

Whether you have heard of the SSP before or not, this blog should provide more of an explanation of what it is, how it works, and who might benefit from it.

Also Read: Managing Stress While Waiting for a Diagnosis

What Is the Safe and Sound Protocol?

The Safe and Sound Protocol is a listening-based therapy created by Dr Stephen Porges, the neuroscientist who developed Polyvagal Theory—a framework for understanding how our nervous system influences emotions, behaviour, and relationships.

SSP uses specially filtered music to gently stimulate the part of the nervous system that helps you feel safe and connected to others. You listen to this music through headphones at home under my guidance. It’s not about the content of the music—it’s about how the sound frequencies interact with the muscles in your middle ear and your vagus nerve. As a result, your nervous system learns, slowly and gently, that it’s okay to relax, engage, and connect.

The Science Behind SSP

According to Polyvagal Theory, your nervous system has three main states: ventral vagal (calm, connected), sympathetic (fight or flight), and dorsal vagal (shutdown, freeze). When you feel unsafe, whether the threat is real or perceived, your body automatically moves into protection mode. Sometimes, your nervous system can get “stuck” in that protective state, even when you are safe.

The Safe and Sound Protocol works by:

• Activating the social engagement system – Your middle ear muscles help you pick up the frequencies of human voices. When those muscles are engaged, your brain receives a “safety” signal.
• Stimulating the vagus nerve – This nerve plays a key role in calming your body and helping you shift into a connected state.
• Re-training the nervous system – Through repeated, gentle listening, your system learns to recognise cues of safety more easily.

More simply, the SSP helps your body stop scanning for danger all the time so you can feel safe enough to connect, focus, and enjoy life.

Also Read: Embracing Mental Health Care and Seeking Support

Who Can Benefit from SSP?

SSP has been used with:

• Autistic children, teens, and adults (including PDAers) who experience sensory sensitivities, social anxiety, or emotional dysregulation
• People living with generalised anxiety, panic, or PTSD
• Individuals healing from early attachment disruptions or relational trauma
• Children who struggle with regulation, attention, or behavioural challenges
• Adults experiencing burnout, chronic stress, or nervous system dysregulation

The SSP is not magic, but it can be a powerful foundation that makes other therapies more effective because your body is in a more receptive, regulated state. I have worked with clients who have seen significant changes as a result of the SSP, and I have even used it myself!

What SSP Feels Like

Listening to the SSP is surprisingly calming. You’ll listen to gentle music (there are several options depending on your preference) through over-ear headphones. The audio has been specifically filtered to target certain frequencies that signal safety to your nervous system.
Some people feel relaxed right away. Others notice subtle shifts over days or weeks, such as:

• More patience with loved ones
• Less reactivity to stressful situations
• Easier sleep or focus
• Feeling more “present” in conversations
• A sense of lightness or calm that wasn’t there before

Because SSP works directly with the nervous system, these changes can feel natural, not forced.

How I Offer SSP in My Practice

Because no one situation fits all, I offer a variety of options for using the SSP. When you work with me, you’ll generally get a tailored program that honours your pace, preferences, and lived experience.

Here’s what it typically looks like:

• Initial Consultation – We discuss your goals, history, and current challenges. I explain how SSP works and answer any questions.
• Preparation Phase – Before we begin listening, I’ll help you learn simple regulation tools you can use during the process.
• Listening Sessions – You’ll have a plan to listen to the SSP music for short segments at first—often 5–15 minutes—at home with my remote support.
• Integration Support – Between sessions, we check in about any changes, insights, or challenges you notice. I’ll guide you in applying new regulation skills in daily life.
• Follow-Up – SSP effects often continue unfolding for weeks after you finish listening. We’ll meet to reflect on what’s shifted and plan next steps.

I customise every program. Some clients move through SSP in a few weeks; others spread it out over months to allow their nervous system more time to adjust. Others may have the background or outside support to use the SSP with minimal additional guidance seamlessly.

Also Read: All About Pathological Demand Avoidance (PDA)

Why SSP Is Different from Other Approaches

You’ve probably tried strategies for calming down or focusing before, like breathing exercises, mindfulness apps, or even traditional therapy. These can be helpful, but they often rely on thinking your way into a calm state.

