Psychosocial disordersThese can be usefully classified into
psychosocial disorders, habit disorders, anxiety disorders,
disruptive behaviour and sleeping problems.These may manifest as
disturbance in: Emotions - eg, anxiety or depression. Behaviour -
eg, aggression. Physical function - eg, psychogenic disorders.
Mental performance - eg, problems at school.This range of disorders
may be caused by a number of factors such as parenting style which
is inconsistent or contradictory, family or marital problems, child
abuse or neglect, overindulgence, injury or chronic illness,
separation or bereavement.[1][2]The child's problems are often
multi-factorial and the way in which they are expressed may be
influenced by a range of factors including developmental stage,
temperament, coping and adaptive abilities of family, and the
nature and the duration of stress. In general, chronic stressors
are more difficult to deal with than isolated stressful events.
Children do not always display their reactions to events
immediately, although they may emerge later. Anticipatory guidance
can be helpful to parents and children in that parents can attempt
to prepare children in advance of any potentially traumatic events
- eg, elective surgery or separation. Children should be allowed to
express their true fears and anxieties about impending events.
In stressful situations, young children will tend to react with
impaired physiological functions such as feeding and sleeping
disturbances.[3]Older children may exhibit relationship
disturbances with friends and family, poor school performance,
behavioural regression to an earlier developmental stage, and
development of specific psychological disorders such as phobia or
psychosomatic illness.[4][5]
It can be difficult to assess whether the behaviour of such
children is normal or sufficiently problematical to require
intervention. Judgement will need to take into account the
frequency, range and intensity of symptoms and the extent to which
they cause impairment.Habit disorders[6]These include a range of
phenomena that may be described as
tension-reducing.Tension-reducing habit disorders
Thumb suckingRepetitive vocalisationsTics
Nail bitingHair pullingBreath holding
Air swallowingHead bangingManipulating parts of the body
Body rockingHitting or biting themselves
All children will at some developmental stage display repetitive
behaviours but whether they may be considered as disorders depends
on their frequency and persistence and the effect they have on
physical, emotional and social functioning. These habit behaviours
may arise originally from intentional movements which become
repeated and then become incorporated into the child's customary
behaviour. Some habits arise in imitation of adult behaviour. Other
habits such as hair pulling or head banging develop as a means of
providing a form of sensory input and comfort when the child is
alone. Thumb sucking- this is quite normal in early infancy. If it
continues, it may interfere with the alignment of developing teeth.
It is a comfort behaviour and parents should try to ignore it while
providing encouragement and reassurance about other aspects of the
child's activities. Tics- these are repetitive movements of muscle
groups that reduce tension arising from physical and emotional
states, involving the head, the neck and hands most frequently. It
is difficult for the child with a tic to inhibit it for more than a
short period. Parental pressure may exacerbate it, while ignoring
the tic can reduce it. Tics can be differentiated from dystonias
and dyskinetic movements by their absence during sleep. Stuttering-
this is not a tension-reducing habit. It arises in 5% of children
as they learn to speak. About 20% of these retain the stuttering
into adulthood. It is more prevalent in boys than in girls.
Initially, it is better to ignore the problem since most cases will
resolve spontaneously. If the dysfluent speech persists and is
causing concern refer to a speech therapist.Anxiety
disordersAnxiety and fearfulness are part of normal development;
however, when they persist and become generalised they can develop
into socially disabling conditions and require intervention.
Approximately 6-7% of children may develop anxiety disorders and,
of these, 1/3 may be over-anxious while 1/3 may have some
phobia.[7]Generalised anxiety disorder,childhood-onsetsocial
phobia, separation anxiety disorder,obsessive-compulsive
disorderand phobia are demonstrated by a diffuse or specific
anxiety predictably caused by certain situations.[8]
School phobia occurs in 1-5% of children and there is a strong
association with anxiety and depression.[9]Management is by
treating the underlying psychiatric condition, family therapy,
parental training and liaison with the school in order to
investigate possible reasons for refusal and negotiate re-entry.
