Behavioural Disorders

What are Behaviour and Conduct Problems?

Children and young people respond to situations in different ways. Temperament, personality factors, resilience and family experiences can be linked to how children cope with different experiences. At some stages of development, children and young people can go phases where they find it more difficult to manage their emotions. This can lead to behavioural problems. Behavioural problems can happen with children of all ages. When children are younger and toddlers, children may have fears or push boundaries and try out different emotions. As children develop into adolescence, they are developing their identity, and there are significant changes biologically and physically. Many young people experience hormonal changes with puberty, and there can be mood changes. Some adolescents may become defiant and rebel against the boundaries set out.

With the help of parents, carers and teachers, most children and young people will learn to behave appropriately. Occasionally, a child will have a temper tantrum, or an outburst of aggressive or destructive behaviour, but this is often nothing to worry about.

What to consider with Behavioural Disorders in childhood

  • Onset of behavioural change – Does your child or young person present with very sudden or gradual behavioural changes.
  • Associated risk – Is your child or young person, putting themselves at risk or others at risk.
  • Transition – Is there anything obvious that might have upset or unsettled them? For example, significant life events include moving country, house or school, divorce and separation, bereavement/loss, friendship problems, trauma, illness
  • Impact on functioning – Is the behaviour having a negative effect on their daily life, for example, is it stopping them attending school or getting their schoolwork done; affecting friendships or family relationships; getting in the way of interests; affecting their self care, eating or sleeping?
  • Who else is worried about the child or young person? E.g. other family members, teachers, friends
  • Insight – Has your child or young person said they think there is a problem or that they are worried, or angry or upset and want help?

Conduct disorder in young people

Someone with a Conduct Disorder or Behavioural Disorder in childhood may get involved in more violent physical fights, and may steal or lie, without any sign of remorse or guilt when they are found out.

They refuse to follow rules and may start to break the law. They may start to stay out all night, and play truant from school during the day. Teenagers with conduct disorder may also take risks with their health and safety.

What effect can this have on others?

Conduct disorder can cause a lot of distress to children, families, schools and wider communities. Children who behave with Conduct issues will often find it difficult to make friends and have difficulties understanding social situations.

Even though children with Conduct disorder might be quite bright, they will not do well at school and may be near the bottom of the class or at risk of exclusion or unable to attend school. On the inside, the young person may be feeling that they are worthless and that they just cannot do anything right. It is common for them to show anger and blame others for their difficulties if they do not know how to change for the better.

There is no single cause of conduct disorder. We are beginning to understand that there are many different possible reasons which lead to conduct disorder. A child may be more likely to develop an oppositional defiant disorder/conduct disorder if they have a difficult temperament, learning or reading difficulties, have been bullied or abused, are hyperactive and/or have family and peer relationship issues.

Longer-term effects of conduct disorder

A young person showing signs of conduct disorder at an early age is more likely to be male, other conditions like attention deficit hyperactivity problems and lower intelligence. The earlier problems start, the higher the risk for the young person being involved with violence and criminal acts. This may also be related to friendship groups, gangs and use of illegal substances.

Getting help

Early diagnosis of conduct disorder and other related difficulties is important to give the child and young person a better chance for improvements and hope for the future.

Depending on the severity of the problem, the treatment can be offered across different settings, for instance at home or in educational and community settings. This is known as systemic support, and is often required as Conduct Disorder impacts not only the individual but also others around them.

The help offered will depend on the child’s development, age and circumstances.

Involving and supporting the family is very important. Focusing on strengths and identifying any specific problem areas for the young person, such as learning difficulties or associated depression, anxiety or attention deficit issues, can improve the outcomes for young people with conduct disorders.

Help for behavioural problems can involve supporting the young person to increase their positive social behaviours, and controlling their antisocial destructive behaviours.

Home-based help for Behavioural and Conduct Disorder

It can be very difficult for parents and carers when their child has oppositional or has conduct problems. Parents may fear your own child, and feel embarrassed, or even be ashamed of their child’s situation. They can feel helpless and unsure how to manage it.

As a parent, it can be easy to ignore child and young people when they are being good, and only pay attention to them when they are behaving badly. Over time, the child learns that they only get attention when they are breaking rules. Most children, including adolescents, do need a lot of attention from their parents and may be unsure how to get this. They may end up preferring angry or critical attention compared to being ignored. It’s easy to see how, over time, a ‘vicious cycle’ can be set up and how the patterns develops where the child or young person presents with behavioural issues.

With children and young people, it can help if discipline is appropriate to the developmental stage, fair and consistent and for parents/carers to agree together on how to handle their child’s behaviour and offer positive praise and love. This can be difficult to manage alone without the support of others, and many parents/carers require extra help from services.

School-based help

Many young people with behavioural problems struggle at school and this can be a source of distress. School staff can help to focus on positive behaviours and reinforce work taking place at home and in the community.

Young people with behavioural problems often need help with social skills and school may be able to offer this. Some children need individual classroom support and an assessment of learning difficulties by a psychologist. When the problems are severe, some children may be placed in special educational placements or schools for their behavioural problems.

Community-based help

If the behavioural problems are severe and persistent or a conduct disorder is suspected, please see a specialist from CAMHS.

Specialists can help to fully assess what is causing the problem and also to suggest practical ways of improving the difficult behavior/s. Please see leaflets on who’s who in CAMHS. They can also offer assessment and treatment of other conditions which can occur at the same time, such as depression, anxiety and hyperactivity.

The treatment recommended by the clinic may include social skills groups, behavioural therapy, talking therapy and family therapy. These therapies can help the child to appropriately express themselves in different situations and manage their anger more effectively.

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