12/14/2025
Many children on the autism spectrum are given an additional diagnosis of Oppositional Defiant Disorder (ODD). Sometimes that diagnosis fits but more often I feel it deserves a closer look.
ODD is defined by a pattern of intentional defiance and hostility. The autistic behaviors that look “oppositional” are frequently rooted in communication challenges, sensory overload, anxiety, cognitive inflexibility, or difficulty with emotional regulation, not willful defiance.
If a child cannot:
• Process language quickly
• Tolerate sensory input
• Express frustration or fear
• Transition without support
…then refusal may be self-protection, not opposition.