Avoidance

Because of the inherent struggles with communication, children with autism often rely on behavior to make their wants and needs known. In essence, behavior is communication. We autism parents become master detectives, constantly sifting through the clues our children give us. We analyze possible triggers for the behavior. We hypothesize the function of the behavior. And we respond accordingly to either reinforce the positive behavior or change the negative behavior.

When examining the function of the behavior, it is important to determine if the behavior is self-stimulatory in nature, if it is to gain access to a preferred task or object, if it is for attention, or if it is to escape/avoid a certain task or object. The majority of Kate's behaviors are related to her desire to escape or avoid situations that she finds aversive. Most aversive to Kate is pooping on the potty.

I will spare you the gory details of this ongoing struggle. It is downright ugly. In order to avoid sitting on the potty Kate will do one or more of the following, depending on her mood at that particular moment: throw a tantrum, cry, scream, throw herself on the ground, whine, argue, complain, kick, hit, line up her toys, or hide in her room. We ignore and/or redirect Kate when she exhibits the above behaviors and slather on the praise when she sits quietly on the toilet and goes about her business.

One recent night after a lengthy battle, Kate finally accepted her fate and sat on the toilet. She was exceptionally quiet. Too quiet. I gently knocked on the door. No answer. Was she even in there? I opened the door, which was fortunately unlocked. Perched on toilet, slightly askew, sat a sleeping Kate. That's right. Sleeping. On the toilet.

My daughter, master avoider of pooping.

Alphabet Soup

Kate's official diagnoses include ASD/PDD-NOS, SPD, and anxiety with a strong OCD component. One of Kate's therapists would like to add a new flavor to the mix: ODD. It is true that Kate is stubborn, a personality trait that runs strong on both sides of the family tree. It is true that she is emotionally reactive, which can be attributed to her struggles with the modulation of sensory input. It is true that she is argumentative, but isn't that related to the poor social skills of children on the spectrum? It is true that she is negative and often complains. Again, a personality trait. Not everybody is a glass-is-half-full kind of person. It is true that Kate tests her limits, but what child doesn't?


Kate receives a variety of services and therapies that address her needs. Occupational therapy for fine motor issues and challenges related to sensory processing. Speech therapy to strengthen pragmatic language skills. Verbal behavior taught Kate how to "use her words". A social skills group to help her interact with her peers. Behavioral health rehabilitative services to teach play skills, flexibility, coping skills. RDI to help Kate become competent in dynamic systems.

So, my question is this- What is the purpose of saddling Kate with this ODD label? Should this label be stamped on her, it might very well change how people look at her. The acronym itself is stigmatizing. Who wants their child labeled "odd"? Also, I am afraid that kids labeled with ODD are perceived as "bad kids". Kate has some challenging behaviors at times, but she is not a "bad kid".

There is no reason to slap this label on Kate. It will not change her needs nor will it change the services she receives. More importantly, it will not change how we are raising her. It will not change how we love her.