Behavioural and cognitive treatments show promise, although most
evidence-based trials involve children with mental health problems
rather than the general population of school refusers per se. More
research needs to be done in this area.[10]Disruptive behaviourMany
behaviours, which are probably undesirable but a normal occurrence
at an early stage of development, can be considered pathological
when they present at a later age. In the young child, many
behaviours such as breath holding or temper tantrums are probably
the result of anger and frustration at their inability to control
their own environment. For some of these situations it is wise for
parents to avoid a punitive response and, if possible, to remove
themselves from the room. It is quite likely that the child will be
frightened by the intensity of their own behaviour and will need
comfort and reassurance. While some isolated incidents of stealing
or lying are normal occurrences of early development, they may
warrant intervention if they persist. Truancy, arson, antisocial
behaviour and aggression should not be considered as normal
developmental features.
Attention deficit hyperactivity disorderis characterised by poor
ability to attend to tasks (eg, makes careless mistakes, avoids
sustained mental effort), motor overactivity (eg, fidgets, has
difficulty playing quietly) and impulsiveness (eg, blurts out
answers, interrupts others). For the diagnosis to be made, the
condition must be evident before age 7 years, present for >6
months, seen both at home and school and impeding the child's
functioning.[11]The condition is diagnosed in 3-7% of school-age
children.[12]
Methylphenidate (initiated by specialists only) is a stimulant
medication that provides reduction of symptoms, at least in the
short term.[13]Behavioural modification and neuro-feedback are the
non-pharmacological treatments with the largest evidence
base.[14][15][16]Various dietary interventions have been mooted, of
which the addition of essential fatty acids has the widest
support.[17]All young children can be naughty, defiant and
impulsive from time to time, which is perfectly normal. However,
some children have extremely difficult and challenging behaviours
that are outside the norm for their age.
The most common disruptive behaviour disorders include
oppositional defiant disorder (ODD), conduct disorder (CD) and
attention deficit hyperactivity disorder (ADHD). These three
behavioural disorders share some common symptoms, so diagnosis can
be difficult and time consuming. A child or adolescent may have two
disorders at the same time. Other exacerbating factors can include
emotional problems, mood disorders, family difficulties and
substance abuse.Oppositional defiant disorder
Around one in ten children under the age of 12 years are thought
to have oppositional defiant disorder (ODD), with boys outnumbering
girls by two to one. Some of the typical behaviours of a child with
ODD include: Easily angered, annoyed or irritated Frequenttemper
tantrums Argues frequently with adults, particularly the most
familiar adults in their lives, such as parents Refuses to obey
rules Seems to deliberately try to annoy or aggravate others Low
self-esteem Low frustration threshold Seeks to blame others for any
misfortunes or misdeeds.Conduct disorder
Children with conduct disorder (CD) are often judged as bad kids
because of their delinquent behaviour and refusal to accept rules.
Around five per cent of 10 year olds are thought to have CD, with
boys outnumbering girls by four to one. Around one-third of
children with CD also have attention deficit hyperactivity disorder
(ADHD).
Some of the typical behaviours of a child with CD may include:
Frequent refusal to obey parents or other authority figures
Repeated truancy Tendency to use drugs, including cigarettes and
alcohol, at a very early age Lack of empathy for others Being
aggressive to animals and other people or showing sadistic
behaviours including bullying and physical or sexual abuse Keenness
to start physical fights Using weapons in physical fights Frequent
lying Criminal behaviour such as stealing, deliberately lighting
fires, breaking into houses and vandalism A tendency to run away
from home Suicidal tendencies although these are more
rare.Attention deficit hyperactivity disorder
Around two to five per cent of children are thought to have
attention deficit hyperactivity disorder (ADHD), with boys
outnumbering girls by three to one. The characteristics of ADHD can
include: Inattention difficulty concentrating, forgetting
instructions, moving from one task to another without completing
anything. Impulsivity talking over the top of others, having a
short fuse, being accident-prone. Overactivity constant
restlessness and fidgeting.Risk factors in childrens behavioural
disorders
The causes of ODD, CD and ADHD are unknown but some of the risk
factors include: Gender boys are much more likely than girls to
suffer from behavioural disorders. It is unclear if the cause is
genetic or linked to socialisation experiences. Gestation and birth
difficult pregnancies, premature birth and low birth weight may
contribute in some cases to the childs problem behaviour later in
life. Temperament children who are difficult to manage,
temperamental or aggressive from an early age are more likely to
develop behavioural disorders later in life. Family life
behavioural disorders are more likely in dysfunctional families.
