Behaviour Problems in Children (Conduct Disorder)

Bad behaviour in children is normal from time to time, but if it is persistent, it is important to tackle it.  Unlike adults, children are not good at expressing their feelings and tend to act them out.  A child who is upset or anxious may behave badly  as a way of dealing with these feelings.  As parents, it is useful to see bad behaviour as a sign that something is wrong for the child.  Professional people working with children, refer to persistent bad behaviour as "conduct disorder". Children who have conduct disorder have normal intelligence but often under-perform because of their disruptive behaviour.

Why do children behave badly?

Children like to feel safe and secure.  If they don't, they will express this insecurity through their behaviour.  Sometimes it is easy to identify the cause of problem behaviour.  For instance, a child may act out after a divorce, because of bullying at school, because of violence in the home, because they have fallen out with their friends, because they cannot get their own way over something and for a variety of other reasons.  Children who come from homes where there is frequent arguing, violence, where they are not properly supervised or looked after are more likely to develop conduct disorders.  Children who have been physically or sexually abused can develop conduct disorders too.

Sometimes, parents cannot properly look after children because of disability, physical illness or serious mental illness such as depression.  It is important in these cases, that parents get support and help for themselves so they are better able to manage their children.  The health and social services can provide such help. You may be able to ask relatives for help if they have a good relationship with the child.

If you can identify what is troubling your child by talking to them, the solution may come fairly easily.  Unfortunately children are not always sure what is troubling them, or don't want to say.  In these instances, you may have to take an educated guess and ask them if a certain incident or situation is troubling them.  If that does not work and the problems continue, seek help and advice from your doctor who can refer you to specialist services. Check with school to see if there are difficulties there and ask if they have any ideas about why a your child may be troubled.

Children with attention deficit hyperactivity disorder (ADHD), learning difficulties, who are bullied or unhappy or depressed, can develop conduct disorders too. Children with these types of specific problems will need treatment and support.  Sometimes, children who are doing badly at school start to misbehave.   For this reason it is useful to discuss any difficulties you are having with school.  If you have a child with conduct disorder, it may be the school who contact you.

What to do if your child has conduct disorder

It is important to think about the way you generally manage your children.  Different families have different ways of dealing with poor behaviour in children.  Research has shown that there are some important things you can do as parents to help children develop better self control and to behave in a more socially acceptable way:

Adults dealing with a particular child or children should work together, in a consistent way.  This means that you should talk as parents about how you will deal with your children when they misbehave.  Pay attention to how you respond when you child is behaving well, by giving praise and encouragement.

Family rules should be clear. If they are broken, a consequence should follow.  The consequence may simply be a reminder of what is expected, but sometimes it will require a firmer response. 

Parents may disagree about how to discipline children.  Many people do not like the term discipline at all. It is important, that as parents, you deal with discipline in a consistent way.  Where parents have differences, they should discuss them with each other, away from the children, until they reach a solution that satisfies each other.  This means you may have to compromise.

Do not  impose rules on children unless you know  you can follow them through.  It is better to have fewer rules that you stick to, than lots of rules you sometimes apply and sometimes don't.  This becomes confusing for children and leads to parents falling out with each other.  It is not a good idea to be flexible about rules, particularly with young children.  Children need to know where they stand and having clear rules and routines makes it simpler for everyone. It helps your children feel safe.  In my own work as a therapist, it is surprising how many children tell me that they want their parents to impose rules.  Although children may sometimes try to break or modify the rules, they need rules to help them contain their behaviour and to develop good self-control and consideration for others.

Don't try to make too many changes at once when confronting a badly behaved child.  Concentrate on one or two areas of concern. Some children appear to like the attention they get from misbehaving. This will happen if they only get attention when they are being naughty. Try to avoid having too many confrontations with your child. This can lead to them gaining attention in an inappropriate and exhausting way.

It is very important to praise your child when they are behaving well.  It is better to comment on it and let them know how pleased you are than to ignore good behaviour.  Sometimes parents worry that if they comment on a child's good behaviour that they will stop behaving well.  The goal is for them to learn that good behaviour, not bad behaviour, is the best way of gaining positive attention. They will not learn this unless you praise them for their good behaviour and stop paying so much attention to their bad behaviour. Give them a hug or touch them when you tell them.  Try to plan some individual time with each child, doing something they like.  You may have to ask them what they like doing or would like to do.

