Behavioral disorders usually manifest in childhood. Signs of a behavioral disorder can include aggression toward siblings and peers, frequent tantrums, learning problems, chronic defiance, early sexual activity, and self-harming. Behavioral disorders are not uncommon. More than 14% of children ages 4 to 17 years have been referred to school staff members due to behavioral or emotional outbursts.
Childhood behavioral problems do not simply disappear. These children are likely to be poor learners and to drop out of school. They usually go on to have problems holding a job. Their aggression and defiance can lead to problems with law enforcement. Behavioral disorders are mental health issues, not the result of failed discipline. At the Centre for Counseling of Aventura, we work with children and teens who have behavioral disorders. We also help their parents build coping strategies.
One or two symptoms are not enough to justify a behavioral disorder diagnosis in a child. However, when symptoms include chronic aggression and defiance or a pattern of self-harm and doing harm to others or to pets, it is important to seek help from a psychiatrist promptly.
The diagnosis of a behavioral disorder in a child requires taking a full history of the child's behavior and medical issues. The family may be interviewed to obtain insights into the child's behavior patterns. Standardized tests may be administered. Diagnosis is usually made based on the most current DSM (Diagnostic and Statistical Manual of Mental Disorders), which is the diagnostic guide of the mental health field. Diagnosis in children requires skill and expertise, because many disorders manifest with similar symptoms. For example, the agitation of a manic phase in bipolar disorder can resemble the hyperactivity of ADD.
The first step is to arrive at a reasonable diagnosis. Research indicates that heredity, exposure to drugs and tobacco during fetal development, organic brain disorders, and dysfunctional family dynamics can all play a part in the development of behavioral disorders. The treatment therefore is typically multidimensional, and may include individual psychotherapy, family therapy, and medication
As psychiatrists, we work to manage the most disruptive symptoms and to assist families in gaining better coping methods. Treatment for behavioral disorders usually involves a combination of drug therapy and cognitive behavioral therapy.
Medications used depend on the specific diagnosis. Often, mental disorders appear congruently, so that a child must be treated for several problems instead of just one. For example, teens with behavioral disorders show a higher incidence of substance abuse because they are self-medicating. Medications are used in combination with helping parents with limit setting, and the child or teenager improve their self-esteem, coping skills, and social skills.
Children and teens with behavioral problems usually have incorrect perceptions of the world around them. These faulty perceptions trigger acting out. A cognitive behavioral therapist can work with a child to reframe their perceptions and to eliminate dysfunctional overgeneralizing and "awful-izing." Most children and teens with behavioral disorders do better in highly structured individual therapy than in group therapy. Group therapy requires social skills that many of these children have not yet developed.
At this point in time, no. The best we can do is manage the most troubling symptoms. Children with behavioral disorders come in many different varieties, some of which go on to have behavioral problems throughout adult life, and others who become assets to society. Early recognition and intervention are shown to improve the outcomes.
The hallmarks of oppositional defiant disorder are persistent argumentativeness, anger and irritability, defiance, and vindictiveness. Features of ODD sometimes overlap with other disorders, such as ADD and CD. ODD can emerge during preschool or much later during early adolescence. It may be mild, moderate, or severe depending on whether the disruptive behavior occurs only at home or at school and in public. Many children with ODD have other problems, such as anxiety and communication disorders.
Conduct disorder has been viewed ODD on steroids. Generally, it makes its appearance before the age of 15. It is marked by aggression toward people and animals, property destruction, theft, deceitfulness, disregard for the law and for rules. Most adults with antisocial personality disorder showed symptoms of conduct disorder in their teens. This disorder is difficult to treat because clients are rarely willing to cooperate and to change.
ADHD affects millions of children and adults. It is a persistent condition that is characterized by difficulty concentrating, hyperactivity, and impulsive behavior. Children with ADHD may have trouble finishing homework, have difficulty following instructions or remembering chores, and may appear not to pay attention when spoken to. Some children outgrow ADHD but are plagued by associated feelings of low self-worth and have difficulty sustaining relationships. The combination of medication and psychosocial treatments often makes a huge difference in children’s lives.