• The challenge is: You can’t talk your nervous system out of feeling unsafe.
• That’s why SSP feels different. It works from the bottom up, retraining the nervous system directly so regulation becomes easier and more automatic.
• Think of it like loosening a knot in your muscles. Once that tightness is gone, you can move more freely—without having to remind yourself to relax constantly.

Is SSP Right for You (or Your Child)

SSP might be a good fit if:

• You’ve tried other therapies but still feel easily overwhelmed or shut down
• Your sensory sensitivities make it hard to engage with life
• You or your child struggles with emotional regulation
• You want a gentle, non-invasive approach to support nervous system health

It’s not recommended for everyone. If you’re in acute crisis or have certain medical conditions, we’ll discuss whether SSP is appropriate and how to adapt it for safety.

My Approach: Neurodiversity-Affirming and Trauma-Informed

As a psychologist, I believe every nervous system has a good reason for how it’s functioning. The SSP is about creating conditions where you can feel more like yourself.
If you’re autistic, PDA, ADHD, or otherwise neurodivergent, we move at your pace, honouring sensory preferences and boundaries. If you have a trauma history, we’ll integrate grounding and safety practices so the process feels empowering, not overwhelming.

Getting Started

If you’re curious about the Safe and Sound Protocol, I’d love to connect. Whether you’re seeking more calm, a better connection, or simply a softer baseline for daily life, SSP can be a powerful step forward. Reach out now for more details.

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have significant experience performing psychological evaluations with children and adults. They offer both in-person and telehealth evaluations for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they are able to work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! Dr Long is also now available to see clients in California. If you are interested in learning more about potentially working with them, you can visit their website here to get the process started.

Why Do I Avoid Things I Actually Want to Do?

A neurodiversity-affirming look at demand avoidance in PDA

Have you ever looked forward to something, only to find yourself avoiding it when the time comes? Maybe you put off replying to a friend’s message, struggle to start a creative project, or cancel an outing you were genuinely excited about. If this sounds familiar, you’re not broken and you’re not alone.

This puzzling pattern is especially common for people with a PDA profile (Pathological Demand Avoidance), a form of autism characterized by a strong sensitivity to perceived demands. This avoidance is the result of how the nervous system responds to pressure rather than laziness, disinterest, or defiance.

Also Read: Could You Have PDA? The Surprising Symptoms You Might Be Missing

The Nervous System’s Role

For PDAers, demands can feel like threats, even when they come from within. The brain and body are constantly scanning for signals of safety and danger, like an overactive guard dog. When something registers as a demand, the nervous system may respond as though it is unsafe, triggering fight, flight, freeze, or shutdown.

Almost anything can feel like a demand:

• I need to send that email.
• I should go for a walk.
• I promised I’d do this, so I have to follow through.
• I’m in a situation where small talk is expected.

Even if you truly want the outcome, the moment it becomes an expectation, resistance often appears. Avoidance in this sense is a nervous system response designed to protect you.

The Internal Tug-of-War

Many PDAers describe feeling like two people at once: one who is eager to do the thing and one who shuts down or resists as soon as it becomes real. You might plan with excitement, only to feel dread or panic when it is time to act. That inner battle can create guilt and frustration, leaving you confused about why you seem to be standing in your own way.

From a PDA perspective, this is not sabotage but survival. The nervous system is saying, “If I do this—even if I want to—I might lose my sense of control.” For PDAers, autonomy is not a preference. It is a core need.

Reframing the Experience

The most effective response is not to push harder, add more pressure, or shame yourself into compliance. These approaches usually make avoidance worse. Instead, the path forward involves compassion and curiosity.

Consider asking yourself:

• What about this feels like a demand right now?
• How can I reframe this so it feels like a choice or invitation?
• Is there a way to bring flexibility, creativity, or playfulness into this task?

The aim is not to trick yourself but to create conditions where your nervous system feels safe. That might mean removing time pressure, breaking tasks into smaller parts, or approaching the activity in a way that emphasizes choice and autonomy. Some of the most creative ideas I’ve heard have involved imaginative ideas like pretending they are on a spaceship and the aliens are watching how they do daily tasks, or acting as if they are closing down a bar or restaurant in an exotic location. When it comes to what you imagine, the sky is the limit!