For example, a child is at increased risk in families where
domestic violence, poverty, poor parenting skills or substance
abuse are a problem. Learning difficultiesproblems with reading and
writing are often associated with behaviour problems. Intellectual
disabilities children with intellectual disabilities are twice as
likely to have behavioural disorders. Brain development studies
have shown that areas of the brain that control attention appear to
be less active in children with ADHD.Diagnosis of childrens
behavioural disorders
Disruptive behavioural disorders are complicated and may include
many different factors working in combination. For example, a child
who exhibits the delinquent behaviours of CD may also have ADHD,
anxiety, depression, and a difficult home life.
Diagnosis methods may include: Diagnosis by a specialist
service, which may include a paediatrician, psychologist or child
psychiatrist In-depth interviews with the parents, child and
teachers Behaviour check lists or standardised questionnaires.A
diagnosis is made if the childs behaviour meets the criteria for
disruptive behaviour disorders in theDiagnostic and Statistical
Manual of Mental Disordersfrom the American Psychiatric
Association.
It is important to rule out acute stressors that might be
disrupting the childs behaviour. For example, a sick parent or
victimising by other children might be responsible for sudden
changes in a childs typical behaviour and these factors have to be
considered initially.
Treatment of behavioural disorders in children
Untreated children with behavioural disorders may grow up to be
dysfunctional adults. Generally, the earlier the intervention, the
better the outcome is likely to be.
A large study in the United States, conducted for the National
Institute of Mental Health and the Office of School Education
Programs, showed that carefully designed medication management and
behavioural treatment for ADHD improved all measures of behaviour
in school and at home.
Treatment is usually multifaceted and depends on the particular
disorder and factors contributing to it, but may include: Parental
education for example, teaching parents how to communicate with and
manage their children. Family therapy the entire family is helped
to improve communication and problem-solving skills. Cognitive
behavioural therapy to help the child to control their thoughts and
behaviour. Social training the child is taught important social
skills, such as how to have a conversation or play cooperatively
with others. Anger management the child is taught how to recognise
the signs of their growing frustration and given a range of coping
skills designed to defuse their anger and aggressive behaviour.
Relaxation techniques and stress management skills are also taught.
Support for associated problems for example, a child with a
learning difficulty will benefit from professional support.
Encouragement many children with behavioural disorders experience
repeated failures at school and in their interactions with others.
Encouraging the child to excel in their particular talents (such as
sport) can help to build self-esteem. Medication to help control
impulsive behaviours.
Sleeping problemsSleep disorders can be defined as more or less
sleep than is appropriate for the age of the child. By the age of
1-3 months, the longest daily sleep should be between midnight and
morning. Sleeping through the night is a developmental milestone
but, at the age of 1 year, 30% of children may still be waking in
the night. Stable sleep patterns may not be present until age 5
years but parental or environmental factors can encourage the
development of circadian rhythm.
See separate articleSleep Problems in Childrenfor more
details.10 Common Child Behavior Problems and Their Solutions
KidStock/Blend Images/Getty ImagesThere are some behavior
problems that almost every child exhibits at one time or another.
Matching those behaviors to the best discipline strategies can
resolve these behaviors before they become even bigger problems.1.
LyingSometimes kids tell stories to get attention, while at other
times they lie to avoid getting into trouble. If lies arent
addressed appropriately, lying can turn into a bad habit for your
child. When you catch your child in a lie, respond in a calm but
direct manner and encourage your child to tell the truth. 10 Ways
to Get a Child to Stop Lying and Start Telling the Truth2.
