Psychosocial disorders

These can be usefully classified into psychosocial disorders, habit disorders, anxiety disorders,
disruptive behaviour and sleeping problems.
These may manifest as disturbance in:

Emotions - eg, anxiety or depression.

Behaviour - eg, aggression.

Physical function - eg, psychogenic disorders.

Mental performance - eg, problems at school.

This range of disorders may be caused by a number of factors such as parenting style which is
inconsistent or contradictory, family or marital problems, child abuse or neglect, overindulgence, injury
or chronic illness, separation or bereavement.[1][2]
The child's problems are often multi-factorial and the way in which they are expressed may be
influenced by a range of factors including developmental stage, temperament, coping and adaptive
abilities of family, and the nature and the duration of stress. In general, chronic stressors are more
difficult to deal with than isolated stressful events.
Children do not always display their reactions to events immediately, although they may emerge later.
Anticipatory guidance can be helpful to parents and children in that parents can attempt to prepare
children in advance of any potentially traumatic events - eg, elective surgery or separation. Children
should be allowed to express their true fears and anxieties about impending events.
In stressful situations, young children will tend to react with impaired physiological functions such as
feeding and sleeping disturbances.[3] Older children may exhibit relationship disturbances with friends
and family, poor school performance, behavioural regression to an earlier developmental stage, and
development of specific psychological disorders such as phobia or psychosomatic illness. [4][5]
It can be difficult to assess whether the behaviour of such children is normal or sufficiently
problematical to require intervention. Judgement will need to take into account the frequency, range
and intensity of symptoms and the extent to which they cause impairment.
Habit disorders[6]
These include a range of phenomena that may be described as tension-reducing.

Thumb sucking
Nail biting
Air swallowing
Body rocking

Tension-reducing habit disorders

Repetitive vocalisations
Tics
Hair pulling
Breath holding
Head banging
Manipulating parts of the body
Hitting or biting themselves

All children will at some developmental stage display repetitive behaviours but whether they may be
considered as disorders depends on their frequency and persistence and the effect they have on
physical, emotional and social functioning. These habit behaviours may arise originally from intentional
movements which become repeated and then become incorporated into the child's customary
behaviour. Some habits arise in imitation of adult behaviour. Other habits such as hair pulling or head
banging develop as a means of providing a form of sensory input and comfort when the child is alone.

Thumb sucking - this is quite normal in early infancy. If it continues, it may interfere with the
alignment of developing teeth. It is a comfort behaviour and parents should try to ignore it while
providing encouragement and reassurance about other aspects of the child's activities.

Tics - these are repetitive movements of muscle groups that reduce tension arising from
physical and emotional states, involving the head, the neck and hands most frequently. It is
difficult for the child with a tic to inhibit it for more than a short period. Parental pressure may
exacerbate it, while ignoring the tic can reduce it. Tics can be differentiated from dystonias and
dyskinetic movements by their absence during sleep.

Stuttering - this is not a tension-reducing habit. It arises in 5% of children as they learn to

speak. About 20% of these retain the stuttering into adulthood. It is more prevalent in boys than
in girls. Initially, it is better to ignore the problem since most cases will resolve spontaneously. If
the dysfluent speech persists and is causing concern refer to a speech therapist.

