Abstract: All 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 figures
The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).
Treatment options include parent management training, cognitive behaviour therapy, medication and treatment for associated problems.
If 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 even suicide. Classes or family therapy may help parents learn to set and enforce limits. Talk therapy and behavior therapy for your child can also help.
Normal Child Behavior
How do I know if my child’s behavior is normal?
Parents often have difficulty telling the difference between variations in normal behavior and true behavioral problems. In reality, the difference between normal and abnormal behavior is not always clear; usually it is a matter of degree or expectation. A fine line often divides normal from abnormal behavior, in part because what is “normal” depends upon the child’s level of development, which can vary greatly among children of the same age. Development can be uneven, too, with a child’s social development lagging behind his intellectual growth, or vice versa. In addition, “normal” behavior is in part determined by the context in which it occurs – that is, by the particular situation and time, as well as by the child’s own particular family values and expectations, and cultural and social background.
Understanding your child’s unique developmental progress is necessary in order to interpret, accept or adapt his behavior (as well as your own). Remember, children have great individual variations of temperament, development and behavior.
Three Types of Behavior
Some parents find it helpful to consider three general kinds of behavior:
- Some kinds of behavior are wanted and approved. They might include doing homework, being polite, and doing chores. These actions receive compliments freely and easily.
- Other behavior is not sanctioned but is tolerated under certain conditions, such as during times of illness (of a parent or a child) or stress (a move, for instance, or the birth of a new sibling). These kinds of behavior might include not doing chores, regressive behavior (such as baby talk), or being excessively self-centered.
- Still other kinds of behavior cannot and should not be tolerated or reinforced. They include actions that are harmful to the physical, emotional, or social well-being of the child, the family members, and others. They may interfere with the child’s intellectual development. They may be forbidden by law, ethics, religion, or social mores. They might include very aggressive or destructive behavior, overt racism or prejudice, stealing, truancy, smoking or substance abuse, school failure, or an intense sibling rivalry.
The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). These three behavioral 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(ODD)
A child with ODD will display symptoms such as an extremely strong will, disrespect and opposition to adults or people in authority positions, defiance in almost any situation, temper tantrums disproportionate to the child’s age, argumentativeness, lying, anger, and resentment. It is not unusual for a child to pick a fight and as soon as an exhausted adult gives in and tells the child, “ok! Yes, you’re right the sky is green.” The child will then argue, “No it isn’t, its blue”. This type of behavior, over and over, leaves parents feeling overwhelmed, exhausted and feeling out of control themselves.
Children with ODD will struggle in school and in making and/or keeping friends. It appears a child with Oppositional defiant disorder thrives on deliberately annoying other people. They refuse to take responsibility, blaming others for their mistakes or misbehavior; they are easily annoyed and act with aggression toward peers and adults. They often have trouble academically.
Parents with a child suffering from ODD should seek support and help from a professional familiar with this disorder as many times it is misdiagnosed, and left untreated ODD can, and most likely will, progress to the more serious Conduct disorder, substance abuse and severe delinquency.
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.
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
Attention-Deficit Hyperactivity Disorder (ADHD)
This disorder is one of the most common mental disorders among children, and two to three more boys than girls are affected. Many children are unable to sit still, finish tasks, plan ahead, or even be aware what is going on around them. Some days, children with ADHD seem fine and the next could be a whirlwind of frenzied and disorganized activity. ADHD can continue on into adolescence and even adulthood, however, within the past decade scientists have learned more about it and how to treat it. From medications, to therapy, and varying educational options, children with ADHD can learn to function in new ways.
The first part of ADHD is the attention deficit. This part of the disorder means that the child usually has trouble paying attention to any one thing for a long period of time. If the child enjoys what he or she is doing than they will stay on task longer, but the amount of time is much less than children without the disorder. The attention deficit can also be noticed when the child seems to be so easily distracted by common things in their environment. Parents and teachers need to know that they need to provide a low stimulus environment for the child if they are really focused on having the child learn. This does occur for all children at sometimes but children with ADHD suffer from this many times each day and this behavior continues for an extended period of the child’s life.