DefianceIts frustrating when a child refuses to follow directions,
especially when he outright says No! when you tell him to do
something. However, its normal for kids to test limits at one time
or another. Sometimes defiance stems from a child testing your
reaction, while other defiant behaviors may signal a childs
attempts to assert his independence. Preschoolers and tweens are
especially likely to behave defiantly. 10 Ways to Deal with a
Childs Defiance and Non-Compliance3. TV and Electronics
AddictionMany children in todays world would sit in front of the TV
or a video game system all day if they could. However, its not
healthy for them physically or mentally.Getting them to play
outside or get involved in other activities can seem like a battle
at first. However, its important to establish healthy habits for
them during childhood that will carry over into their adult lives.
10 Tips for Setting Limits on Electronics and Screen Time4.
Food-Related ProblemsFood-related issues can lead to a lot of
behavior problems. Whether youve got a picky eater or a child who
always claims to be hungry, food-related issues can lead to power
struggles if youre not careful. With so much emphasis on being thin
combined with an epidemic of obesity, its important tohelp kids
develop a healthy attitude about food. Discipline Strategies that
Can Prevent Children From Becoming Overweight How to Avoid Power
Struggles with a Picky Eater How to Create Rules for Mealtimes
Setting Limits with Food to Keep Kids Healthy5. Disrespectful
BehaviorDisrespectful behavior can frustrate even the calmest of
parents. If its not addressed appropriately, disrespect can get
worse through the years. The way you respond to behaviors such as
talking back, inappropriate language, and attitude problems will
discourage your child from doing it again. 5 Ways to Respond to
Disrespectful Behavior What to do About Swearing6. WhiningWhining
is a behavior that can become a terribly bad habit for a child,
especially if it is an effective means for getting him what he
wants. Whining can have a lot of social consequences for children,
however.A child who whines is likely to have peer-related issues
because other kids wont want to put up with it. Teachers and other
caregivers may also not take kindly to a child who whines
frequently. Put an end to whining quickly and teach your child more
appropriate ways to deal with upsetting feelings such as
disappointment. 6 Steps to Get a Child to Stop Whining7. Impulsive
BehaviorImpulsive behavior comes in many forms. Young children tend
to be physically impulsive. Theyre more likely to hit, push or grab
something without thinking.Older children and teens should have
better control over their physical impulses, but are often still
verbally impulsive. They may say things without thinking and may
have trouble controlling their emotions.There are manyreasons why
impulse control is an important skill. When children master impulse
control, theyre likely to behave better. They are even more likely
to have increased academic success. Teach impulse control skills to
curb impulsive behavior as early as possible and set your child up
for success. 8 Ways to Teach Kids Self-Discipline 10 Ways to Teach
Impulse Control8. Bedtime Behavior ProblemsWhether your child
refuses to stay in bed, wont go to sleep, or insists on sleeping
with you, bedtime behavior problems are common. If you dont fix
them, they can get worse over time, which can have serious
consequences for your child. A lack of sleep can lead to increased
behavior problems and academic issues. 7 Discipline Strategies to
Prevent Bedtime Behavior Problems9. AggressionAggression can range
from a child throwing his math book when he doesnt want to do his
homework to outright punching his brother when hes mad. Usually,
aggressive behavior is common at one time or another and should
subside as a child learns impulse control. However, there are times
when aggression indicates that you shouldseek professional help for
your childs behavior. Discipline Strategies to Manage Aggressive
Behavior10. Temper TantrumsTemper tantrums are most common in
toddlers and preschoolers. Sometimes they occur when a child isnt
sure how to manage his anger and at other times, they serve as a
manipulation technique. Sometimes kids throw tantrums to gain
attention or to try and get what they want.Sometimes older kids
exhibit temper tantrums as well. Grade school children, tweens and
sometimes even teens, may sulk, stomp their feet or scream when
they get angry. Take action to curb these annoying behaviors as
soon as possible. The Best Ways to Deal with Temper Tantrums 5 Ways
to Teach Your Child Anger Management SkillsCommon Behavior Problems
in School-Age ChildrenAlong with the wonderful milestones you can
expect to see among school-age children such as increased
independence and ability to handle more responsibilities, there is
also the less-pleasant emergence of common behavior problems for
this age group.While child-discipline issues such as defiance and
back talk may have cropped up at earlier ages in a child, such
behaviors can take on a entirely-more challenging aspect as
children become older, more verbal, and more independent.Here are
some typical behavior problems you can expect to see in children at
this age.
