Drs. Wiggins and Wakschlag Reply

We thank Benarous et al. for their recognition of the necessity of a developmental view on disruptive mood dysregulation disorder (DMDD) and for their thoughtful comments. Indeed, a growing science base challenges the "old thinking" that developmental instability precludes earlier identification of DMDD syndromes. Notably, our paper was designed to promote a move toward a dimensional approach, which ultimately would obviate the need to make "you have it or you don't" decisions. In the short term, because real-world clinical decision making still rests on the presence or absence of DSM syndromes, our goal was to generate a developmentally informed evidence base for earlier identification and prevention of early-onset clinically significant irritability.