The second part of ADHD is the hyperactivity. This can often be the most difficult thing to deal with because the child just seems to be unable to sit still or do anything other than being extremely active. The biggest sign of hyperactivity is the constant need to be moving, especially during activities that the child truly enjoys. Children that are hyperactive simply cannot control what their brain is telling them to do, so you must be patient and understand this fact.
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.
- Over-activity– constant restlessness and fidgeting.
Children with autism appear to be remote, indifferent, isolated in their own world, and are unable to form emotional connections with other people. Autism is a found in every region of the country, it is more common in boys than girls, and affects about 1 or 2 people in every thousand. This brain disorder can manifest itself in mental retardation, language delays, and other children are very high-functioning with intelligence and speech intact. Because their brains do not function in the same way other children’s do, consistency is the key when dealing with an autistic child.
Risk factors in children’s 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 child’s 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 difficulties–problems 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 children’s 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 child’s behaviour meets the criteria for disruptive behaviour disorders in theDiagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.
It is important to rule out acute stressors that might be disrupting the child’s behaviour. For example, a sick parent or victimising by other children might be responsible for sudden changes in a child’s 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.
Your Response Plays a Role
Your own parental responses are guided by whether you see the behavior as a problem. Frequently, parents over-interpret or overreact to a minor, normal short-term change in behavior. At the other extreme, they may ignore or downplay a serious problem. They also may seek quick, simple answers to what are, in fact, complex problems. All of these responses may create difficulties or prolong the time for a resolution.
Behavior that parents tolerate, disregard or consider reasonable differs from one family to the next. Some of these differences come from the parents’ own upbringing; they may have had very strict or very permissive parents themselves, and their expectations of their children follow accordingly. Other behavior is considered a problem when parents feel that people are judging them for their child’s behavior; this leads to an inconsistent response from the parents, who may tolerate behavior at home that they are embarrassed by in public.
The parents’ own temperament, usual mood, and daily pressures will also influence how they interpret the child’s behavior. Easygoing parents may accept a wider range of behavior as normal and be slower to label something a problem, while parents who are by nature more stern move more quickly to discipline their children. Depressed parents, or parents having marital or financial difficulties, are less likely to tolerate much latitude in their offspring’s behavior. Parents usually differ from one another in their own backgrounds and personal preferences, resulting in differing parenting styles that will influence a child’s behavior and development.
When There Is No Response
When children’s behavior is complex and challenging, some parents find reasons not to respond. For instance, parents often rationalize (“It’s not my fault”), despair (“Why me?”), wish it would go away (“Kids outgrow these problems anyway”), deny (“There’s really no problem”), hesitate to take action (“It may hurt his feelings”), avoid (“I didn’t want to face his anger”) or fear rejection (“He won’t love me”).
Threats by Children: When are they Serious?
Every year there are tragedies in which children shoot and kill individuals after making threats. When this occurs, everyone asks themselves, “How could this happen?” and “Why didn’t we take the threat seriously?”
Most threats made by children or adolescents are not carried out. Many such threats are the child’s way of talking big or tough, or getting attention. Sometimes these threats are a reaction to a perceived hurt, rejection, or attack.
What threats should be taken seriously?
Examples of potentially dangerous or emergency situations with a child or adolescent include:
- threats or warnings about hurting or killing someone
- threats or warnings about hurting or killing oneself
- threats to run away from home
- threats to damage or destroy property
Child and adolescent psychiatrists and other mental health professionals agree that it is very difficult to predict a child’s future behavior with complete accuracy. A person’s past behavior, however, is still one of the best predictors of future behavior. For example, a child with a history of violent or assaultive behavior is more likely to carry out his/her threats and be violent.
When is there more risk associated with threats from children and adolescents?