Also Read: All About Pathological Demand Avoidance (PDA)

You’re Not Alone

Many PDAers go years without understanding why they struggle to follow through on things that matter to them. Once they learn about demand avoidance, the pattern begins to make sense, and much of the unnecessary self-blame can fall away.

You deserve support that respects how your nervous system works. By approaching yourself with understanding and flexibility, you can begin to work with your nervous system rather than against it. This shift allows you to move toward the things you want on terms that feel safe and sustainable.

If you are curious about whether you or your loved one meets the PDA profile, we would love to help! Reach out if you want to learn more about an evaluation.

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have significant experience performing psychological evaluations with children and adults. They offer both in-person and telehealth evaluations for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they are able to work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! If you are interested in learning more about potentially working with them, you can visit their website here to get the process started.

What Actually Helps a PDAer Feel Safe?

Understanding safety from a nervous system perspective. If you’ve ever supported someone with a PDA profile—or you are one—you’ve probably seen how quickly things can spiral when demands are involved. But what often gets overlooked is why PDAers respond the way they do.

At the heart of PDA, there is a nervous system reacting to a perceived lack of safety. So the real question becomes: What actually helps a PDAer feel safe? The answer might surprise you: it’s not just about reassurance or calm tones. For a PDAer, safety is deeply tied to autonomy, respect, and nervous system regulation.

It Starts with Autonomy

For most people, safety means being physically secure and emotionally supported. But for PDAers, safety also requires freedom. The freedom to choose, to say no, to have control over their body, schedule, and environment. When autonomy is threatened, even by something as small as a well-meaning suggestion, the nervous system may react as if it’s under attack.

Also Read: Understanding Masking: Helping Neurodiverse Kids Thrive

This is why so many traditional parenting strategies, school expectations, or therapeutic approaches fall flat, or even make things worse. If the PDAer doesn’t feel in control, the demand (no matter how minor it seems) can trigger a full-blown fight, flight, or freeze response. For children, I’ve seen PDA described as an overprotective guard dog in their brain—It is trying to protect the child from perceived dangers, but sometimes it might overreact to things.

Autonomy is not optional. It is a core need—a prerequisite for regulation and connection.

Co-Regulation > Compliance

When a PDAer becomes dysregulated, many people default to strategies that aim to “get them back on track.” But PDAers often don’t need redirection—they need co-regulation..

Co-regulation means offering calm presence and emotional attunement without trying to fix or control. It says, “I’m here. I’m not pushing. You’re safe with me, exactly as you are.”

That might look like:

• Sitting nearby without making demands
• Matching their energy in a playful way
• Using humor or imagination to shift the energy
• Backing off completely and returning when invited

For PDAers, the relationship is the intervention. Connection can open the door to regulation—but it has to come without pressure. No strings attached.

Respect Over Reassurance

Here’s something that surprises a lot of people: traditional reassurance doesn’t always help PDAers feel safe. Telling someone “It’s okay, just try it!” or “There’s nothing to be anxious about” can feel dismissive, even when it’s well-intended. It may increase the pressure to comply rather than reduce the sense of threat.

Instead, PDAers need respectful validation—an acknowledgment that their experience is real and their response makes sense, even if it’s different.
Try:

• “This feels like too much right now. I get that.”
• “You don’t have to explain. I’ll wait until it feels okay for you.”
• “What would help this feel more in your control?”

Respect invites collaboration. Reassurance often invites resistance.

It’s Not About Lowering Expectations. It’s About Shifting the Lens

Helping a PDAer feel safe doesn’t mean abandoning boundaries or giving up on goals. It means shifting how we approach them. It means prioritizing the relationship, honoring autonomy, and creating space for the nervous system to feel safe enough to engage.

Also Read: What Comes Next? Navigating Life After an Autism Diagnosis

When safety is present, cooperation can emerge organically. But it won’t be on your timeline—and that’s okay.