Jamie Grill/The Image Bank/Getty Images1. How to Handle Defiant
ChildrenIf you are hearing a whole lotta "no's" from your child or
are increasingly seeing defiant behavior such as refusing to do
something you asked your child to do, you are not alone. Defiant
behavior is a very common problem among school-age children. But
with the right strategies, you can get to the root of your child's
behavior and get your child back on your team.More
iStockphoto2. Why Kids Tattle and What You Can Do About
ItTattling is an annoying but very common problem among
grade-school age kids. Children this age are figuring out right
from wrong, learning about rules and consequences, and putting a
high value on being fair. All that is a recipe for tattling, but
parents can help guide kids toward more positive behavior and teach
children how to tell the difference between tattling and telling to
help someone.More
iStockphoto3. Solutions for Sibling Rivalry and FightingAs much
as your children may love one another, sibling rivalry and fighting
is a very common part of many sibling relationships. Here are some
excellent ideas for building sibling love and reducing the friction
that can lead to sibling conflict among brothers and
sisters.More
Getty Images4. How to Handle DawdlingDoes your child take 10
minutes to put on one sock in the morning? Is she a s-l-o-w eater
who takes a half-hour to eat a few bites of her dinner? This
frustrating behavior can be managed with some fun and creative
solutions.More
123RF5. How to Stop Whining in ChildrenWhining can be one of the
most unpleasant sounds known to Man. And as almost every parent can
attest, children are born with the ability to produce this sound,
almost as if it's something encoded into their DNA. The good news
is that with a few simple strategies, parents can get their kids to
stop whining--and save their sanity in the process.More Talking
back and defiance are common child discipline problems that are
best handled with a calm manner and a few smart, simple
strategies.iStockphoto6. How to Handle a Child Who is Talking
BackTalking back may be a normal part of child development, but
it's certainly one of the most maddening. Here are some
tried-and-true techniques for nipping this behavior problem in the
bud and helping your child express herself in a more appropriate
and respectful manner.More
iStockphoto7. What to Do When a Child Wont Go to BedIs bedtime
all too often a battle of wills in your house? If your child
regularly won't go to bed or has trouble falling asleep or staying
asleep, try these tips to find out what may be causing her sleep
problems and learn how to help her get a good night's rest --
something that's especially important for school-age
children.More
Getty Images8. How to Help Shy Kidswhile some parents may worry
that shyness in their child may be something that could be a
drawback, research shows that there are many positive aspects and
benefits to being an introvert.More
Getty Images9. How to Handle Lying in ChildrenHaving your child
lie to you can be upsetting. But the truth is that lying is a
common behavior among children that can be addressed with love and
reassurance balanced out with consequences.More How to Help Shy
Kids
Shy kids will often outgrow their fears and become more
comfortable in social settings as time goes on.Getty ImagesIf you
have a shy child, chances are you know exactly what it feels like
to have to peel a clinging kid from around your legs in the
beginning days of the school year or in other social situations.
While some children jump in and start engaging with other kids
right away at birthday parties, school, or other social settings,
others are naturally more reluctant, and need more time to warm up
to a situation.For parents, seeing shyness in kids can often cause
some concern. They may think, "Will shyness hold my child back?"
But the truth is, shyness is not always a bad thing, and can have
benefits.To help kids who are shy, parents can first try to
understand what is behind the behavior. In many cases, children are
simply born introverted while others are naturally more ooutgoing.
