My son has been diagnosed with Asperger’s Syndrome. He can be very oppositional and defiant. So exactly what is the difference between behaviors associated with Asperger’s and those of Oppositional Defiant Disorder?
This is an insightful question because, quite frankly, the line separating the two conditions sometimes can be quite fine. That being said, I can’t see where I would diagnose both conditions in the same child, although I’ve seen it done. In the case of these two conditions, it’s best to stay with one or the other.
First of all, it’s quite possible that behaviors characteristic of ODD will continue without ever being diagnosed. Short-term interventions might bring just enough compliance for a child to clear a hurdle, such as doing just enough work at the end of the school year to pass (barely). Then everyone takes a break … until the next hurdle.
A child with Asperger’s, the highest level of functioning on a diagnostic continuum called Autism Spectrum Disorders, is less likely to slip through the cracks undiagnosed. Youngsters with Asperger’s tend to have unusual mannerisms that, over time, are bound to be recognized and addressed.
Let’s compare these two youngsters on five characteristics of Etiology, Language and Communication, Social Awareness and Interaction, Capacity to Adapt, and Nature of Noncompliance.
Etiology: The behaviors characteristic of ODD are mostly related to temperament and the youngster’s perception and reaction to circumstances and events close to them. External events can influence behavior dramatically, a critical notion in intervention. There are many theories as to the causes of Asperger’s, but genetics and organicity (brain chemistry and neurology) are thought to play a big part. With these children, issues of adaptation are significantly more internal than external.
Language & Communication: Although Asperger’s youngsters might have strong language skills, they are apt to comment inappropriately and even talk incessantly about a topic of their interest. The tone, volume and even the precision of their speech can be affected. They also have trouble with communication that contains humor, especially when it is subtle. ODD kids, on the other hand, can have excellent language and communication skills, and can use them well. In fact, they’d often rather talk than do—which is precisely the problem.
Social Awareness & Interaction: ODD youngsters tend to be socially aware and responsive. They can participate in groups, enjoy athletics, and are good leaders (partly because they don’t want to be compliant to another leader). By contrast, Asperger’s youngsters don’t handle social contexts well at all. In fact, they tend to isolate. Avoidance of eye contact is a big issue, and it is diagnostically significant. These youngsters often fail to sense a group code of conduct, and their interactions show it.
Capacity to Adapt: ODD children and adolescents can and do adapt to new and unique situations fairly well. It’s interesting to note, however, new and unique circumstances often can put a temporary halt to defiant behavior, as the child is not “comfortable” enough to be defiant. (There’s a hint there for intervention.) Youngsters with Asperger’s Syndrome don’t handle change well at all. Change for them is apt to bring on significant tantrum behavior and major meltdowns.
Nature of Noncompliance: ODD youngsters generally understand the compliance expected of them. They just don’t want to do it. There can be a strong quality of arrogance and passive-aggression in their noncompliance. Asperger’s kids, on the other hand, can distract themselves from compliance. They don’t necessarily intend to refuse, but the job doesn’t get done. It’s also possible they don’t make the “connection” when a compliance request is actually a mandate, not a suggestion.
As one can readily see, treatment of these two conditions would be quite different.
Although a nationally recognized child and adolescent psychologist, author and speaker, Dr. James Sutton deeply values his first calling as a public school teacher. Today he is in demand for his expertise on emotionally and behaviorally troubled youngsters, and his skill for sharing it. Dr. Sutton is the founder and host of The Changing Behavior Radio Network, a popular internet radio program supporting young people and their families, and every month he publishes The Changing Behavior Digest, offering tips on managing difficult children and teens. Both resources (and others) are available at no cost through his website, http://www.DocSpeak.com.