Final Thoughts

Whether you’re a PDAer yourself or someone who supports one, remember this: the goal isn’t compliance. It’s a connection. It’s a collaboration. It’s creating a world where autonomy and support can co-exist.

That’s what safety really looks like for a PDAer.

Need Professional Support?

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have significant experience performing psychological evaluations with children and adults. They offer both in-person and telehealth evaluations for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! Dr. Long is also now available to see clients in California, and Dr. Myszak is available to see clients in New York. If you are interested in learning more about potentially working with them, you can visit their website here to initiate the process.

For many adults, receiving an autism diagnosis can be a profound and validating moment. It can bring clarity to lifelong patterns, ease years of self-doubt, and open the door to self-compassion and understanding. But that doesn’t mean it’s easy.

At our practice, we have the privilege of working with adults from all walks of life who are exploring whether they may be autistic. Some have spent years feeling out of sync or misunderstood. Others are just beginning to connect the dots, often after a friend, therapist, or family member raises the possibility, or they see a video on social media that resonates a little too much. When someone chooses to pursue a neurodiversity-affirming autism evaluation with us, we take care to ensure that the experience is as supportive, thorough, and empowering as possible.

We assess not just for a diagnosis, but for the person as a whole, taking into account their lived experiences, strengths, challenges, coping strategies, and goals. After this process, we share our findings in a feedback session, where we walk through the testing results, the diagnostic formulation, and provide tailored recommendations.

Many people tell us this process is incredibly validating. But it can also be overwhelming.

The “Now What?” Moment

It’s not unusual for clients to leave the feedback session feeling both seen and stunned. We sometimes describe it as the “deer in the headlights” moment: a mix of relief, recognition, and confusion about what comes next.

Even when the diagnosis fits and the insights feel accurate, it’s a lot to take in—especially after years or decades of masking, second-guessing, or being told a different story about yourself. For many people, the evaluation is just the beginning of a longer process of self-discovery, healing, and navigating a world that often wasn’t designed with neurodivergent people in mind.

We’ve heard things like:

• “That makes so much sense… but I don’t know what to do with it yet.”
• “I feel like I need time to process all of this.”
• “Can we talk more about what this means for my relationships?”
• “I wish I could come back and ask more questions.”

Until now, those questions and feelings have often been left for clients to navigate on their own, with a summary report in hand and a list of resources to explore. While many people thrive with this information, others benefit from having more structured, individualized support to help bridge the gap between diagnosis and integration.

Also Read: How To Support a Loved One Newly Diagnosed with Autism?

Introducing Autism Follow-Up Sessions with Dr. Jaime Long

In response to these needs, we’re excited to share a new offering: individualized follow-up sessions with Dr. Jaime Long for adults who have received an autism diagnosis.

Dr. Long is a licensed psychologist who brings warmth, insight, and a deep understanding of neurodivergence to her work. After several conversations about the post-diagnostic experience and how best to support our clients beyond the evaluation, she will now offer follow-up sessions to help adults explore what their diagnosis means and how to move forward in an intentional and affirming way.

These sessions are designed to be flexible and tailored to your needs. There is no one “right” path after a diagnosis, and we don’t believe in a one-size-fits-all approach. Instead, these follow-up sessions are an opportunity to:

• Revisit testing results and diagnostic language in more depth
• Ask questions about what the diagnosis means in everyday life
• Explore how to communicate the diagnosis with family, friends, or employers
• Reflect on your identity and how you want to integrate this new self-understanding
• Problem-solve around work, relationships, routines, sensory needs, or burnout
• Learn about supports, accommodations, or strategies that might help
• Validate and work through mixed emotions—relief, grief, hope, anger, pride

Whether you’re newly diagnosed or still trying to make sense of what it all means, these sessions offer a safe and supportive space to process and plan.

Who Are These Sessions For?

We’re initially offering these sessions to previous clients of our practice—those who have already completed a neurodiversity-affirming autism evaluation and would like more support. If you’ve found yourself with lingering questions or have been meaning to reconsider for a deeper conversation, this is for you.

