Behaviour Disorders - Introduction.
Children regarded as having behaviour problems form a very broad group. Parents who experience difficulty managing a child, may describe the child as having behaviour problems: it may be the expectation of the parents, or their way of managing the child, that are inappropriate, rather than the child's behaviour. Problem behaviours are common in children: they are often trivial, and of short duration. More serious persistent problems of behaviour are likely to come to the attention of professionals: health visitors; teachers; school doctors and nurses; psychologists, child psychiatrists or paediatricians. Oppositional defiant disorder, and conduct disorder, are medically recognised categories of problem behaviour.
Clinical Description.
Oppositional Defiant Disorder
This is a pattern of negative and defiant behaviour. The child often loses his temper; argues with adults, is defiant or non-compliant to requests or rules. The child may be irritable and easily annoyed, or deliberately annoy other people. The child is often angry and resentful.
Conduct Disorder
This is a repetitive and persistent pattern of behaviour in which the basic rights of others, or normally accepted rules are violated. The types of behaviour included are bullying and threatening of others; initiating physical fights; using weapons to harm others; physical cruelty to people or animals; deliberate destruction of property by fire or otherwise. It also includes significant theft, running away from home for significant periods, and truancy from school.
Causes of Behaviour Disorder
Childrens' behaviour problems may arise from a condition affecting the child itself, or the environment in which it grows up (ie. early family experiences, parenting), or both of these. Factors intrinsic to the child include: attention deficit disorder; organic brain disease; epilepsy; mental retardation; autism and specific learning difficulties (eg. dyslexia). Family factors include: neglect; inconsistent parenting; unstable families; violence and anti-social personalities in the parents. It can be difficult to establish the precise cause in any particular case of behaviour disorder.
Care Needs.
Although children with behaviour problems are by definition more difficult to manage, they will not require more attention for their bodily functions than normal children (unless the behaviour problems are associated with such conditions as significant mental retardation).
Some of these children will show poor awareness of danger, and will not learn to take more care as a result of experience. Such children will require a greater level of vigilance from parents and carers than ordinary children. However, this is unlikely to amount to continual supervision; indeed, some children are perceived as problematic largely because they are not receiving the amount of supervision which is appropriate to their age. If behaviour problems are severe and associated with another significant disability, such as severe mental retardation, then much higher levels of care are likely to be required.
Children with behaviour problems are often said to be difficult to settle atnight. Once settled however, the majority will sleep through the night, and would be unlikely to require regular night-time attention.
Mobility Considerations.
Children with behaviour problems do not have difficulty walking, unless there are other associated disabilities. They should be able to get around with no greater supervision than a normal child of the same age.
Further Evidence
Children with severe disorders of behaviour are likely to be known to professionals in the health and education services. Reports from school will be helpful; a Statement of Special Educational Needs may be available for information, or a report from an educational psychologist should be sought. Alternatively, the health visitor, GP, clinical psychologist, child psychiatrist, or paediatrician, may be able to provide a report on the degree of the child's behavioural difficulties, and the likely cause. Because of the wide range of possible behaviour problems, it is not adequate to rely on parents alone identifying their child as having a behaviour disorder.
