Behavioural disorders in children (2024)

Oppositional defiant disorder

Around one in 10 children under the age of 12 years are thought to have oppositional defiant disorder (ODD), with boys outnumbering girls by two to one. Some of the typical behaviours of a child with ODD include:

• easily angered, annoyed or irritated
• frequent temper tantrums
• argues frequently with adults, particularly the most familiar adults in their lives, such as parents
• refuses to obey rules
• seems to deliberately try to annoy or aggravate others
• low self-esteem
• low frustration threshold
• seeks to blame others for any misfortunes or misdeeds.

Conduct disorder

• frequent refusal to obey parents or other authority figures
• repeated truancy
• tendency to use drugs, including cigarettes and alcohol, at a very early age
• lack of empathy for others
• being aggressive to animals and other people or showing sad*stic behaviours including bullying and physical or sexual abuse
• keenness to start physical fights
• using weapons in physical fights
• frequent lying
• criminal behaviour such as stealing, deliberately lighting fires, breaking into houses and vandalism
• a tendency to run away from home
• suicidal tendencies – although these are more rare.

Attention deficit hyperactivity disorder

Around 2 to 5 per cent of children are thought to have attention deficit hyperactivity disorder (ADHD), with boys outnumbering girls by three to one. The characteristics of ADHD can include:

• Inattention – difficulty concentrating, forgetting instructions, moving from one task to another without completing anything.
• Impulsivity – talking over the top of others, having a ‘short fuse’, being accident-prone.
• Overactivity – constant restlessness and fidgeting.

Risk factors in children’s behavioural disorders

The causes of ODD, CD and ADHD are unknown but some of the risk factors include:

• Gender – boys are much more likely than girls to suffer from behavioural disorders. It is unclear if the cause is genetic or linked to socialisation experiences.
• Gestation and birth – difficult pregnancies, premature birth and low birth weight may contribute in some cases to the child’s problem behaviour later in life.
• Temperament – children who are difficult to manage, temperamental or aggressive from an early age are more likely to develop behavioural disorders later in life.
• Family life – behavioural disorders are more likely in dysfunctional families. For example, a child is at increased risk in families where domestic violence, poverty, poor parenting skills or substance abuse are a problem.
• Learning difficulties – problems with reading and writing are often associated with behaviour problems.
• Intellectual disabilities – children with intellectual disabilities are twice as likely to have behavioural disorders.
• Brain development – studies have shown that areas of the brain that control attention appear to be less active in children with ADHD.

Diagnosis of children’s behavioural disorders

• Diagnosis by a specialist service, which may include a paediatrician, psychologist or child psychiatrist
• In-depth interviews with the parents, child and teachers
• Behaviour checklists or standardised questionnaires.

Treatment of behavioural disorders in children

• Parental education – for example, teaching parents how to communicate with and manage their children.
• Family therapy – the entire family is helped to improve communication and problem-solving skills.
• Cognitive behavioural therapy – to help the child to control their thoughts and behaviour.
• Social training – the child is taught important social skills, such as how to have a conversation or play cooperatively with others.
• Anger management – the child is taught how to recognise the signs of their growing frustration and given a range of coping skills designed to defuse their anger and aggressive behaviour. Relaxation techniques and stress management skills are also taught.
• Support for associated problems – for example, a child with a learning difficulty will benefit from professional support.
• Encouragement – many children with behavioural disorders experience repeated failures at school and in their interactions with others. Encouraging the child to excel in their particular talents (such as sport) can help to build self-esteem.
• Medication – to help control impulsive behaviours.

Where to get help

• Your GP (doctor) – for a referral to a specialist service below
• Paediatrician
• Child psychologist
• Child psychiatrist
• The Royal Children's Hospital Melbourne fact sheet on Attention deficit hyperactivity disorder (ADHD)
• The Royal Children's Hospital Melbourne fact sheets on Challenging behaviour in toddlers and young children, school-aged children and teenagers
• Attention Deficit Hyperactivity Disorder Association
• Association for Children with a Disability Tel. (03) 9818 2000, rural callers free call on 1800 654 013
• Australian Psychological Society, APS Psychologist Referral Service Tel. (03) 8662 3300 or 1800 333 497.