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Conduct disorder and Oppositional Defiant disorder
Background
Managing tantrums, arguments and other difficult behaviours in children and young people is a common experience for parents. However, for about five per cent of children their negative behaviour is severe, persistent and enormously challenging for parents and teachers. Family relationships become strained and school progress may be affected. Conduct disorder and Oppositional Defiant disorder (ODD) are the diagnostic terms for those types of long lasting, aggressive and defiant behaviours that are extreme and outside the range of normal.
These problems are more common in boys and may start at a very young age. Some children grow out of them but some do not. Those who have persistent problems are at risk of poor social functioning as adults and social exclusion. Antisocial behaviour at the age of ten years predicts increased use of services such as special educational provision, the criminal justice system, foster and other residential care and state benefits. Most young people with these severe behaviours leave school with no qualifications, a third become recurrent juvenile offenders and problems continue into adulthood.
Children who show such behaviours at a very early age (around two to three years) often have other problems such as a difficult temperament, hyperactivity and Attention Deficit Hyperactivity disorder (ADHD), language disorders, some degree of learning disability and specific learning problems with reading. They often live in a family environment that leads to harsh, inconsistent and critical parenting. In contrast, behaviours that appear for the first time in adolescence are less likely to be associated with other problems and seem to be more influenced by environmental factors.
Some young people with difficult behaviour are depressed and may be using illicit substances. Self-esteem is often low despite the superficial appearance of bravado.
Parents understandably tend to end up stressed by their child's provocative and difficult behaviour but may unintentionally worsen it by giving attention (such as by shouting, smacking or other negative reactions) rather than ignoring it. Positive, co-operative behaviour in their child then becomes less and less likely as it is not rewarded with attention.
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