Even within one family, you can have one sibling who is shy and
another who is a social butterfly.In other instances, a child may
feel shy in certain new or uncomfortable situations, or develop
shyness after an embarrassing experience. For instance, a child may
feel shy in a new school but feel more comfortable as he gets to
know more people. Or he may forget a line in a school play and then
be reluctant about performing again in front of people.
What to Remember About Shyness in KidsShyness is something kids
often outgrow, or at least learn to handle.Even when a child is one
of those shy kids who are plastered to a parents legs at birthday
parties and during the first days of school, they will eventually
learn how to handle new situations much more comfortably. It may
take some time (sometimes years!) before an introverted child is
more relaxed in social situations, but it will get better.Shy kids
may still stay cautious.Dont expect your child to be something she
is not. A naturally introverted child will most likely never become
someone who jumps in immediately without hesitation and thrives in
highly social settings. She will probably still exercise caution in
new situations and wont jump in with out checking things out.People
usually end up being a mixture of both.Many people who were shy as
kids can grow up to be great at social settings such as parties and
events. But there may be times when they also need to be alone and
just be by themselves to create, relax, or work on their own.There
are many important advantages to being an introvert.A February,
2012Timemagazine cover storydetailed some of the many upsides to
being shy. They include the following benefits: Introverts may have
fewer friends but they are deep and lasting relationships.
Introverts may be cautious, but they tend to think things through
thoroughly and perhaps make better decisions. Introverts tend to be
good at working alone for long periods of time to come up with new
ideas. Many kids who are shy are great at working by themselves --
say, to practice their skills as a musician or a writer -- and are
very creative.
How Parents Can HelpSummaryAll young children can be naughty,
defiant and impulsive from time to time, which is perfectly normal.
However, some children have extremely difficult and challenging
behaviours that are outside the norm for their age.
The most common disruptive behaviour disorders include
oppositional defiant disorder (ODD), conduct disorder (CD) and
attention deficit hyperactivity disorder (ADHD). These three
behavioural disorders share some common symptoms, so diagnosis can
be difficult and time consuming. A child or adolescent may have two
disorders at the same time. Other exacerbating factors can include
emotional problems, mood disorders, family difficulties and
substance abuse.
Oppositional defiant disorder
Around one in ten children under the age of 12 years are thought
to have oppositional defiant disorder (ODD), with boys outnumbering
girls by two to one. Some of the typical behaviours of a child with
ODD include: Easily angered, annoyed or irritated Frequenttemper
tantrums Argues frequently with adults, particularly the most
familiar adults in their lives, such as parents Refuses to obey
rules Seems to deliberately try to annoy or aggravate others Low
self-esteem Low frustration threshold Seeks to blame others for any
misfortunes or misdeeds.Conduct disorder
Children with conduct disorder (CD) are often judged as bad kids
because of their delinquent behaviour and refusal to accept rules.
Around five per cent of 10 year olds are thought to have CD, with
boys outnumbering girls by four to one. Around one-third of
children with CD also have attention deficit hyperactivity disorder
(ADHD).
Some of the typical behaviours of a child with CD may include:
Frequent refusal to obey parents or other authority figures
Repeated truancy Tendency to use drugs, including cigarettes and
alcohol, at a very early age Lack of empathy for others Being
aggressive to animals and other people or showing sadistic
behaviours including bullying and physical or sexual abuse Keenness
to start physical fights Using weapons in physical fights Frequent
lying Criminal behaviour such as stealing, deliberately lighting
fires, breaking into houses and vandalism A tendency to run away
from home Suicidal tendencies although these are more
rare.Attention deficit hyperactivity disorder
Around two to five per cent of children are thought to have
attention deficit hyperactivity disorder (ADHD), with boys
outnumbering girls by three to one. The characteristics of ADHD can
include: Inattention difficulty concentrating, forgetting
instructions, moving from one task to another without completing
anything. Impulsivity talking over the top of others, having a
short fuse, being accident-prone. Overactivity constant
restlessness and fidgeting.Risk factors in childrens behavioural
disorders
The causes of ODD, CD and ADHD are unknown but some of the risk
factors include: Gender boys are much more likely than girls to
suffer from behavioural disorders. It is unclear if the cause is
genetic or linked to socialisation experiences. Gestation and birth
difficult pregnancies, premature birth and low birth weight may
contribute in some cases to the childs problem behaviour later in
life. Temperament children who are difficult to manage,
temperamental or aggressive from an early age are more likely to
develop behavioural disorders later in life. Family life
behavioural disorders are more likely in dysfunctional families.
