As the name implies, these disorders have to do with bad behavior. Kids with these issues tend to defy authority, have angry outbursts, and may be aggressive toward others. Behavior disorders are ‘pervasive,’ meaning that these behaviors happen a lot. This is not the kid that occasionally throws a fit. This is the child who has taken on these behaviors as a ‘way of being in the world.’ Getting his or her way is the sole purpose of the behavior and the child will stop at nothing to make sure that happens. The child may have no friends, or very few. He or she likely to spend a lot of time in the principal’s office. You might shutter when the phone rings with the school’s number on the caller ID. Children with behavior disorders are irritable and angry often; however, they may have periods of a calm or happy disposition. Their meltdowns last too long and are far too frequent. They may make hateful comments when they are upset, saying things like, “I hate you!” “I wish you were dead!” “I’m running away and I will never come back.” They may swear loudly. They may yell in your face. It might feel like your house is a war-zone. You may be left wondering where you went wrong and how to get your sweet child back.
What are Behavior Disorders?
Children who have significant problems in this area may have any of the following potential disability. *Note, this does not serve as a diagnosis in any way. See Where to Go for Help With Behavior Disorders for professionals who can diagnose or provide a referral.
In this article we wish to introduce and differentiate a few behavior disorders that may be diagnosed in children and teenagers. These are Oppositional Defiant Disorder, Conduct Disorder, and Intermittent Explosive Disorder.
Behavior Disorders include a number of disorders that are marked by oppositional, defiant, rule breaking and aggressive behavior. They are classified as “Disruptive, Impulse Control and Conduct Disorders” by the DSM-5. These behaviors are thought to be learned rather than innate. Behavior Disorders differ from Mood and Depressive Disorders because while irritable, angry and rule breaking behavior can occur in the context of say depression, in a Behavior Disorder this behavior is geared towards achieving a goal (getting something or getting out of something) and is not rooted in depression. The DSM-5 does not permit diagnosis of a behavior disorder when symptoms can be better explained by a mood or other emotional disorder.
Another example of conduct related behavior is fire setting with the intent to destroy property. This is a rule/law breaking behavior not rooted in mood. Being rude and irritable or not listening to the teacher may be rooted in depression. On the other hand, defying the teacher in school could be a rule breaking behavior in an attempt to avoid work. As you can see it can be challenging to tell the difference between depression and mood symptoms versus behavior disorders. Depressed children may refuse to do anything you ask; but Oppositionally Defiant children have learned that by refusing they can get their own way. Behavioral symptoms tend to be first visible in the preschool years. This is the time to target behavior problems so they do not develop into a behavior disorder.
What are the signs and symptoms of Behavior Disorders?
Children who have significant problems in this area may have any of the following potential disability. *Note, this does not serve as a diagnosis in any way. See Where to Go for Help With Behavior Disorders for professionals who can diagnose or provide a referral.
Oppositional Defiant Disorder – Some defiance is typical in children. ODD indicates a pervasive pattern of defiant, irritable and angry behavior with symptoms from three categories. Symptoms include angry and irritable behaviors, argumentative and defiant behaviors, and vindictiveness. This disorder can occur from childhood on. At age 5 or younger a child must exhibit 4 different behaviors in these categories most days for at least 6 months. For children older, 4 different behaviors must occur weekly for at least 6 months. Children with ODD often blame others for their mistakes and often act in a manner that is spiteful and vindictive. ODD is classified mild, moderate or severe.
It is important to carefully differentiate ODD from depression in children as depressed children and teens tend to be very irritable. If a child meets full criteria for depression it would not be appropriate to diagnose ODD, rather treat the depression. Link to that article here. An evaluation may be warranted here to determine whether a behavior disorder or emotional disorder is the appropriate diagnosis.
Conduct Disorder – Includes behaviors that violate the rights of others and can be considered antisocial. Conduct disorder behavior violates laws and social norms and occurs before the age of 18. CD involves a callous disregard for others and behaviors including fighting, lying, cheating, stealing, starting fires, destroying property, cruelty to animals or those smaller than yourself, and bullying. Children with untreated ODD at a young age may develop CD in adolescence. Often Conduct Disorder in children, particularly early onset, is a precursor to Antisocial Personality Disorder in adults. Only a few behaviors are required to make the diagnosis and more incidents of behavior or more severe behaviors indicate a higher severity level; mild, moderate or severe. This disorder can be diagnosed in school aged children up to the age of 18.
