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J Autism Dev Disord (2008) 38:13021310 DOI 10.1007/s10803-007-0516-8
ORIGINAL PAPER
Oppositional Deant Disorder as a Clinical Phenotype in Children with Autism Spectrum Disorder
Kenneth D. Gadow Carla J. DeVincent Deborah A. G. Drabick
Published online: 11 January 2008 Springer Science+Business Media, LLC 2008
Abstract To examine the validity of oppositional deant disorder (ODD) as a clinical phenotype distinct from attention-decit hyperactivity disorder (ADHD), parents and teachers completed a DSM-IV-referenced rating scale and a background questionnaire for 608 children (ages 3 12 years) with autism spectrum disorder (ASD). The ASD sample was separated into four groups: ODD, ADHD, ODD + ADHD, and neither (NONE). Comparison samples were non-ASD clinic (n = 326) and community (n [ 800) controls. In the ASD sample, all three ODD/ ADHD groups were clearly differentiated from the NONE group, and the ODD + ADHD group had the most severe co-occurring symptoms, medication use, and environmental disadvantage. There were few differences between ASD + ODD and ASD + ADHD groups. Findings for ASD and control samples were similar, supporting overlapping mechanisms in the pathogenesis of ODD.
Keywords Oppositional deant disorder Autism spectrum disorder Autism Aspergers syndrome PDDNOS Pervasive developmental disorder Attention-decit/hyperactivity disorder DSM-IV Diagnosis
Introduction
A large percentage of children with autism spectrum disorder (ASD) exhibit the symptoms of DSM-IV-dened oppositional deant disorder (ODD), which is characterized by a pattern of hostile and deant behavior directed toward adults. For example, two recent studies found that the percentage of 3- to 5- and 6- to 12-year-olds with ASD meeting DSM-IV symptom criteria for ODD according to their parents was 13 and 27%, respectively, and the rates for teachers were 21 and 25%, respectively (Gadow et al. 2004a, 2005). Interestingly, these symptom prevalence rates for ODD in children with ASD are comparable to the rates for ODD in non-ASD children referred for child psychiatric outpatient clinic evaluation. Moreover, there are other similarities (age, gender, and rater differences) in clinical characteristics associated with ODD in ASD, clinic-based, and community-based samples, which support the notion that ODD may be a unique behavioral syndrome in children with ASD, and equally important, may be the same (or a similar) disorder as observed in non-ASD children. This having been said, whether ODD and other behavioral disturbances in children with...