In time, we also plan to open up availability for adults who were evaluated elsewhere but feel their experience was lacking in clarity, compassion, or follow-up. We recognize that not all evaluations are created equal, and unfortunately, many individuals leave the diagnostic process feeling more confused than before. We hope to offer a re-grounding point: a thoughtful and affirming place to make sense of your diagnosis and how it fits into the larger picture of your life.

If you had an evaluation that felt too clinical, too brief, or too invalidating—or if you didn’t get a chance to talk about what the results meant for you—we invite you to connect with us.

Why Post-Diagnosis Support Matters?

An autism diagnosis doesn’t change who you are—it reveals who you’ve been all along. But even a welcome realization can come with emotional weight.

There may be grief for the years spent not knowing, or for the way your needs were misunderstood. There might be confusion about what parts of your experience are “autistic” and what parts are just…you. There can be excitement and curiosity, but also fear about what lies ahead.

Post-diagnostic support helps create space for these feelings. It’s a chance to move beyond the label and into a fuller understanding of your story—one that makes sense of the past and opens possibilities for the future.

These sessions are psychoeducational and individualized. They are guided conversations focused on education, insight, and self-advocacy. They’re meant to help you build a bridge between insight and action, between diagnosis and identity.

Also Read: Assessing Autism in High-Masking Adults for Accuracy

What to Expect?

Follow-up sessions with Dr. Long are typically 50 minutes in length and are held virtually. The content of the session depends on you—your questions, your goals, your concerns. Some clients may benefit from a single session; others may wish to schedule multiple sessions over time as they continue to reflect and grow.

When you schedule a session, you’ll share ahead of time what you’d like to focus on, so Dr. Long can prepare resources or guidance tailored to your needs. Whether you’re wondering about employment supports, navigating relationships, coping with sensory sensitivities, or just trying to make sense of your internal landscape, she will meet you with curiosity, validation, and clarity.

Looking Ahead

• We’re genuinely excited about the potential of these sessions to meet a very real and deeply felt need. Diagnosis can be a decisive first step, but it’s not the destination. It’s the beginning of a different way of seeing yourself.
• If you’re a previous client and would like to schedule a follow-up session, please don’t hesitate to contact us. We’ll be sharing more information about scheduling and availability soon.
• If you were evaluated elsewhere and would like to explore a follow-up session with us, please do not hesitate to contact our office. We’re happy to talk about whether this service is a good fit for you.

You Don’t Have to Figure It All Out at Once

• One of the things we often say to clients is, ‘You don’t have to do this alone, and you don’t have to have all the answers right away.’
• Coming to understand your autistic identity is a process—sometimes a lifelong one. These sessions are here to help you take the next step, whatever that may look like.
• Whether you’re seeking clarity, direction, reassurance, or simply a space to talk through what you’re learning about yourself, we’re here for you.

Need Professional Support?

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have significant experience performing psychological evaluations with children and adults. They offer both in-person and telehealth assessments for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! Dr. Long is also now available to see clients in New York and California. If you are interested in learning more about potentially working with them, you can visit their website here to initiate the process.

If you’ve ever searched “Am I autistic?”, you’re not alone. Many adults begin exploring the possibility of autism later in life, often after years of feeling different, misunderstood, or exhausted by masking. It can be overwhelming to sift through, and it’s challenging to determine what information is accurate and reliable. As a psychologist specializing in adult autism evaluations, I aim to create this blog post as a starting point for individuals exploring neurodivergence and considering whether an assessment is a suitable next step.

Why Autism Often Goes Undiagnosed Until Adulthood

Autism can manifest in very different ways across individuals. People who are social, verbal, sensitive, or intelligent may not “fit” outdated stereotypes of autism. Many adults, especially women, nonbinary people, and those with co-occurring ADHD or anxiety, were missed as children.

Many late-diagnosed autistic people have been labeled:

• Gifted
• Intense
• Shy
• Awkward
• Anxious
• Overthinking
• Perfectionist
• Too sensitive

Only later do they realize that these were signs of being autistic all along.

