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Conduct Disorder

Conduct Disorder

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What is Conduct Disorder (CD)

CD is a psychiatric disorder affecting behavior and emotion. This is one of the most serious of the behavior disorders. CD is similar to ODD, however, it is much worse. Some believe that CD is a much more severe form of ODD. Many believe that those with CD will become criminals as they get older. Characteristics of the child who has CD are: aggression (to people and animals), defiance, anti social, destructive behavior. Many children who have CD also have learning disabilities.

When documenting the child's behavior; characteristics or behavior patterns should be in place for at least 6 months. The behaviors will have a negative impact on social and academic functioning. The behaviors are very deliberate. It is important to look for the following characteristics:

  • Physical aggression to people and animals
  • The child is defiant and doesn't obey rules/routines
  • The child argues often with adults and peers
  • The child seems to go out of his/her way to bully and harm others
  • The child is often lacking accountability and blames others for inappropriate behaviors
  • The child often seems angry, spiteful and vindictive and is physically cruel as well as destructive to property
  • The child is non-compliant and difficult to control
  • The child violates rules regularly and will destruct property, be involved in theft, start fights, and lacks respect for authority.
  • The child rarely shows concern for others
  • There is also a tendancy for this child to run away

One should exercise caution when reading lists of characteristics, remember that some children will exhibit many of the characteristics listed at some point in time. Key to determining CD is the frequency of the characteristics.

How is CD diagnosed?

Psychiatric disorders are diagnosed by a review of medical history, the ruling out other disorders, medical tests and ongoing observation. Good documentation from both parents and teachers over a period of time about the child's behavior is critical for the practitioner. Although there's no clearly understood cause, it is believed to be a combination of genetics, environment, and/or medical problems. Family conflicts including child abuse, low social economic status (SES) or poverty, and parental drug addiction or alcoholism have all been associated with the onset of CD. The onset of the pattern of behaviors often starts early from toddler/pre-school ages and is believed to effect both females and males, although the incidence tends to be a higher for males. Some children will have both ODD, ADD and CD.

How is CD Treated?

You have your work cut out for you, CD is by far one of the hardest disorders to treat, let alone cope with. There are relatively few studies done on the effective treatment for CD. There is no one way to treat cases of CD. Sometimes, medication is used to treat some of the symptoms, sometimes psycho therapy and or family therapy is used but more often than anything else, behavior modification is used. As with all disorders, the earlier a form of consistent treatment is in place, the greater chance of success. See best practices below for some tips.

Best Practices

The best way to treat a child with CD in and out of the classroom include behavior management techniques, using a consistent approach to discipline and following through with positive reinforcement of appropriate behaviors. Be fair but be firm, give respect to get respect.

  • Develop consistent behavior expectations.
  • Communicate with parents so that strategies are consistent at home and school.
  • Apply established consequences immediately, fairly and consistently.
  • Establish a quiet cooling off area.
  • Teach self talk to relieve stress and anxiety.
  • Provide a positive and encouraging classroom environment.
  • These children are often lacking confidence and have low self-esteem, promoting both will be beneficial
  • Give praise for appropriate behavior and always provide timely feedback.
  • Provide a 'cooling down' area/time out.
  • Avoid confrontation and power struggles
  • Use Behavior Contracts
  • Try one of these 3 thinksheets
  • Successful treatment requires committment and follow up on a regular basis from both parents and teachers. Expect setbacks from time to time but know that an ongoing consistent approach is in the best interest of the child. Remember, even though you put the best of strategies in place, the outcome may still be negative. However, if you turn the child with CD around, what an amazing, worthwhile experience!

    See also ODD

    A good read to support a child with CD is The Explosive Child

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