Conduct Disorders are a pattern of persistent and repetitive antisocial aggressive,
or defiant behaviours that are seen at a level,
that is more severe than you'd expect for a child that age.
Conduct Disorders are the most common mental health disorder in children.
Prevalence runs at about 5% overall before the age of ten.
It's more common in boys. In boys it's about 7% and girls about 3%.
The most common type of Conduct Disorder in primary school-aged children,
is called Oppositional Defiant Disorder and it's also known as ODD.
Children with Oppositional Defiant Disorder can present with persistent defiant behaviour,
arguing with adults and actively defying or refusing adults' requests or rules.
They may seem spiteful or vindictive, touchy and easily annoyed by others.
Severe temper tantrums might be frequent and children may generally seem angry or resentful.
They may deliberately annoy other people and blame others for their own mistakes or misbehaviour.
One of the characteristics of a full-blown conduct disorder,
is that there tends to be a victim of the behaviours.
It's less about arguing and being defiant,
it's more about hurting and perhaps causing damage to people or to property.
Children with Conduct Disorder can present with a range of violent and destructive behaviours.
These might include aggression and fighting,
perhaps with weapons and frequently lying.
In the most extreme cases cruelty to animals and fire setting.
One distinction that we sometimes make is between Socialised and Unsocialised Conduct Disorder.
The difference with the Socialised Conduct Disorder is that the child maintains good social relationships.
They may even do some other behaviours with other children.
Probably more worrying is the unsocialised child with conduct problems,
who doesn't have peer relationships,
isn't very good at social interactions and they are more solitary,
committing these types of behaviours.
An interesting distinction we sometimes make with children of Conduct Disorder
is in terms of whether they have lower levels of guilt and remorse about the actions
and it's very important to think about this
because it can predict a more severe and enduring form of conduct problem.
Children with Conduct Disorder are quite likely to suffer from other mental health conditions.
One of the most common would be ADHD, Attention Deficit Hyperactivity Disorder.
A significant minority of children with Conduct Disorder will suffer from a depressive,
or anxiety disorder as well
and these disorders are often missed because of the focus on the behavioural problems
but it is very important to remember that children with Conduct Disorder aren't just bad,
they can also be sad.
A child may only be experiencing behaviour problems at home and not at school.
A parent may feel misunderstood if the difficulties they're experiencing at home,
aren't understood at school.
If the parents are not experiencing difficulties at home
and the difficulties only occur at school,
it may be hard for them to recognise and accept that you're finding problems with their child in the classroom.
There are a number of reasons why a child might develop a Conduct Disorder.
Inconsistent and harsh parenting,
conflict within the home,
child abuse,
exposure to substance abuse,
extreme poverty
or parental mental health difficulties
or being involved with child protection services.
These can all affect a child's behaviour.
It's important to recognise that these factors can interact with each other.
It's important not to think about one or two in isolation.
In the short term Conduct Disorder can impact upon educational attainments.
It can lead to elevated stress within the family
and it can also impair the child's ability to make effective and good peer relationships.
In the longer term children with Conduct Disorder are more likely to have difficult family relationships,
a poorer work history and end up in the criminal justice system.
Parents and teachers can help children with Conduct Disorders
by being aware that it's very easy to get into a pattern of paying attention to children's negative behaviours.
Adults tend to pay more attention to the negative behaviours that the child is showing
and much less to the positive behaviours
and we know, the children are driven to seek attention from adults, so this cycle gets embedded.
You should think about making a referral to mental health services for Conduct Disorder
if the child's behaviour in the classroom is really quite different to other children.
Bear in mind that many children will show these behaviours from time to time.
The key thing is to notice when they become a significant problem for the child's learning,
or with their interactions with their friends and peers.
If you suspect a child has a conduct problem, you can make a referral to the child's GP
or via a SENCO in school
and potentially to your local Child and Adolescent Mental Health Service or CAMHS service.
Many children show challenging behaviour at times
but when this becomes much more frequent and severe than other children their age
or it's having a big impact on your household
or on the child's ability to engage in education
or make and keep friendships,
then, it is time to seek help.