Behavioural problems and conduct disorder: information for
parents, carers and anyone who works with young people
About this factsheet
This is one in a series of factsheets for parents, teachers
and young people entitled Mental Health and Growing Up.
The aims of these factsheets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This factsheet looks at how to recognise signs of serious
behavioural problems such as conduct disorder, and gives some
practical advice about how to deal with this and get help.
Introduction
It takes time for children to learn how to behave properly.
With help and encouragement from parents and teachers, most of them
will learn quickly. All children will sometimes disobey adults.
Occasionally, a child will have a temper tantrum, or an outburst of
aggressive or destructive behaviour, but this is nothing to worry
about.
Behavioural problems - the signs
Behavioural problems can occur in children of all ages. Very
often they start in early life. Toddlers and young children may
refuse to do as they are asked by adults, in spite of being asked
many times. They can be rude, swear and have tantrums. Hitting and
kicking of other people is common. So is breaking or spoiling
things that matter to others.
Some children have serious behavioural problems. The signs of
this to look out for are:
- if the child continues to behave badly for several months or
longer, is repeatedly being disobedient, cheeky and aggressive
- if their behaviour is out of the ordinary, and seriously breaks
the rules accepted in their family and community, this is much more
than ordinary childish mischief or adolescent rebelliousness.
This sort of behaviour can affect a child's development, and
can interfere with their ability to lead a normal life. When
behaviour is this much of a problem, it is called a conduct
disorder.
What does this mean?
Children with a conduct disorder 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 truant from school during the day. Teenagers with
conduct disorder may also take risks with their health and safety
by taking illegal drugs or having unprotected sexual
intercourse.
What effect can this have?
This kind of behaviour puts a huge strain on the family.
Children who behave like this will often find it difficult to make
friends. Even though they might be quite bright, they don't do well
at school and are often near the bottom of the class. On the
inside, the young person may be feeling that they are worthless and
that they just can't do anything right. It is common for them to
blame others for their difficulties if they do not know how to
change for the better.
What causes oppositional defiant disorder/conduct
disorder?
A child is more likely to develop an oppositional defiant
disorder/conduct disorder if they:
- have a difficult temperament;
- have learning or reading difficulties - these
make it difficult for them to understand and take part in lessons.
It is then easy for them to get bored, feel stupid and
misbehave;
- are depressed;
- have been bullied or abused;
- are `hyperactive' - this causes difficulties
with self-control, paying attention and following rules (see
Factsheet 5 on ADHD and hyperkinetic
disorder).
Parents themselves can sometimes unknowingly make things worse
by giving too little attention to good behaviour, always being too
quick to criticise, or by being too flexible about the rules and
not supervising their children adequately. This often happens if a
parent is depressed, exhausted or overwhelmed.
Giving too little attention to good
behaviour
As a parent, it can be easy to ignore your child 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 teenagers,
need a lot of attention from their parents, and will do whatever it
takes to get it. Perhaps surprisingly, they seem to prefer angry or
critical attention to being ignored. It's easy to see how, over
time, a `vicious cycle' is set up.
Being too flexible about the rules
Children need to learn that rules are important and that `no'
means `no'. Keeping this up is hard work for parents. It can be
tempting to give in `for a quiet life'. The trouble is that this
teaches the child to push the limits until they get what they want.
Teenagers need to know that their parents care about them. They
must also understand that rules are needed to protect their safety
and that they must learn to live within these rules.
Where can I get help?
Parents can do a lot. It helps if discipline is fair and
consistent, and it is crucial for both parents to agree on how to
handle their child's behaviour (see
Factsheet 2 on good parenting). All young people
need praise and rewards when they improve their behaviour. This can
be hard. Remember to praise even the small, everyday things, and
let them know that you love and appreciate them.
It is worth asking the school about whether they are also
worried about your child's behaviour. It is helpful if parents and
teachers can work together. Extra teaching may be necessary. You
can seek advice from the school nurse or from an educational
psychologist.
If serious problems continue for more than 3 months, it is
worth asking your health visitor or general practitioner for
advice. If more specialist help is needed, they will be able to
make a referral to your local child and adolescent mental health
service. Specialists can help by finding out what is causing the
problem, and also by suggesting practical ways of improving the
difficult behaviour.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Hartley-Brewer, E. (1994) 'Positive Parenting'.
London: Vermilion.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (4th edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (2001) 'Finding the
Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
- EPOCH (End Physical
Punishment of Children) provides useful alternatives
to smacking. 77 Holloway Road, London N7 8JZ; tel: 020 7700
0627.
- NEWPIN (New Parent Information
Network) offers support to parents with babies and
toddlers.
- The Mental Health and Growing Up series contains 36
factsheets on a range of common mental health problems. To order
the pack, contact Book Sales at the Royal College of Psychiatrists,
17 Belgrave Square, London SW1X 8PG; tel. 020 7235 2351, ext. 146;
fax 020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or
you can download them from this website.
© [2004]
Royal College of Psychiatrists. This factsheet may be downloaded,
printed out, photocopied and distributed free of charge as long as
the Royal College of Psychiatrists is properly credited and no
profit is gained from its use. Permission to reproduce it in any
other way must be obtained from the Head of Publications. The College
does not allow reposting of its factsheets on other sites, but
allows them to be linked to directly.
Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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