Autism and Oppositional Defiant Disorder: Are They Related?
- HEALIS AUTISM CENTRE
- Mar 31
- 4 min read
What is Oppositional Defiant Disorder (ODD)?
Oppositional Defiant Disorder, as the name suggests, is a behavioural disorder that is most commonly diagnosed during childhood (John Hopkins Medicine, n.d.) . Children with ODD consistently show hostility and uncooperativeness, particularly towards authority figures such as teachers and parents. The type of behaviours vary depending on the child, and can vary from arguing with others to deliberately doing things that would annoy others to blaming others for their own mistakes (Cleaveland Clinic, 2022; National University Health System, 2023). On its own, ODD is already troubling and can heavily affect the child’s relationships with other people as well as themselves, such as their learning in school for example. However, more concerning is the fact that ODD often occurs in tandem with other disorders, which may further drive its negative impacts on the child.
Comorbidity of ODD and ASD
Research has found overlaps of symptoms of ODD in children with autism. While this is not to say that autistic children will always develop ODD behaviours, it is likely for some of them to display behaviours of hostility towards adults and repeated defiance towards instruction, often leading to outbursts or tantrums. Schoorl et al. (2016) suggests that this may be due to ODD symptoms being a result of impairments in emotional regulation, which is one of the reasons behind certain behaviours autistic people exhibit. Mandy (2013) also states that it is likely for autistic children to exhibit irritability in particular — one of the more notable symptoms of ODD — due to “rigidity, dysregulated attention and poor emotional processing”, which can cumulate into more frustration and the lack of ability to deal with said frustration. Undoubtedly, there are plenty of similarities between traits displayed by people with autism and oppositional defiant disorder. In most studies, the occurrence of common ODD traits in autistic people is usually more than 20% (Posar & Visconti, 2024). However, while there are key overlaps between symptoms of the two, we should be careful to point towards comorbidity of the two disorders, as Posar & Visconti (2024) also state that certain behaviours displayed by autistic people that seem like ODD behaviours may simply be consequences of the “core” aspects of autism. This is not to say that it does not exist, but each person’s situation is different, and all should be taken into consideration as an explanation for any behaviours and resistances, before jumping to the conclusion of comorbidity.
Other Research: Pathological Demand Avoidance
Rather than ODD, some researchers suggest that pathological demand avoidance (PDA) is what presents itself in children with autism when interacting with adults of authority (Miller, 2024). Similarly, it results in autistic children having extreme avoidance to being told what to do or how to behave, with the child making excuses, escaping, having a meltdown or other reactions in order to avoid what they perceive as a demand. Unlike ODD, PDA occurs when the child refuses to listen to authority figures and instructions because of anxiety related to loss of autonomy (having to follow instructions) (Neff, n.d.). Additionally, although behaviours may escalate to a point of aggression, it is not always the case, unlike in ODD where behaviours are always hostile and aggressive to a degree.
Why Is My Child Not Listening?
When interacting with children with autism, especially as caregivers, we often face resistance and defiance to instructions which can most definitely be frustrating, especially when it occurs repeatedly. However, it is important to consider what the reasons for the child’s behaviours are. Caregivers should take note of their child’s behaviours, particularly recurring ones, as well as what precedes them and inform medical professionals and psychologists accurately so as to avoid misdiagnoses (Júnior et al., 2023). That way, diagnosis can be done correctly and prevent the child and parents from having to deal with unnecessary additional stress.
Written by Kai
References
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John Hopkins Medicine. (n.d.). Oppositional defiant disorder (ODD) in children.
Júnior, M. F., da Silva, E. S. A., Araújo, D. F., & Anomal, R. F. (2023). Autism spectrum disorder
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