Common Signs of Autism in Adults

Here are some of the most frequently reported traits of late-identified autistic individuals:

• Difficulty with unspoken social rules
• Sensory overwhelm (sound, light, textures)
• Intense, all-consuming interests or deep dives
• Emotional regulation difficulties or shutdowns
• A strong need for routine, predictability, or control
• High empathy or emotional sensitivity
• A lifelong sense of being “different” or out of sync
• History of masking or people-pleasing to survive socially
• You deeply relate to content created by neurodivergent people

If you resonate with this list, it’s worth exploring further.

Do I Need an Autism Evaluation?

You may benefit from a professional autism assessment if:

• You experience social burnout or sensory overwhelm
• You’ve been misdiagnosed or misunderstood in therapy
• You want validation or language to advocate for your needs
• You’re curious about accommodations at work or school

What Happens During an Autism Evaluation?

As a small psychology practice, we approach adult autism evaluations in a neurodiversity-affirming and collaborative manner. The process includes:

• A detailed clinical interview and developmental history
• Self-report measures that look at autistic traits
• PDA (Pathological Demand Avoidance) screening
• Optional inclusion of ADHD or cognitive screening
• An emphasis on understanding your lived experience, not just checking diagnostic boxes

We see clients in both traditional office settings and through telehealth, depending on their proximity to the office and their preference.

The goal of an evaluation is to gain a clearer understanding of yourself with greater compassion.

Download: Free Self-Reflection Guide

Still undecided? Here is a free guide to help you reflect on your experiences in a low-pressure, affirming way. Get your free copy of “Could I Be Autistic? A Neurodiversity-Affirming Self-Reflection Guide” here.

Related Resources

• Understanding Masking: How to Support Authentic Self-Expression
• Assessing Autism in High-Masking Adults for Accuracy
• Could You Have PDA? Recognizing the Signs and Symptoms

Are you Ready to Move Forward?

Whether you’re seeking a diagnosis or just starting to explore, your curiosity is valid, and you deserve support that meets your needs. We offer autism evaluations for adults, teens, and children, grounded in professionalism, warmth, and respect for neurodivergent experiences.

Contact us today to learn more about the evaluation process or to schedule an appointment.

Need Professional Support?

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have significant experience performing psychological evaluations with children and adults. They offer both in-person and telehealth assessments for children, teens, and adults looking for answers. In addition to seeing clients on the Chicago North Shore, they can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Washington DC, West Virginia, Wisconsin, and Wyoming! Dr. Long is also now available to see clients in New York and California. If you are interested in learning more about potentially working with them, you can visit their website here to initiate the process.

Receiving an autism diagnosis in adulthood can be both a powerful relief and an emotional whirlwind. It can validate years or even decades of wondering why things felt harder, different, or inexplicably draining. But the path forward isn’t always clear. Now that you finally have an explanation, what do you do with it?

In short, there is no single “right way” to move forward.

Some adults feel energized to explore what life looks like when they no longer mask or camouflage who they are. Others feel grief, confusion, or hesitation, especially when thinking about past experiences through this new lens. Whether you choose to lean into your uniqueness or continue using learned strategies to blend in, the important thing is that you get to decide. Social difficulties are not a flaw to be fixed. They often reflect a mismatch between a person and their environment, not a problem within the individual.

Getting a diagnosis can be out of reach for many, which is why self-diagnosis is generally accepted in the autistic community. While I believe that having a psychological evaluation can provide helpful information for neurodivergent adults, I don’t want to gate-keep some of the most helpful next steps for those who are navigating this journey on their own. Regardless of how you come to understand your unique self, here are some recommendations to support you as you explore this new chapter with self-compassion, curiosity, and confidence:

1. Give Yourself Permission to Feel Everything

Relief, grief, validation, sadness, empowerment—all of it is valid. You’re reprocessing your life with new language and insight, and that takes time. Some people find it helpful to talk to a therapist who is knowledgeable about both autism and mental health. Searching for “neurodiversity-affirming therapists” is a good start—these providers will help you accept your differences, not try to “fix” you.

Read More: Understanding the Rise In Adult Autism Assessments Today

2. Understand and Respect Autistic Burnout

If you’re feeling emotionally fried, exhausted, or overwhelmed by basic tasks, you may be in autistic burnout. This is not laziness or depression—it’s a nervous system collapse from years (or decades) of high-demand living, masking, and navigating an unaccommodating world.

