DIAGNOSING PDA within the guidelines!!

I have posted this in a comment on an existing thread, but it is important enough to give it its own thread... The following is on The PDA Resource website, in PDF form, but here it is in text form for everyone.

Never mind the clinicians' reluctance to diagnose PDA, they CAN do so, within the guidelines, and it is simply the way they write it down:-

November 2016 (original version in January 2015)

PDA does not appear in the diagnostic manuals published by the World Health Organisation or the American Psychiatric Association. In fact, it only just gets a footnote in an appendix of the guidance produced by the UK National Institute for Health and Clinical Excellence.

It will be a while before it gets into any of those manuals because you need research studies involving thousands of diagnosed patients before the editorial boards will even start to notice it.

However, clinicians who are aware of the diagnostic criteria are free, in both the US and the UK, to diagnose PDA as a sub-type of an existing diagnosable condition.

Indeed, the latest versions of the diagnostic manuals positively encourage clinicians diagnosing ASD to go on and describe the individual presentation in narrative detail.

The wording now being promoted by NAS, the Lorna Wing centre, and professionals such as Phil Christie is "ASD with a profile of [pathological] demand avoidance". This fits in with their recommendations for other subtypes of autism such as "ASD with a profile of Aspergers", "ASD with a female profile" etc.

It is also worth noting this paragraph from the NAS website about the use of the word "pathological":-
"Demand avoidance can be seen in the development of many children, including others on the autism spectrum. It is the extent and extreme nature of this avoidance that causes such difficulties, which is why it has been described as 'pathological'."

For this reason, a diagnosis of "ASD with a profile of [pathological] demand avoidance" (with or without the word pathological) is a perfectly valid means of diagnosing PDA and remaining firmly within the letter and spirit of the American diagnostic manuals.

 EDIT (of 15th February 2017)
 Worth noting that the change of language to PDA being a "profile within the autism spectrum" is now reflected on the NAS website and in some supporting articles:
http://www.autism.org.uk/about/what-is/pda.aspx 
http://www.pdasociety.org.uk/blog/2017/02/pda-profiles-nas-changes-and-new-article 

Thanks to Tom Crellin for the explanation above :) 

EDIT of August 2017

(Other information related to insurance in the US) - even with a Diagnostic Billing Code of F84.0 for ASD as I pointed out above, many employers do not purchase the extra "Autism Coverage" plan and therefore many (and in fact it is MOST times in the US) that if there is only ONE diagnostic billing billing code F84.0 (the correct one for ASD) it will still get turned down ... there are ways around this - but the EASIEST way is if there is simply one additional diagnostic billing code it can be billed under - such as Generalized Anxiety Disorder or Mood Disorder etc (in addition to the ASD) 
Since these other mental health overlays very often co-exist with PDA this should not present as a difficulty - Anxiety can be the billing code diagnosis that gets the service billed for even though the main diagnostic presentation is PDA - which be sure to also include as F84.0 - just have an additional diagnostic billing code as well so it's most easily covered:) XX

TIP: Most Insurance Companies will have an Autism Coordinator to serve as your advocate: To find out if you have the "Autism Package" the Autism Coordinator or other Representative can contact your employer (who you get insurance through) directly for you - this is easiest way and easily determine if you have "Autism Package". If you do not have Autism Package - do NOT worry. Just follow above. 

Autism Package is simply ABA - which is not useful for PDA kids anyway. For payment of other services (life skills, 1:1 therapy, psych etc) simply use a second diagnostic code as stated above. 

If you do have the Autism Package, the F84.0 code for ASD will go through as a single diagnosis (this is the only time it will). Medicaid has the Autism Package

Thanks to Colleen Logiodice for the USA additional info :)