For example, a child is at increased risk in families where
domestic violence, poverty, poor parenting skills or substance
abuse are a problem. Learning difficultiesproblems with reading and
writing are often associated with behaviour problems. Intellectual
disabilities children with intellectual disabilities are twice as
likely to have behavioural disorders. Brain development studies
have shown that areas of the brain that control attention appear to
be less active in children with ADHD.Diagnosis of childrens
behavioural disorders
Disruptive behavioural disorders are complicated and may include
many different factors working in combination. For example, a child
who exhibits the delinquent behaviours of CD may also have ADHD,
anxiety, depression, and a difficult home life.
Diagnosis methods may include: Diagnosis by a specialist
service, which may include a paediatrician, psychologist or child
psychiatrist In-depth interviews with the parents, child and
teachers Behaviour check lists or standardised questionnaires.A
diagnosis is made if the childs behaviour meets the criteria for
disruptive behaviour disorders in theDiagnostic and Statistical
Manual of Mental Disordersfrom the American Psychiatric
Association.
It is important to rule out acute stressors that might be
disrupting the childs behaviour. For example, a sick parent or
victimising by other children might be responsible for sudden
changes in a childs typical behaviour and these factors have to be
considered initially.
Treatment of behavioural disorders in children
Untreated children with behavioural disorders may grow up to be
dysfunctional adults. Generally, the earlier the intervention, the
better the outcome is likely to be.
A large study in the United States, conducted for the National
Institute of Mental Health and the Office of School Education
Programs, showed that carefully designed medication management and
behavioural treatment for ADHD improved all measures of behaviour
in school and at home.
Treatment is usually multifaceted and depends on the particular
disorder and factors contributing to it, but may include: Parental
education for example, teaching parents how to communicate with and
manage their children. Family therapy the entire family is helped
to improve communication and problem-solving skills. Cognitive
behavioural therapy to help the child to control their thoughts and
behaviour. Social training the child is taught important social
skills, such as how to have a conversation or play cooperatively
with others. Anger management the child is taught how to recognise
the signs of their growing frustration and given a range of coping
skills designed to defuse their anger and aggressive behaviour.
Relaxation techniques and stress management skills are also taught.
Support for associated problems for example, a child with a
learning difficulty will benefit from professional support.
Encouragement many children with behavioural disorders experience
repeated failures at school and in their interactions with others.
Encouraging the child to excel in their particular talents (such as
sport) can help to build self-esteem. Medication to help control
impulsive behaviours.Where to get help Your doctor (for a referral
to a specialist service below) Paediatrician Child psychologist
Child psychiatrist The Specialist Childrens Services, Department of
Human Services Tel. 1300 650 172 The Resource Centre for Child
Health and Safety (CHAS) Tel. (03) 9345 6429 Attention Deficit
Hyperactivity Disorder Association of Victoria Tel. (03) 9890 2144
or 1800 233 842 Association for Children with a Disability Tel.