The presence of one or more of the following increases the risk of violent or dangerous behavior:
- past violent or aggressive behavior (including uncontrollable angry outbursts)
- access to guns or other weapons
- bringing a weapon to school
- past suicide attempts or threats
- family history of violent behavior or suicide attempts
- blaming others and/or unwilling to accept responsibility for one’s own actions
- recent experience of humiliation, shame, loss, or rejection
- bullying or intimidating peers or younger children
- a pattern of threats
- being a victim of abuse or neglect (physical, sexual, or emotional)
- witnessing abuse or violence in the home
- themes of death or depression repeatedly evident in conversation, written expressions, reading selections, or artwork
- preoccupation with themes and acts of violence in TV shows, movies, music, magazines, comics, books, video games, and Internet sites
- mental illness, such as depression, mania, psychosis, or bipolar disorder
- use of alcohol or illicit drugs
- disciplinary problems at school or in the community (delinquent behavior)
- past destruction of property or vandalism
- cruelty to animals
- firesetting behavior
- poor peer relationships and/or social isolation
- involvement with cults or gangs
- little or no supervision or support from parents or other caring adult
What should be done if parents or others are concerned?
When a child makes a serious threat it should not be dismissed as just idle talk. Parents, teachers, or other adults should immediately talk with the child. If it is determined that the child is at risk and the child refuses to talk, is argumentative, responds defensively, or continues to express violent or dangerous thoughts or plans, arrangements should be made for an immediateevaluation by a mental health professional with experience evaluating children and adolescents. Evaluation of any serious threat must be done in the context of the individual child’s past behavior, personality, and current stressors. In an emergency situation or if the child or family refuses help, it may be necessary to contact local police for assistance or take the child to the nearest emergency room for evaluation. Children who have made serious threats must be carefully supervised while awaiting professional intervention. Immediate evaluation and appropriate ongoing treatment of youngsters who make serious threats can help the troubled child and reduce the risk of tragedy.
When to Seek Help for Your Child?
Parents are usually the first to recognize that their child has a problem with emotions or behavior. Still, the decision to seek professional help can be difficult and painful for a parent. The first step is to gently try to talk to the child. An honest open talk about feelings can often help. Parents may choose to consult with the child’s physicians, teachers, members of the clergy, or other adults who know the child well. These steps may resolve the problems for the child and family.
Following are a few signs which may indicate that a child and adolescent psychiatric evaluation will be useful.
- Marked fall in school performance
- Poor grades in school despite trying very hard
- Severe worry or anxiety, as shown by regular refusal to go to school, go to sleep or take part in activities that are normal for the child’s age
- Frequent physical complaints
- Hyperactivity; fidgeting; constant movement beyond regular playing with or without difficulty paying attention
- Persistent nightmares
- Persistent disobedience or aggression (longer than 6 months) and provocative opposition to authority figures
- Frequent, unexplainable temper tantrums
- Threatens to harm or kill oneself
Pre-Adolescents and Adolescents
- Marked decline in school performance
- Inability to cope with problems and daily activities
- Marked changes in sleeping and/or eating habits
- Extreme difficulties in concentrating that get in the way at school or at home
- Sexual acting out
- Depression shown by sustained, prolonged negative mood and attitude, often accompanied by poor appetite, difficulty sleeping or thoughts of death
- Severe mood swings
- Strong worries or anxieties that get in the way of daily life, such as at school or socializing
- Repeated use of alcohol and/or drugs
- Intense fear of becoming obese with no relationship to actual body weight, excessive dieting, throwing up or using laxatives to loose weight
- Persistent nightmares
- Threats of self-harm or harm to others
- Self-injury or self destructive behavior
- Frequent outbursts of anger, aggression
- Repeated threats to run away
- Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism
- Strange thoughts, beliefs, feelings, or unusual behaviors
If problems persist over an extended period of time or if others involved in the child’s life are concerned, consider speaking with your seeking a consultation with a child and adolescent psychiatrist or a trained mental health professional.
