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 not 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 may 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 circumstantes and events close to them. External events can influence behavior dramatically, a critical notice 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 may have strong language skills, they are apt to comment inappropriately and even speak 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've often talked less than do -which is 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 do not want to be compliant to another leader). By contrast, Asperger's youngsters do not 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 do not 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 do not 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 do not necessarily intend to refuse, but the job does not get done. It's also possible that they do not make the "connection" when a compliance request is actually a mandate, not a suggestion.
As one can read see, treatment of these two conditions would be quite different.