Try to end each day on a good note.

Make your rules appropriate to the age of your child.  For instance, a fourteen year old child should have a different bedtime from an eleven year old.  A teenager should be allowed out later than a ten year old etc.  I know this sounds obvious, but younger children often demand the same rights as their older siblings!  Sometimes it feels easier to give in. Try to resist this. If you are unsure about what to do, try checking with friends who are parents to see how they handle similar situations.

As children get older, give them more responsibilities. This reflects their growing maturity. Link their greater freedom and privileges to these increased responsibilities.  For instance, if a teenager wants more money to socialise, find a way to help them earn it.

The sooner you begin to tackle your child's difficult behaviour, the better.  It is much easier to get control of your children if you begin early in their lives.  Once children get past about nine to eleven years old, it can be very difficult to change their behaviour.  Once they get pass sixteen, you will find there is very little help available apart from the police and some voluntary agencies unless they have a mental illness and they want to take up help themselves.

As children get older their behaviour usually improves.  Of conduct disordered children, about half will get better, half will get worse over time.  Older children can become aggressive and violent, defiant and generally awkward to handle.  They may steal and drift into criminal activity.  They often perform poorly at school, have poor confidence and self-esteem and lose the will to achieve.  Many of them will truant and hang around with older children or adults who may lead them into more trouble.  Older conduct disordered teenagers can become involved in drug taking, alcohol abuse, crime and other dangerous behaviours.  If they become too involved with older children you will find their peer group becomes more important to them than obeying you.

Getting help for yourself and child

It can be very difficult living with a child who is conduct disordered.  You can contact your GP about this and they can refer you to a specialist service for help - though this is an area where their is very little help available.  For very young children, health visitors can offer advice.  For older children, a referral to a child and adolescent mental health clinic may be made, but most child and adolescent mental health services will not work with conduct disordered children unless their is a mental health component to their behaviour, such as self-harm or depression.  In these clinics there will be a number of professionals who can offer you advice and help.  Some children benefit from individual anger management and social skills training.  You may find that some schools have access to anger management groups. In the UK, these are often run by the Connexions Service, based in every High School and available to every child over the age of 13. Family therapists can provide you with an opportunity to sit down as a family and discuss the situation.  Sometimes it is difficult to get teenagers to attend such meetings.  In that case, you can often attend without the children for help and advice in dealing with the difficulties you are experiencing.  In some areas, there are parenting groups to help you manage your children. Parenting groups may be run by social services, child and adolescent mental health services, primary mental health workers, schools and voluntary agencies. See my Finding Help leaflet for some ideas about where to find help.

The school will probably be concerned as well if your child has a conduct disorder.  You can discuss your concerns with them and they may refer your child to an educational psychologist or to specialist members of staff called SENCO's who often help to manage and support children with such difficulties.  In serious cases, where a school cannot cope with a child, children may be educated in special units.  These units are called EBD units (emotionally and behaviourally disturbed). They offer children a structured teaching environment with specially trained teaching staff and support workers.  Very often, transport to and from such schools is provided.  In exceptional circumstances, residential education may be offered. Some education authorities use short-term units your child may be referred to. Ask what's available to your school.

If you are experiencing violence at home from your child, or you are not safe, contact social services or the police.  The police have specialist workers who deal with domestic violence. Although this may sound drastic, for some families the situation can become dangerous.

Check out the Finding Help article to find out how to get additional support and information in the UK.

Many social service departments and health authorities, as well as voluntary agencies, offer parenting advice and parenting courses.  These courses can be very useful and give you a chance to talk with other parents who may be experiencing similar difficulties.

You may find my other leaflet, Dealing with Difficult Behaviour in Children useful to read.

Books

For young children:

Christopher  Green "Toddler Taming - A survival guide for parents"

Dennis Neill

Family Therapist

Family Therapy UK

1st May 2008