A Classical Case of ADHD treated successfully with Homoeopathy
A boy, XYZ, age 15 yrs. was brought to my clinic by his parents on 16/03/2016.The parents complained that the boy was very mischievous, restless and poor in studies. There were several complaints from his school that he did not pay attention in class, is always fidgety, and distracts the attention of the whole class. There were also complaints that he picked up fights with his classmates, hit them and back-answered the class teacher. There is severe lack of concentration. He cannot sit in one place for study for a long time, is restless, and gets easily distracted. Memory is poor and as a result brings continuous bad grades. Problems in writing, cannot form sentences, spelling mistakes, handwriting is not legible. He throws a lot of temper-tantrums at home. Gets angry at silliest things, wants this and that and gets angry when refused. Gets violent, hits, bites, bangs his head against the wall when angry, shouts, cries. Is hyperactive. Tries to do several things at one time but cannot do a single thing. Cannot bear contradiction. Cannot wear his uniform properly, is always untidy. Forgetfulness, always forgets some of his belongings in class.
Chief Complaint: Restlessness, Lack of Concentration, weak memory, Attention deficit, hyperactive, temper-tantrums, untidiness, forgetfulness
No other complaint.
Premature birth, 7th month of pregnancy. Delayed Milestones. Late in walking, talking.
Family history: No major illness in the family.
Apetite: No Change
Thirst: small quantity at small interval.
Bowels: Constipation, hard stools, straining, painful
Perspiration: Excess on the head, palms and soles
Dreams: Nothing specific, does not remember.
Mind: Irritable++, anger++, wants this and that, throws things when refused, lack of concentration and attention, temper-tantrums, restlessness, forgetfulness, hyperactive
Diagnosis: Attention Deficit Hyperactivity Disorder (ADHD)
Repertorial Totality & Repertorization(RADAR 10)
16/03/2016: Baryta Carb 1M Single Dose, S.L T.D.S for 15days
02/04/2016: Slight improvement, restlessness, temper tantrums less, lack of concentration, attention++, S.L T.D.S for 15days.
19/04/2016: Status Quo. Baryta Carb 10M, single dose, S.L T.D.S for 15 days.
06/05/2016: Much better. Restless, temper tantrums much less, improvement in concentration, hyperactivity less, memory improved, attention slightly improved. S.L T.D.S for 15 days.
26/05/2016: Much better. Baryta Carb 50M, Single dose, S.L. T.D.S for 1month.
03/06/2016: Much better, restless much less, can concentrate for long time, attention span improved, temper tantrums much reduced. Memory improved, improvement in grades in class. Baryta Carb CM, single dose, S.L. T.D.S for 1month.
10/07/2016: Much better, no complaints. S.L T.D.S for 1month.
ADHD is very tedious to handle and a homoeopathic physician should handle these cases with utmost responsibility and care. It is very difficult to read the mind of children and mould them and channelize them in the right direction. Homoeopathy has lots to offer in such cases. It acts not superficially but on the deeper level and brings about a change from within. Some may call it as magic but it does wonders when the selected remedy is a perfect similimum prescribed according the laws of potency selection and repetition of doses laid down in Organon. In the above case the constitution i.e. the mental as well as physical make-up of the child perfectly matched the constitution of Baryta Carb. Within 2 doses of Baryta Carb prescribed in high and ascending potency there was rapid improvement in the child. After completing the complete cycle i.e. from 1M to CM, there was tremendous improvement in the child and the parents were extremely happy with the performance of their kin. This shows that Homoeopathy is not just magic but is highly scientific. What matters is the selection of similimum in correct potency, correct repetition and overall attitude of the homoeopathic physician towards the child. Such children with ADHD require special attention, care and proper counselling along with the medicine.
- behavioural–disorders-in-children medlineplus.gov
- kidsmentalhealth.ca › For Parents and Families
Source: The Homoeopathic Heritage, December 2016.