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| Childhood Disorders - Behavioural Problems |
The two main behavioural problems that parents should be concerned about are Oppositional Defiant Disorder and Conduct Disorder. As the terms suggest, both disorders are associated with some form of misconduct that falls outside the range of age appropriate behaviour. The two conditions are similar and mainly separated by the severity levels and type of behavioural problems that children display. Our approach to help families and children with behavioural problems is based on the functional behavioural assessment model. First we evaluate the seriousness of the problem behaviour than we identify why the child is behaving in certain ways. Once we identified the extent of the difficulties and the underlying causes, we will provide specific suggestions to parents and teachers to modify the child’s problem behaviour at home and at school. OPPOSITIONAL DEFIANT DISORDER Characteristics Children with Oppositional Defiant Disorder show hostile and generally negative behaviour patterns towards authority figures, such as parents and teachers. They likely to loose their temper easily, react strongly when their demands are refused, they can appear to be stubborn and uncompromising. These characteristics often result in arguments and verbal aggression, such as swearing at adults. Oppositional children rarely, if ever, take responsibility for their actions. In their minds they are not at fault, but others who place demands on them. These children may tease others and may enjoy causing distress. Since they do not accept responsibility for their actions the resulting arguments may lead to anger outbursts and vindictiveness. It should be noted that some oppositional behaviour is normal part of development. In fact, under some circumstances the ability to lie and to test boundaries may signal above average intelligence. In order to be outside the normal range, oppositional behaviour must be intense, broad and cause significant impairment in the child's overall functioning. Similarly, oppositional behaviour can be the symptom of other disorders, such as ADHD or emotional difficulties. It is important to distinguish the primary causes of oppositional tendencies as many children externalise their emotional reactions to environmental factors (e.g., family distress) and are not at risk from Oppositional Defiant Disorder. Course and Prognosis Depending on the family context, children can overcome oppositional behaviour relatively easily. In fact, the standard intervention strategy for the treatment of oppositional behaviour is family therapy and parenting skills training. There are children who appear to be born with oppositional tendencies, however, the family environment can still greatly improve or exacerbate such conditions. Children with oppositional tendencies can function well in different environments. It is not unusual to observe oppositional children displaying prosocial and generally positive behaviour towards their peers while seldom acting similarly towards their parents. For a successful engagement with oppositional children, it is important to identify situational triggers and protective factors. CONDUCT DISORDER Characteristics Conduct Disorder is characterised by rule breaking behaviour, deceit and lack of respect for others' rights. Whereas young children are more likely to be diagnosed with oppositional tendencies, Conduct Disorder more often appear among older children and adolescents. Conduct Disorder is the serious violation of rules and include bullying and intimidation of others, cruelty to people and animals, engaging in physical fights, using a weapon when fighting, stealing and breaking into houses and cars, fire settings and vandalism, frequent lying, staying out at night, truancy and running away from home. Course and Prognosis Early symptoms of Conduct Disorder often include oppositional tendencies in childhood. The majority of children and adolescents diagnosed with Conduct Disorder have long standing history of oppositional behaviour and persistent problems at home and at school. Once diagnosed, adolescents with Conduct Disorder are at an increased risk of developing Antisocial Personality Disorder in their adulthood. Some of the protective factors associated with good overall outcome include late onset or the lack of oppositional tendencies in early childhood, limited antisocial behaviours, above average intelligence and learning ability, non-deviant peer relations, at least one positive relationship with an adult (such as a grandparent, youth worker or teacher), experience of some form of achievement that can motivate positive behaviour and the absence of other psychological disorders. What We Offer Evidence based methods show that the best possible approach to change problem behaviour is through changed parental practices. Apart from the diagnostic assessment and report, we offer advice and parenting skills training. The Positive Parenting Program (Triple P) was designed to teach parents specific skills to change their children's problem behaviour through re-enforcement and classical conditioning techniques. Our psychologists are familiar with the Triple P principles and will provide you with sound advice about how to manage oppositional or behaviourally difficult children. |
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