The most effective remedy? Reduce demands and rest. Let yourself say no, unmask, and lower your commitments. Recovery takes time—and pushing through will only delay healing.

3. Reflect on the Role of Masking in Your Life

Masking (adapting your behavior to appear more neurotypical) can help people survive in school, work, and relationships, but it often comes at a high emotional cost. Long-term masking is associated with anxiety, depression, identity confusion, and burnout. If you resonate with being high-masking, consider where you mask the most. Where do you feel safest being yourself? With time, many adults work toward a more authentic lifestyle, slowly peeling back layers that were once protective but are no longer necessary.

4. Explore Sensory and Social Needs

Autistic people often experience the world through a heightened or altered sensory lens. If you’re sensitive to light, sound, textures, or crowds, you are not being picky or dramatic. Your nervous system just works differently. Occupational therapy (OT) can be helpful here, and those who specialize in helping adults can assist you with the creation of sensory-friendly strategies for work, home, and daily routines.

Socially structured environments can be a great way to build community without overwhelming pressure. Volunteer groups, interest-based classes, or hobby meetups can offer ways to connect while reducing unstructured small talk.

5. Seek Medical and Mental Health Support When Needed

There are no medications “for autism,” but many autistic adults benefit from treatment for co-occurring conditions like anxiety, depression, ADHD, or sleep disorders. If these challenges interfere with your daily life, talk to your doctor or psychiatrist about possible options. You may also want to speak with a neurologist, especially if you experience chronic sleep disturbances—these are common among autistic adults and can greatly affect both mental and physical well-being.

6. Know Your Rights and Advocate for Yourself

You may be entitled to accommodations in work or educational settings. These adjustments can help level the playing field and allow you to perform at your best. Examples might include flexible scheduling, communication via email instead of meetings, or the use of sensory tools. In some cases, if mental health symptoms significantly interfere with your ability to maintain employment, it may be worth speaking with a disability attorney about disability benefits.

7. Consider Resources Designed for Autistic Adults

There’s a growing library of affirming books, podcasts, and courses created by and for autistic adults. If you’re looking for a structured next step, you might benefit from Dr. Myszak’s self-paced e-course designed specifically for adults processing a late diagnosis. It includes practical guidance and connection with others who are walking the same path.

8. Share Your Diagnosis with Medical Providers (If You Feel Safe)

Your primary care physician may not be fully aware of how autism presents in adults, especially in high-masking women or those with complex internal experiences. Sharing your diagnostic report with them can help them better understand your needs and provide more informed, tailored care.

Read More: Why Are So Many Adults Getting Diagnosed with Autism?

9. Explore PDA-Informed Approaches That Align With Your Needs

Some autistic individuals experience a profile called Pathological Demand Avoidance (PDA), which involves a heightened stress response to everyday demands, even ones they want to do. If you find yourself avoiding tasks due to overwhelm, anxiety, or feeling “trapped,” PDA-informed strategies may help reduce family conflict, workplace challenges, and inner distress.

10. Invest in Self-Knowledge and Self-Advocacy

Your diagnosis is not the end of the road—it’s a gateway to deeper self-understanding. Learning how your brain processes the world, where your boundaries lie, and what conditions help you thrive will empower you to move through life with more clarity and compassion. Finding neurodiversity-affirming books, websites, and social media can help you better understand your own needs and identify possible helpful strategies.

Conclusion

Overall, if you are coming to understand that you are Autistic, whether from an evaluation or self-diagnosis, there is a lot to consider. You’ve always been you—now you simply understand why better. With support, self-awareness, and the right accommodations, you can live a fulfilling, authentic life.

If you’re looking for a place to start, we offer neurodiversity-affirming evaluations for children, adolescents, and adults. Reach out for more information!

Need Professional Support?

Dr. Jessica Myszak, Dr. Jaime Long, and Dr. Aimee Rovane have over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! You can contact her to start the process if you want to learn more about potentially working with her.

A Blog Post from Dr. Jaime Long

Dr. Jaime Long is doing something exciting this month, and she wrote this blog to share more information about this with friends and clients of the Help and Healing Center. Learn more about body-doubling below!