Anxiety disorders
Anxiety and fearfulness are part of normal development; however, when they persist and become
generalised they can develop into socially disabling conditions and require intervention. Approximately
6-7% of children may develop anxiety disorders and, of these, 1/3 may be over-anxious while 1/3 may
have some phobia.[7] Generalised anxiety disorder,childhood-onset social phobia, separation anxiety
disorder, obsessive-compulsive disorderand phobia are demonstrated by a diffuse or specific anxiety
predictably caused by certain situations.[8]
School phobia occurs in 1-5% of children and there is a strong association with anxiety and depression.
[9]
Management is by treating the underlying psychiatric condition, family therapy, parental training and
liaison with the school in order to investigate possible reasons for refusal and negotiate re-entry.
Behavioural and cognitive treatments show promise, although most evidence-based trials involve
children with mental health problems rather than the general population of school refusers per se. More
research needs to be done in this area.[10]
Disruptive behaviour
Many behaviours, which are probably undesirable but a normal occurrence at an early stage of
development, can be considered pathological when they present at a later age. In the young child,
many behaviours such as breath holding or temper tantrums are probably the result of anger and
frustration at their inability to control their own environment. For some of these situations it is wise for
parents to avoid a punitive response and, if possible, to remove themselves from the room. It is quite
likely that the child will be frightened by the intensity of their own behaviour and will need comfort and
reassurance. While some isolated incidents of stealing or lying are normal occurrences of early
development, they may warrant intervention if they persist. Truancy, arson, antisocial behaviour and
aggression should not be considered as normal developmental features.
Attention deficit hyperactivity disorder is characterised by poor ability to attend to tasks (eg,
makes careless mistakes, avoids sustained mental effort), motor overactivity (eg, fidgets, has difficulty
playing quietly) and impulsiveness (eg, blurts out answers, interrupts others). For the diagnosis to be
made, the condition must be evident before age 7 years, present for >6 months, seen both at home
and school and impeding the child's functioning. [11] The condition is diagnosed in 3-7% of school-age
children.[12]
Methylphenidate (initiated by specialists only) is a stimulant medication that provides reduction of
symptoms, at least in the short term.[13] Behavioural modification and neuro-feedback are the nonpharmacological treatments with the largest evidence base.[14][15][16] Various dietary interventions have
been mooted, of which the addition of essential fatty acids has the widest support. [17]
All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging
behaviours that are outside the norm for their age.
The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD).
These three behavioural disorders share some common symptoms, so diagnosis can be difficult and time consuming. A child or adolescent may have two disorders at
the same time. Other exacerbating factors can include emotional problems, mood disorders, family difficulties and substance abuse.

Oppositional defiant disorder

Around one in ten 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
Children with conduct disorder (CD) are often judged as bad kids because of their delinquent behaviour and refusal to accept rules. Around five per cent of 10 year olds
are thought to have CD, with boys outnumbering girls by four to one. Around one-third of children with CD also have attention deficit hyperactivity disorder (ADHD).
Some of the typical behaviours of a child with CD may include:

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 sadistic 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 two to five 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 childrens 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 childs 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 childrens behavioural disorders

Disruptive behavioural disorders are complicated and may include many different factors working in combination. For example, a child who exhibits the delinquent
behaviours of CD may also have ADHD, anxiety, depression, and a difficult home life.
Diagnosis methods may include:

Diagnosis by a specialist service, which may include a paediatrician, psychologist or child psychiatrist

In-depth interviews with the parents, child and teachers

Behaviour check lists or standardised questionnaires.

A diagnosis is made if the childs behaviour meets the criteria for disruptive behaviour disorders in theDiagnostic and Statistical Manual of Mental Disorders from the
American Psychiatric Association.
It is important to rule out acute stressors that might be disrupting the childs behaviour. For example, a sick parent or victimising by other children might be responsible
for sudden changes in a childs typical behaviour and these factors have to be considered initially.

Treatment of behavioural disorders in children

Untreated children with behavioural disorders may grow up to be dysfunctional adults. Generally, the earlier the intervention, the better the outcome is likely to be.
A large study in the United States, conducted for the National Institute of Mental Health and the Office of School Education Programs, showed that carefully designed
medication management and behavioural treatment for ADHD improved all measures of behaviour in school and at home.
Treatment is usually multifaceted and depends on the particular disorder and factors contributing to it, but may include:

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.

