Conduct Disorder in Children

What is conduct disorder in children?

Conduct disorder is a type of behavior disorder. It’s when a child has antisocial behavior. They may disregard basic social standards and rules. They may also:

• Be irresponsible

• Skip school or run away (delinquent behavior)

• Steal or do other things to violate the rights of others

• Physically harm animals or other people, such as committing assault or rape

These behaviors sometimes happen together. But one or more may occur without the others.

What causes conduct disorder in a child?

Experts believe that many factors play a role in conduct disorder. These are:

• Brain damage

• A traumatic event

• Genes

• Child abuse

• Past school failure

• Social problems

Some children with conduct disorders seem to have a problem in the frontal lobe of the brain. This interferes with a child’s ability to plan, stay away from harm, and learn from negative experiences.

Some experts believe that a series of traumatic experiences occurs for a child to develop a conduct disorder. These experiences then often lead to depressed mood, behavior problems, and involvement in a deviant peer group.

Which children are at risk for conduct disorder?

A conduct disorder is more common in boys than in girls. It's also more likely to develop in children or teens who come from homes that are:

• Disadvantaged

• Dysfunctional

• Disorganized

Children with these mental health problems are also more likely to have conduct disorder:

• Mood or anxiety disorders

• Posttraumatic stress disorder (PTSD)

• Substance abuse

• Attention-deficit/hyperactivity disorder (ADHD)

• Learning problems or learning disorders

Children or teens who are considered to have a difficult temperament are more likely to develop behavior problems.

What are the symptoms of conduct disorder in a child?

Most symptoms seen in children diagnosed with conduct disorder can also be seen at times in children without this disorder. But in children with the disorder, these symptoms occur more often. They also interfere with learning, school adjustment, and the child’s relationships with peers and adults.

Each child’s symptoms may vary. But the four main groups of behaviors are described below.

Aggressive conduct

• Intimidating behavior

• Bullying

• Physical fights

• Cruelty to others or animals

• Using a weapon

• Forcing someone into sexual activity, rape, or molestation

Destructive conduct

• Intentionally destroying property (vandalism)

• Arson

Deceitfulness

• Lying

• Theft

• Shoplifting

• Delinquency

Violation of rules or age-appropriate norms

• Not going to school (truancy)

• Running away

• Pranks

• Mischief

• Very early sexual activity

These symptoms may look like other mental health problems. Have your child see a child psychiatrist or qualified mental health expert for a diagnosis.

How is conduct disorder diagnosed in a child?

A child psychiatrist or qualified mental health expert can diagnose a conduct disorder. They will talk with parents and teachers about the child’s behavior and may observe the child in different settings. In some cases, your child may need mental health testing.

If you notice symptoms of conduct disorder in your child or teen, or if trusted professionals, such as teachers, express concern, you can help your child by seeking a diagnosis right away. Early treatment can often prevent future problems.

How is conduct disorder treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for conduct disorder may include:

• Cognitive-behavioral therapy. A child learns how to better solve problems, communicate, and handle stress. They also learn how to control impulses and anger.

• Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions.

• Peer group therapy. A child develops better social and interpersonal skills.

• Medicines. These are not often used to treat conduct disorder. But a child may need them for other symptoms or disorders, such as ADHD. These other disorders often occur along with symptoms of conduct disorder.

How can I help prevent conduct disorder in my child?

Experts don’t know exactly why some children develop conduct disorder. Things such as a traumatic experience, social problems, and biological factors may be involved. To reduce the risk for this disorder, parents can learn positive parenting strategies. They can be good role models for their children. This can help to create a closer parent-child relationship and give the child with examples of how to respectfully treat other people, animals, and property. It can also create a safe and stable home life for the child.

How can I help my child live with conduct disorder?

Early treatment for your child can often prevent future problems. Here are things you can do to help your child:

• Keep all appointments with your child’s healthcare provider.

• Take part in family therapy as needed.

• Take the time to listen to your child and help them express thoughts and concerns to the team members.

• Talk to your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, teachers, school psychologists, school counselors, school nurses, and psychiatrists. Your child’s care team will depend on their needs and how serious the disorder is.

• Work closely with the staff at your child's school. A special individualized educational plan may need to be developed to help your child succeed in school.

• Tell others about your child’s conduct disorder. Work with your healthcare provider and schools to develop a treatment plan.

• Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful. If you feel overwhelmed or stressed out, talk with your healthcare provider about individual counseling, or a support group for caregivers of children with conduct disorder.

When should I call my child’s healthcare provider?

Call your healthcare provider right away if your child:

• Makes you worried about your own safety or the safety of others

• Abuses or kills animals

• Physically injures himself or others (bruises, head injuries, cuts, teeth marks)

• Attacks other children or adults

• Is barred from school or by neighbors because of his severe behavior

• Feels extreme depression, fear, anxiety, or anger toward themselves or others

• Expresses thoughts of self-harm or suicide

• Feels out of control

• Hears voices that others don’t hear

• Sees things that others don’t see

• Can’t sleep or eat for 3 days in a row

• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 988 in a crisis

Call or text 988 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. Never leave them alone until the situation is assessed and treatment laid out. This may include a hospital stay. When you call or text 988, you will be connected to trained crisis counselors at the 988 Suicide and Crisis Lifeline, formally known as the National Suicide Prevention Lifeline. An online chat choice is also available at www.suicidepreventionlifeline.org. Lifeline is free and available 24/7.

Key points about conduct disorder in children

• Conduct disorder is a type of behavior disorder. It’s when a child has antisocial behavior.

• Both genetic and environmental factors may play a role.

• Children with other mental health problems are more likely to have this disorder.

• Symptoms are divided into four main groups. They are aggression, destruction, deceitfulness, and violation of rules.

• Therapy that helps the child interact better with others is the main treatment. Therapy may include both individual and family counseling. Medicines may be needed for other problems, such as ADHD.

• Reach out for support. Being in touch with other parents who have a child with conduct disorder may be helpful.

• Call or text 988 or 800-273-TALK (8255) if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan. You will be connected to trained mental health crisis services at the 988 Suicide & Crisis Lifeline. An online chat choice is also available. This service is free and available 24/7. Act immediately. Never leave the child alone.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.