Recognizing Signs of Conduct Disorder in Young Children With ADHD
Behavior disorders such as oppositional defiant disorder (ODD) and conduct disorder (CD) are diagnosed in about 25 percent of children with ADHD, according to the U.S. Centers for Disease Control and Prevention. Recognizing the signs and starting treatment for conduct disorder early is important as those with CD who haven’t received treatment may be unable to adapt to the demands of adulthood and continue to have [problems with relationships and holding a job](https://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages /Conduct_Disorder_33.aspx).
What is conduct disorder?
The term conduct disorder refers to a group of behavioral and emotional problems, according to the American Academy of Child and Adolescent Psychiatry. Children and teens with CD have a callous disregard for and aggression toward others ― behaviors that can include pushing, hitting, and biting, according to the Child Mind Institute. They may break rules, such as staying out past their curfew or skipping school. They might run away. They might lie or steal on purpose and often blame others instead of taking responsibility. They frequently disregard social norms.
Who is at risk for developing conduct disorder?
There isn’t any one single factor that points to a child developing conduct disorder and the cause isn’t fully understood. Some experts believe that experiencing a series of traumatic events can lead to developing conduct disorder and others point to a problem in the frontal lobe of the brain, according to John Hopkins Medicine.
Even so, there are some known risk factors, such as: ·
- Brain damage
- Child abuse
- Past school failure
- Social problems
Some experts believe that CD develops as a more severe form of ODD. (See work presented by James Johnson of the University of Florida.) This is based information on early development of children diagnosed with CD as described by parents.
According to researchers, children showed oppositional characteristics, including stubbornness, temper tantrums and a tendency to argue with parents at a young age. Johnson also points to a study that found children with ODD were much more likely to develop conduct disorders than those without ODD.
What to look for
Many descriptions of conduct disorder include the phrase “may disregard basic social standards and rules.” But what does that mean? Some warning signs, according to Boston Children’s Hospital, include:
- Aggressive behavior, including bullying, toward others
- Seeing other people’s behaviors as threatening
- Inability to tolerate frustration, restrictions or rules
- Chronic lying
- Destroying property
- Fighting, including physically attacking others
- Abusing and mistreating animals
Because CD can be a result of untreated ODD, signs of oppositional defiance disorder in early childhood may also serve as a warning. These include defiance toward authority figures, uncooperative behavior, frequent temper tantrums, excessive arguing, blaming others, and frequent angry outbursts.
Adolescents with CD may also participate in the following behaviors:
- Disregard for personal space of others
- Seem to enjoy causing harm to others
- Feel gratification from aggression, deceit or coercion
- Lying, cheating, stealing
- Emotionally or physically abusing others
- Aggression against people and animals
- Destruction of property, including setting fires
- Physically attacking others, including forced sex, sometimes with weapons
- Skipping school or running away
- Disregarding household rules
Family life with CD is often stressful. Parents may consistently receive disciplinary notices from the school regarding their child’s behavior toward teachers or other students or destruction of property. They might have to deal with the legal system because of attacks on others, destruction of propert, or truancy. Their child might seem unconcerned with their school performance, legal problems, or difficult relationships. Parents and siblings might be afraid for their physical safety.
Diagnosis and treatment
CD can be difficult to diagnose because many of the behaviors are those that happen in other children without CD, especially in the younger years. The key is how frequently they occur. Look for persistent patterns of behavior, per Child Mind Institute. CD can be difficult to overcome but it is not hopeless, according to Child Mind Institute.
- Cognitive behavioral therapy (CBT) to teach children better ways of communicating with parents, authority figures and the world at learn and teach problem solving, handling stress, controlling impulses and anger
- Peer therapy for developing better social and interpersonal skills
- Parent management training on encouraging desired behaviors, especially in young children
There is no medication to treat CD. However, many children with CD have other conditions, such as ADHD or depression, and medication might play a role in treating these conditions.
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