The Diagnostic and Statistical Manual of Mental Disorders, fifth edition characterizes oppositional defiant disorder (ODD) as reflecting pervasive patterns of irritable mood, defiant behavior, and/or vindictiveness. Youth with autism spectrum disorder (ASD) exhibit high rates of disruptive behaviors commonly associated with ODD, such as noncompliance, irritability, temper tantrums, and mood dysregulation. This chapter reviews the presentation of ODD in individuals with ASD, including current prevalence estimates, proposed etiology, validated assessment methods, and emerging best practices designed to treat challenging behaviors. Although there is a robust literature describing assessment and treatment procedures for disruptive behaviors in individuals with ASD, conceptualizing these hallmark behaviors within the framework of ODD is relatively novel and not without controversy. Discussion thus includes challenges around the applicability of the diagnostic criteria in this population and future research directions that may provide clarity on this issue.