Many neurodivergent individuals, including those with ADHD and autism, struggle with executive functioning. This can make it difficult to start tasks, stay focused, stay organized, and manage priorities.

A common challenge is the inability to begin tasks, even when there is a strong desire to do so. Many people find themselves stuck, thinking about everything they need to do but unable to take action. This is not laziness; it is a result of how the brain processes tasks.

For those who experience this, body doubling can be an effective strategy to improve focus and accountability.

What Is Body Doubling?

Body doubling is a productivity technique where you work on a task while another person is present, either in person or virtually. This method helps create a sense of accountability and urgency, making it easier to start and stay focused.

Read More: Understanding Masking: How to Support Authentic Self Expression

Body doubling can be done in various ways:

• In-person sessions – Studying with a friend, working in a shared space, or cleaning the house with a partner.
• Virtual body doubling – Platforms like Focusmate allow users to schedule Zoom sessions with a work partner. Participants check in, work independently for a set time, and then check in again at the end.

Because there is minimal social interaction, body doubling is particularly useful for people who need external motivation but prefer to work independently. The added accountability makes it harder to procrastinate or abandon tasks.

How Body Doubling Helps with Productivity

Many neurodivergent individuals find that they need external structure to begin tasks, especially on days when there is no set schedule. Body doubling creates that built-in structure, reducing the mental barriers that prevent task initiation.

For example, scheduling a morning body doubling session can:

• Encourage waking up at a reasonable time
• Provide an early sense of accomplishment
• Help prioritize important tasks
• Reduce procrastination and decision fatigue

Even short sessions can help individuals gain momentum and break through mental blocks that make task initiation difficult.

Common Challenges and How to Overcome Them

While body doubling is an effective strategy, it is important to set realistic expectations. Many people with ADHD fall into the trap of overloading their to-do lists, expecting to accomplish an unrealistic number of tasks in a day.

Some key tips for success:

• Set achievable goals – Focus on one or two key tasks rather than trying to do everything at once.
• Recognize time blindness – People with ADHD often underestimate how long tasks take. Allow extra time for each task.
• Avoid self-judgment – Productivity is not about perfection. Be kind to yourself if you do not complete everything on your list.
• Take breaks – Overworking can lead to burnout. Short breaks improve focus and efficiency.

Read More: Back-to-School Tips for Neurodiverse Families and PDAers

Free Body Doubling Sessions

To help people experience the benefits of body doubling, free virtual sessions are available. These sessions are designed for productivity, not discussion. Participants can join without turning on their cameras or sharing personal details.

Upcoming body doubling sessions:

• Friday, March 14 – 9:30 to 10:15 a.m. CST
• Saturday, March 22 – 10:00 to 10:45 a.m. CST
• Friday, March 28 – 1:00 to 1:45 p.m. CST

All times are in Central Standard Time (CST).

Sign up here: https://forms.gle/3PdVQgAtnbPxaEXj9

FAQs

Who benefits from body doubling?

Body doubling is especially helpful for people with ADHD, autism, or executive functioning challenges. However, anyone who struggles with task initiation, focus, or motivation can benefit.

Do I need to talk to my body doubling partner?

No, body doubling is about accountability, not conversation. While check-ins may occur at the beginning and end of a session, there is minimal social interaction.

What if I do not complete my tasks?

Productivity is about progress, not perfection. The goal is to create momentum and reduce mental barriers to starting tasks. Completing even a small portion of a task is still progress.

Can meditation help with focus?

Yes, meditation has been shown to improve attention, reduce impulsivity, and help regulate emotions, which can be beneficial for individuals with ADHD. Resources for self-compassion and mindfulness can be found here: https://self-compassion.org/self-compassion-practices/

Conclusion

Body doubling is a powerful tool for individuals who struggle with executive functioning. By working alongside another person, whether in person or virtually, many people find it easier to start tasks, stay engaged, and remain accountable.

For neurodivergent individuals, the key to productivity is often structure, realistic expectations, and self-compassion. If you struggle with task initiation, consider trying body doubling as a way to boost motivation and focus.

Need Professional Support?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.