Intermittent Explosive Disorder – Symptoms include several episodes of impulsive behaviors damaging/ hurting people or property. This episodic violence must be severe or out of proportion with what might be considered typical behavior for a child. Verbal outburst behaviors may occur twice a week while significant physical aggression leading to injury or property destruction may only occur a few times per year to meet criteria for IED. This disorder can be differentiated from ODD or CD based on the frequency of misbehaviors and intensity of outbursts. Finally the child cannot meet criteria for another mental condition that might include tantrums and outbursts. Outbursts cannot be premeditated and children cannot be younger than 6 to receive this diagnosis.
How is Behavior Disorders treated?
Children who have significant problems in this area may have any of the following potential disability.*Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.
Oppositional Defiant Disorder – Some defiance is typical in children. ODD indicates a pervasive pattern of defiant, irritable and angry behavior with symptoms from three categories. Symptoms include angry and irritable behaviors, argumentative and defiant behaviors, and vindictiveness. This disorder can occur from childhood on. At age 5 or younger a child must exhibit 4 different behaviors in these categories most days for at least 6 months. For children older, 4 different behaviors must occur weekly for at least 6 months. Children with ODD often blame others for their mistakes and often act in a manner that is spiteful and vindictive. ODD is classified mild, moderate or severe.
It is important to carefully differentiate ODD from depression in children as depressed children and teens tend to be very irritable. If a child meets full criteria for depression it would not be appropriate to diagnose ODD, rather treat the depression. Link to that article here. An evaluation may be warranted here to determine whether a behavior disorder or emotional disorder is the appropriate diagnosis.
Conduct Disorder – Includes behaviors that violate the rights of others and can be considered antisocial. Conduct disorder behavior violates laws and social norms and occurs before the age of 18. CD involves a callous disregard for others and behaviors including fighting, lying, cheating, stealing, starting fires, destroying property, cruelty to animals or those smaller than yourself, and bullying. Children with untreated ODD at a young age may develop CD in adolescence. Often Conduct Disorder in children, particularly early onset, is a precursor to Antisocial Personality Disorder in adults. Only a few behaviors are required to make the diagnosis and more incidents of behavior or more severe behaviors indicate a higher severity level; mild, moderate or severe. This disorder can be diagnosed in school aged children up to the age of 18.
Intermittent Explosive Disorder – Symptoms include several episodes of impulsive behaviors damaging/ hurting people or property. This episodic violence must be severe or out of proportion with what might be considered typical behavior for a child. Verbal outburst behaviors may occur twice a week while significant physical aggression leading to injury or property destruction may only occur a few times per year to meet criteria for IED. This disorder can be differentiated from ODD or CD based on the frequency of misbehaviors and intensity of outbursts. Finally, the child cannot meet criteria for another mental condition that might include tantrums and outbursts. Outbursts cannot be premeditated and children cannot be younger than 6 to receive this diagnosis.
Behavior Disorders can be challenging to treat. Consistent parenting with immediate use of rewards and control of reinforcers (like video games, allowance) gives parents the opportunity to set and hold limits and reward good behaviors. It is valuable to obtain a diagnosis and engage in the appropriate therapies as early as is feasible. With these supports in place, it is possible to see improvement in behavior. A child needs to learn that society, school and parents make the rules and that there are consistent and predictable reinforcers for following these.
How can Clear Child Psychology help with Behavior Disorders?
If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, it’s time to seek professional help.
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Helpful resources for Behavior Disorders
[1] Yamada, Kobi (2016). What do you do with a problem?
[3] Cook, Julia (2011). Soda pop head.
[4] Meiners, Cheri J. (2010). Cool down and work through anger (Learning to get along).
[5] McNeil, Cheryl & Hembree-Kigin, Toni. (2010) Parent Child Interaction Therapy, Edition 2
[6] Mulcahy, William (2012). Zach gets frustrated (Zach rules series).