Sleeping problems
Sleep disorders can be defined as more or less sleep than is appropriate for the age of the child. By the
age of 1-3 months, the longest daily sleep should be between midnight and morning. Sleeping through
the night is a developmental milestone but, at the age of 1 year, 30% of children may still be waking in
the night. Stable sleep patterns may not be present until age 5 years but parental or environmental
factors can encourage the development of circadian rhythm.
See separate article Sleep Problems in Children for more details.
10 Common Child Behavior Problems and Their Solutions

KidStock/Blend Images/Getty Images

There are some behavior problems that almost every child exhibits at one time or another. Matching
those behaviors to the best discipline strategies can resolve these behaviors before they become even
bigger problems.
1. Lying
Sometimes kids tell stories to get attention, while at other times they lie to avoid getting into trouble. If
lies arent addressed appropriately, lying can turn into a bad habit for your child. When you catch your
child in a lie, respond in a calm but direct manner and encourage your child to tell the truth.

10 Ways to Get a Child to Stop Lying and Start Telling the Truth

2. Defiance
Its frustrating when a child refuses to follow directions, especially when he outright says No! when
you tell him to do something. However, its normal for kids to test limits at one time or another.
Sometimes defiance stems from a child testing your reaction, while other defiant behaviors may signal
a childs attempts to assert his independence. Preschoolers and tweens are especially likely to behave
defiantly.

10 Ways to Deal with a Childs Defiance and Non-Compliance

3. TV and Electronics Addiction

Many children in todays world would sit in front of the TV or a video game system all day if they could.
However, its not healthy for them physically or mentally.
Getting them to play outside or get involved in other activities can seem like a battle at first. However,
its important to establish healthy habits for them during childhood that will carry over into their adult
lives.

10 Tips for Setting Limits on Electronics and Screen Time

4. Food-Related Problems
Food-related issues can lead to a lot of behavior problems. Whether youve got a picky eater or a child
who always claims to be hungry, food-related issues can lead to power struggles if youre not careful.
With so much emphasis on being thin combined with an epidemic of obesity, its important to help kids
develop a healthy attitude about food.

Discipline Strategies that Can Prevent Children From Becoming Overweight

How to Avoid Power Struggles with a Picky Eater

How to Create Rules for Mealtimes

Setting Limits with Food to Keep Kids Healthy

5. Disrespectful Behavior
Disrespectful behavior can frustrate even the calmest of parents. If its not addressed appropriately,
disrespect can get worse through the years. The way you respond to behaviors such as talking back,
inappropriate language, and attitude problems will discourage your child from doing it again.

5 Ways to Respond to Disrespectful Behavior

What to do About Swearing

6. Whining
Whining is a behavior that can become a terribly bad habit for a child, especially if it is an effective
means for getting him what he wants. Whining can have a lot of social consequences for children,
however.
A child who whines is likely to have peer-related issues because other kids wont want to put up with it.
Teachers and other caregivers may also not take kindly to a child who whines frequently. Put an end to
whining quickly and teach your child more appropriate ways to deal with upsetting feelings such as
disappointment.

6 Steps to Get a Child to Stop Whining

7. Impulsive Behavior
Impulsive behavior comes in many forms. Young children tend to be physically impulsive. Theyre more
likely to hit, push or grab something without thinking.
Older children and teens should have better control over their physical impulses, but are often still
verbally impulsive. They may say things without thinking and may have trouble controlling their
emotions.
There are many reasons why impulse control is an important skill. When children master impulse
control, theyre likely to behave better. They are even more likely to have increased academic success.
Teach impulse control skills to curb impulsive behavior as early as possible and set your child up for
success.

8 Ways to Teach Kids Self-Discipline

10 Ways to Teach Impulse Control

8. Bedtime Behavior Problems

Whether your child refuses to stay in bed, wont go to sleep, or insists on sleeping with you, bedtime
behavior problems are common. If you dont fix them, they can get worse over time, which can have

serious consequences for your child. A lack of sleep can lead to increased behavior problems and
academic issues.

7 Discipline Strategies to Prevent Bedtime Behavior Problems

9. Aggression
Aggression can range from a child throwing his math book when he doesnt want to do his homework to
outright punching his brother when hes mad. Usually, aggressive behavior is common at one time or
another and should subside as a child learns impulse control. However, there are times when
aggression indicates that you should seek professional help for your childs behavior.

