It is typical for children to experience challenging phases as they grow up. Part of gaining dominance and asserting independence involves testing rules and boundaries.
However, behavioral disorders go beyond occasional outbursts of anger or defiant behavior. A child diagnosed with a behavioral disorder faces issues severe enough to impact their school performance or relationships with friends and family.
Without proper treatment, behavioral disorders can escalate over time. Therefore, it is crucial to have the child evaluated by a qualified mental health professional if a behavioral disorder is suspected.
Behavioral Disorders
When a child’s disruptive behaviors persist for six months or longer, affecting their school, home, and social life, seeking a specialist for diagnosis is advisable. Signs that may indicate a behavioral disorder include:
• Carelessness
• Hyperactivity
• Impulsivity
• Contempt
• Drug use
• Criminality
Diagnosis involves an evaluation to assess your child’s symptoms and medical history.
A child psychiatrist will gather information from both you and your child. They may also request to speak with your child’s teachers and other caregivers to gain a more comprehensive understanding of how your child behaves in various situations. It’s important to note that only a qualified professional can diagnose a behavioral disorder.
Attention Deficit Hyperactivity Disorder (ADHD)
Attention deficit hyperactivity disorder (ADHD) stands as one of the most common behavioral disorders. While often perceived as a childhood disorder, it is not something an individual can outgrow.
ADHD is a neurodevelopmental disorder that impacts 11% of children aged 3 to 17 years.
Remarkably, 75% of people with ADHD continue to experience symptoms into adulthood.
Symptoms can range from mild to severe.
Types of Attention Deficit Hyperactivity Disorder:
• Hyperactive – Impulsive
• Careless
• Combination of Hyperactive-Impulsive with Careless
Symptoms:
ADHD symptoms vary based on the severity and type of the disorder. Manifestations can differ at different ages. For instance, a toddler may struggle with following directions and exhibit restlessness, while a teenager might face challenges in setting priorities and display withdrawal tendencies.
Symptoms of Inattentive ADHD:
• Careless mistakes
• Difficulty concentrating
• Difficulty following directions
• Disruption
• Avoidance of tasks requiring mental effort
• Frequently loses things
• Easily detached
• Forgetfulness
Symptoms of Hyperactive-Impulsive ADHD:
• Non-stop talking
• Inability to sit still
• Difficulty participating in quiet activities
• Impatience
• Hesitation in answers or making inappropriate comments
• Impulsive actions without considering consequences
Diagnosis and Treatment
The diagnosis of ADHD is crucial. Without appropriate support and treatment, children may encounter difficulties in academic, social, and emotional domains. To diagnose ADHD, a child psychiatrist conducts a comprehensive evaluation, including a thorough medical history and a general history of your child’s behavior. Perspectives from parents, teachers, and the child are essential.
A child psychiatrist can provide a diagnosis for children as young as 4 years old. During the assessment, they will determine whether your child’s symptoms primarily involve inattention, impulsivity, hyperactivity, or a combination of these. This information guides the development of a treatment plan.
Treatment for ADHD is often comprehensive, involving a combination of medication, behavioral therapy, parent education, and academic modifications and supports.
Oppositional Defiant Disorder
Oppositional Defiant Disorder (ODD) is characterized by persistent contempt and disobedience toward authority figures. Oppositional behavior is a normal developmental stage in infancy and adolescence. However, when this behavior becomes hostile, frequent, and extreme compared to others of the same age, it may indicate ODD.
Symptoms:
The symptoms of Oppositional Defiant Disorder are often more pronounced at home and at school. Between 1% and 16% of school-age children and adolescents have ODD.
Symptoms of ODD include:
• Frequent outbursts of anger
• Frequent arguments with adults
• Deliberately disturbing other people
• Frequent questioning and denial of rules
• Blaming others for mistakes
• Easily getting angry
• Revengeful behavior
Diagnosis and treatment
ODD often coexists with other behavioral disorders. Without intervention, ODD can progress into a conduct disorder, making early diagnosis and treatment crucial. To diagnose ODD, a child psychiatrist conducts a comprehensive evaluation, during which they also look for co-occurring disorders. Parents and caregivers play a key role in treatment. Learning how to manage a child with ODD requires training. Additionally, family and individual therapy are often components of treatment. Medications can also be used to control symptoms.
