In my experience, there is a professional understanding that untreated, ODD can become Conduct Disorder, and if that worsens, it may be expressed as APD in adulthood. But I have never met a professional who assumes that ODD will lead to Conduct Disorder and APD. In children, the whole point of identifying a problem is to make changes and provide treatment, and prevent it from becoming worse.

But often it isn't helpful to focus on a diagnosis. It is important to remember that there are a lot of factors involved in any mental illness or behavior problem. There may be biological components, but social, environmental, emotional factors, etc. all make a difference, even with a diagnosis thought to be primarily medical. An autistic child will do better in life with supportive, understanding parents, for example. Treatment and education make a difference too. The goal is best possible outcomes, and hopefully stopping any progression to worse problems or diagnoses.

Kim, I'm not sure if we are mostly agreeing with each other, or if you disagree with what I am posting. I'm feeling a little lost. I think that we are all advocating what we see as the most helpful approach to children with ODD, whether it's useful to label it such or not.