Discipline Strategies to Manage Aggressive Behavior

10. Temper Tantrums

Temper tantrums are most common in toddlers and preschoolers. Sometimes they occur when a child
isnt sure how to manage his anger and at other times, they serve as a manipulation technique.
Sometimes kids throw tantrums to gain attention or to try and get what they want.
Sometimes older kids exhibit temper tantrums as well. Grade school children, tweens and sometimes
even teens, may sulk, stomp their feet or scream when they get angry. Take action to curb these
annoying behaviors as soon as possible.

The Best Ways to Deal with Temper Tantrums

5 Ways to Teach Your Child Anger Management Skills

Common Behavior Problems in School-Age Children

Along with the wonderful milestones you can expect to see among school-age children such as
increased independence and ability to handle more responsibilities, there is also the less-pleasant
emergence of common behavior problems for this age group.
While child-discipline issues such as defiance and back talk may have cropped up at earlier ages in a
child, such behaviors can take on a entirely-more challenging aspect as children become older, more
verbal, and more independent.
Here are some typical behavior problems you can expect to see in children at this age.

Jamie Grill/The Image Bank/Getty Images

1. How to Handle Defiant Children
If you are hearing a whole lotta "no's" from your child or are increasingly seeing defiant behavior such
as refusing to do something you asked your child to do, you are not alone. Defiant behavior is a very

common problem among school-age children. But with the right strategies, you can get to the root of
your child's behavior and get your child back on your team. More

iStockphoto
2. Why Kids Tattle and What You Can Do About It
Tattling is an annoying but very common problem among grade-school age kids. Children this age are
figuring out right from wrong, learning about rules and consequences, and putting a high value on
being fair. All that is a recipe for tattling, but parents can help guide kids toward more positive behavior
and teach children how to tell the difference between tattling and telling to help someone. More

iStockphoto
3. Solutions for Sibling Rivalry and Fighting
As much as your children may love one another, sibling rivalry and fighting is a very common part of
many sibling relationships. Here are some excellent ideas for building sibling love and reducing the
friction that can lead to sibling conflict among brothers and sisters. More

Getty Images
4. How to Handle Dawdling
Does your child take 10 minutes to put on one sock in the morning? Is she a s-l-o-w eater who takes a
half-hour to eat a few bites of her dinner? This frustrating behavior can be managed with some fun and
creative solutions. More

123RF
5. How to Stop Whining in Children
Whining can be one of the most unpleasant sounds known to Man. And as almost every parent can
attest, children are born with the ability to produce this sound, almost as if it's something encoded into
their DNA. The good news is that with a few simple strategies, parents can get their kids to stop
whining--and save their sanity in the process. More
Talking back and defiance are common child discipline problems that are best handled with a calm
manner and a few smart, simple strategies. iStockphoto
6. How to Handle a Child Who is Talking Back
Talking back may be a normal part of child development, but it's certainly one of the most maddening.
Here are some tried-and-true techniques for nipping this behavior problem in the bud and helping your
child express herself in a more appropriate and respectful manner. More

iStockphoto
7. What to Do When a Child Wont Go to Bed
Is bedtime all too often a battle of wills in your house? If your child regularly won't go to bed or has
trouble falling asleep or staying asleep, try these tips to find out what may be causing her sleep

problems and learn how to help her get a good night's rest -- something that's especially important for
school-age children. More

Getty Images
8. How to Help Shy Kids
while some parents may worry that shyness in their child may be something that could be a drawback,
research shows that there are many positive aspects and benefits to being an introvert. More

Getty Images
9. How to Handle Lying in Children
Having your child lie to you can be upsetting. But the truth is that lying is a common behavior among
children that can be addressed with love and reassurance balanced out with consequences. More
How to Help Shy Kids