Conduct Disorder
Conduct disorder involves a repeated pattern of violating other people’s rights or persistently breaching social rules. Children with conduct disorder are often perceived as “bad” or delinquent, but they are in fact leaving with a mental illness. Certain factors can elevate a child’s risk of developing conduct disorder. Abuse or neglect, school failure, and traumatic experiences are all contributors to conduct disorder.
Symptoms:
Conduct disorder manifests as a disregard for rules and engaging in socially unacceptable behaviors. Children with conduct disorder often exhibit a lack of respect and empathy for others.
Symptoms of conduct disorder include:
• Physical aggression towards people and animals
• Destruction of property and vandalism
• Deception and lies
• Theft
• Serious rule violations (such as running away, getting expelled from school)
Children with conduct disorder may require intensive interventions, including support at home. A child with conduct disorder may struggle to trust adults, complicating the treatment process. Behavioral therapy, psychotherapy, academic support, and medication are all tools used to treat this disorder. Early intervention and treatment yield the best results.
Intermittent Explosive Disorder
Intermittent Explosive Disorder (IED) is a relatively under-researched mental illness in young people. It is characterized by recurrent acts of violence and destruction that are disproportionate to the situation. It stands as the only clinical disorder distinguished by impulsive aggression.
Symptoms:
IED may resemble simple tantrums. Children with IED may throw objects, engage in physical fights, and exhibit abusive behavior.
Symptoms of IED include:
• Anger
• Irritability
• Impulsive thoughts
• High energy
• Palpitations of the heart, tightness in the chest
• Explosions of anger
• Arguments and shouting matches
• Physical altercations
• Threats of violence
• Assaults on individuals or animals
• Destruction of property
Diagnosis and Treatment:
A child psychiatrist can diagnose Intermittent Explosive Disorder through a thorough evaluation of the child’s medical and psychiatric history, along with the presence of persistent symptoms meeting specific criteria. To receive a diagnosis of IED, a person must demonstrate verbal or physical aggression twice a week for three months or exhibit three episodes of property damage within 12 months or engage in three episodes of assault resulting in physical injury over the past 12 months. Treatment for IED typically involves a combination of medication and cognitive-behavioral therapy. Coping techniques such as relaxation, stress management in challenging situations, and avoidance of drugs and alcohol can also be beneficial.
Reasons
The precise cause of behavioral disorders remains unknown, although several theories exist regarding their development. It’s plausible that developmental, environmental, and genetic factors may contribute. Children with a family history of substance use, personality disorders, or mood disorders face an elevated risk of developing conduct disorders.
Treatment
Early intervention is key in treating behavioral disorders. If you observe symptoms of behavioral disorders in your child, prompt evaluation is advisable. Treatment approaches vary based on your child diagnosis and the severity of the disorder. Collaborate with your child’s doctor to devise a plan that suits your needs.
Psychotherapy
Psychotherapy often forms an integral part of behavioral disorder treatment. It provides a space to process thoughts and emotions, while also teaching social and behavioral skills, and appropriate anger management techniques. Cognitive-behavioral therapy can be beneficial in assisting individuals in modifying their behavior. Family therapy offers an opportunity to resolve interpersonal conflicts and acquire healthy communication strategies.
Medication
Medication is a powerful tool for managing many behavioral disorders and is often used with psychotherapy.
Common medications include:
• Stimulants
• Non- stimulants
• Antidepressants
• Anticonvulsants
• Tranquilizers
Parent Education
Parental education is crucial for the success of treatment. When a child has a behavioral disorder, learning effective communication and strategies for managing your child’s outbursts can contribute to maintaining a calm and stable environment. Parental involvement and understanding play a significant role in the overall well-being and progress of the child undergoing treatment.
Source: Amy Morin, LCSW, Signs and Symptoms of the Most Common Behavior Disorders in
Children, Verywell Family.
