Childhood-Onset Conduct Disorder

When other children are playing, sharing and treating each other with kindness and yours is out of control, it can make you feel like an ineffective parent. If your child begins getting into trouble with legal authorities, teachers and others, you might find yourself going over in your mind anything you might have done to cause this rebellious child to emerge. If you find that you are dealing with an out-of-control child or teenager, you may have a child with conduct disorder. Childhood-onset conduct disorder is recognized in the DSM-IV as a disorder that occurs when a child or teenager continues to display evidence of misconduct in the face of repeated attempts at correction.

Official Guidelines

• According to the American Psychiatric Association, the DSM-IV uses four main categories to diagnose childhood-onset conduct disorder. The first groups includes personal conduct that is aggressive and can include causing physical harm or threatening harm to people or animals. The second group of behaviors in conduct disorder includes non-aggressive conduct toward people or animals; however, the behaviors cause property damage or property loss to others. The third grouping includes deceitful behaviors including lying and stealing. The fourth and final behavior pattern for conduct disorder is a consistent and blatant violation of rules and boundaries.
  Children with conduct disorder do not seem to respect the rights of others or society as a whole and in addition they often ignore normal behavioral rules that the majority of people in their age group would follow.
  For conduct disorder to be diagnosed there must be three of the following in the past year with one occurrence in the past six months: aggression shown against a person or an animal, by bullying, using threats or intimidation; initiation of physical fights using a weapon that has the ability to cause great harm (i.e. a bat, knife, gun, brick); has been cruel to those around him/her; has stolen with the victim present (including robbery, purse snatching or extortion); has committed sexual attacks; has destroyed property; theft; serious lies; truancy; ignoring curfew and ignoring other rules beginning before age 13.

Childhood-Onset

• Childhood-onset conduct disorder is one of two sub-groups of recognized conduct disorders. In childhood-onset conduct disorder the behaviors begin before the child is 10 years old and the child has often displayed physical aggression. Most patients with childhood-onset conduct disorders are males and they frequently display problems with peer relationships and often get into physical altercations. Childhood-onset conduct disorder has a higher ratio of patients who go on to develop antisocial personality disorders than do those who develop conduct disorder in their adolescence.

Range of severity

• Conduct disorder is classified in different ranges depending on the severity of the problems that it causes. If a child has a few conduct problems above and beyond the minimum required for diagnosis it is classified as mild. Things that would fall under this classification include lying, truancy and breaking the rules of the household in which the child lives. If the child displays more serious conduct issues beyond what is needed for diagnosis, it is classified as moderate. These behaviors include theft, conning people through manipulation to get out of obligations or to get what they want and break household rules. The severe category is used when the person is committing acts against society that can cause great harm including rape, mugging, armed robberies and other acts of violence.

Co-existing conditions

• The American Psychiatric Association reports that up to 95 percent of children with conduct disorders also have co-existing disorders that can include Attention Deficit Hyperactivity Disorder, Tourette's Syndrome, Oppositional Defiant Disorder or Depression.
  A study conducted by Phelps and McClintock in 1994 determined that approximately 6 percent of the population will develop conduct disorder. It also found that different areas of the country had higher or lower incidences depending on the demographics of the area.

Prognosis

• Childhood-onset conduct disorder can be a serious disorder; however, there is no evidence that all children who develop conduct disorder will go on to develop antisocial disorders later in life. Approximately 50 to 70 percent of children with childhood-onset conduct disorder will become stable in their adult lives. Risk factors for childhood-onset conduct disorder are not entirely clear at this time, but there appears to be a combination of biological and environmental elements involved.
  Childhood personality traits are thought to act as precursors to which children will develop conduct disorders. Children with conduct disorders often misread social cues and they also often have parents who were impatient with them when they were very small.

Treatment

• The treatment of childhood-onset conduct disorder includes several aspects of the child's life. The child should be in counseling, where he will be taught skills that will assist in the child's development and growth and teach the child how to adapt to changes and problem solve effectively.
  The parents should also go through counseling to develop parenting skills not only for general parenting but also for the specific ability to parent a child with conduct disorder.
  Teachers and others involved in the education of the child with conduct disorder should also receive support and training in how to effectively handle and teach the conduct-disordered child.