(03) 9818 2000, rural callers free call on 1800 654 013 Australian
Psychological Society, APS Psychologist Referral Service Tel. (03)
8662 3300 or 1800 333 497.Things to remember Some children have
extremely difficult and challenging behaviours that are outside the
norm for their age. These problems can result from temporary
stressors in the childs life, or they might represent more enduring
disorders. The most common disruptive behaviour disorders include
oppositional defiant disorder (ODD), conduct disorder (CD) and
attention deficit hyperactivity disorder (ADHD). Boys are more
likely than girls to suffer from behavioural disorders. Treatment
options include parent management training, cognitive behaviour
therapy, medication and treatment for associated problems.Child
Behavior DisordersAll kids misbehave some times. And some may have
temporary behavior problems due to stress. For example, the birth
of a sibling, a divorce, or a death in the family may cause a child
to act out. Behavior disorders are more serious. They involve a
pattern of hostile, aggressive, or disruptive behaviors for more
than 6 months. The behavior is also not appropriate for the child's
age.Warning signs can include Harming or threatening themselves,
other people or pets Damaging or destroying property Lying or
stealing Not doing well in school, skipping school Early smoking,
drinking or drug use Early sexual activity Frequent tantrums and
arguments Consistent hostility towards authority figuresIf you see
signs of a problem, ask for help. Poor choices can become habits.
Kids who have behavior problems are at higher risk for school
failure,mental health problems, and evensuicide. Classes or family
therapy may help parents learn to set and enforce limits. Talk
therapy and behavior therapy for your child can also help.Rely on
teachers.They have great ideas for how to handle shyness,
especially in the classroom.Know that it will change.Shyness is
something kids often outgrow, or at least learn to handle. My child
was often the one plastered to my leg at birthday parties and
during the first days of school. Now, he is much more comfortable
in new situations. However, he is still cautious and doesnt jump in
with out checking things out.Think about positives of being
introverted.Kids who are shy often enjoy meaningful relationships,
tend to make careful decisions, and are often better at creating
and working alone.Dont push.Scolding your child for being shy wont
change your child. In fact, it will lead to anxiety and may only
serve to make a child feel bad about himself.Child Mental
HealthIt's important to recognize and treat mental illnesses in
children early on. Once mental illness develops, it becomes a
regular part of your child's behavior and is more difficult to
treat.But it's not always easy to know when your child has a
serious problem. Everyday stresses can cause changes in your
child's behavior. For example, getting a new brother or sister or
going to a new school may cause a child to temporarily act out.
Warning signs that it might be a more serious problem include
Problems in more than one setting (at school, at home, with peers)
Changes in appetite or sleep Social withdrawal or fear of things he
or she did not used to be not afraid of Returning to behaviors more
common in younger children, such as bedwetting Signs of being
upset, such as sadness or tearfulness Signs of self-destructive
behavior, such as head-banging or suddenly getting hurt often
Repeated thoughts of deathTo diagnose mental health problems, the
doctor or mental health specialist looks at your child's signs and
symptoms, medical history, and family history. Treatments include
medicines and talk therapy.NIH: National Institute of Mental
HealthSuicideSuicide is the tenth most common cause of death in the
United States. People may consider suicide when they are hopeless
and can't see any other solution to their problems. Often it's
related to seriousdepression,alcoholorsubstance abuse, or a major
stressful event.People who have the highest risk of suicide are
white men. But women and teens report more suicide attempts. If
someone talks about suicide, you should take it seriously. Urge
them to get help from their doctor or the emergency room, or call
the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
It is available 24/7.Therapy and medicines can help most people who
have suicidal thoughts. Treating mental illnesses and substance
abuse can reduce the risk of suicide.NIH: National Institute of
Mental HealthDepressionDepression is a serious medical illness that
involves the brain. It's more than just a feeling of being "down in
the dumps" or "blue" for a few days. If you are one of the more
than 20 million people in the United States who have depression,
the feelings do not go away. They persist and interfere with your
everyday life. Symptoms can include Sadness Loss of interest or
pleasure in activities you used to enjoy Change in weight
Difficulty sleeping or oversleeping Energy loss Feelings of
worthlessness Thoughts of death orsuicideDepression is a disorder
of the brain. There are a variety of causes, including genetic,
environmental, psychological, and biochemical factors. Depression
usually starts between the ages of 15 and 30, and is much more
common in women. Women can also getpostpartum depressionafter the
birth of a baby. Some people getseasonal affective disorderin the
winter. Depression is one part ofbipolar disorder.There are
effective treatments for depression, includingantidepressantsand
talk therapy. Most people do best by using both.NIH: National
Institute of Mental Health