Shy kids will often outgrow their fears and become more comfortable in social settings as time goes
on. Getty Images
If you have a shy child, chances are you know exactly what it feels like to have to peel a clinging kid
from around your legs in the beginning days of the school year or in other social situations. While some
children jump in and start engaging with other kids right away at birthday parties, school, or other
social settings, others are naturally more reluctant, and need more time to warm up to a situation.
For parents, seeing shyness in kids can often cause some concern. They may think, "Will shyness hold
my child back?" But the truth is, shyness is not always a bad thing, and can have benefits.
To help kids who are shy, parents can first try to understand what is behind the behavior. In many
cases, children are simply born introverted while others are naturally more ooutgoing. Even within one
family, you can have one sibling who is shy and another who is a social butterfly.
In other instances, a child may feel shy in certain new or uncomfortable situations, or develop shyness
after an embarrassing experience. For instance, a child may feel shy in a new school but feel more
comfortable as he gets to know more people. Or he may forget a line in a school play and then be
reluctant about performing again in front of people.

What to Remember About Shyness in Kids

Shyness is something kids often outgrow, or at least learn to handle.
Even when a child is one of those shy kids who are plastered to a parents legs at birthday parties and
during the first days of school, they will eventually learn how to handle new situations much more
comfortably. It may take some time (sometimes years!) before an introverted child is more relaxed in
social situations, but it will get better.
Shy kids may still stay cautious.
Dont expect your child to be something she is not. A naturally introverted child will most likely never
become someone who jumps in immediately without hesitation and thrives in highly social settings.
She will probably still exercise caution in new situations and wont jump in with out checking things out.

People usually end up being a mixture of both.

Many people who were shy as kids can grow up to be great at social settings such as parties and
events. But there may be times when they also need to be alone and just be by themselves to create,
relax, or work on their own.
There are many important advantages to being an introvert.
A February, 2012 Time magazine cover story detailed some of the many upsides to being shy. They
include the following benefits:

Introverts may have fewer friends but they are deep and lasting relationships.

Introverts may be cautious, but they tend to think things through thoroughly and perhaps make
better decisions.

Introverts tend to be good at working alone for long periods of time to come up with new ideas.
Many kids who are shy are great at working by themselves -- say, to practice their skills as a
musician or a writer -- and are very creative.

How Parents Can HelpSummary

All young children can be naughty, defiant and impulsive from time to time, which is perfectly normal.
However, some children have extremely difficult and challenging behaviours that are outside the norm
for their age.
The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct
disorder (CD) and attention deficit hyperactivity disorder (ADHD). These three behavioural disorders
share some common symptoms, so diagnosis can be difficult and time consuming. A child or adolescent
may have two disorders at the same time. Other exacerbating factors can include emotional problems,
mood disorders, family difficulties and substance abuse.

Oppositional defiant disorder

Around one in ten 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

Children with conduct disorder (CD) are often judged as bad kids because of their delinquent
behaviour and refusal to accept rules. Around five per cent of 10 year olds are thought to have CD, with
boys outnumbering girls by four to one. Around one-third of children with CD also have attention deficit
hyperactivity disorder (ADHD).
Some of the typical behaviours of a child with CD may include:

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 sadistic 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 two to five 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 childrens 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 childs 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 childrens behavioural disorders

Disruptive behavioural disorders are complicated and may include many different factors working in
combination. For example, a child who exhibits the delinquent behaviours of CD may also have ADHD,
anxiety, depression, and a difficult home life.
Diagnosis methods may include:

Diagnosis by a specialist service, which may include a paediatrician, psychologist or child

psychiatrist

In-depth interviews with the parents, child and teachers

Behaviour check lists or standardised questionnaires.

A diagnosis is made if the childs behaviour meets the criteria for disruptive behaviour disorders in
the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.
It is important to rule out acute stressors that might be disrupting the childs behaviour. For example, a
sick parent or victimising by other children might be responsible for sudden changes in a childs typical
behaviour and these factors have to be considered initially.

Treatment of behavioural disorders in children

Untreated children with behavioural disorders may grow up to be dysfunctional adults. Generally, the
earlier the intervention, the better the outcome is likely to be.
A large study in the United States, conducted for the National Institute of Mental Health and the Office
of School Education Programs, showed that carefully designed medication management and
behavioural treatment for ADHD improved all measures of behaviour in school and at home.
Treatment is usually multifaceted and depends on the particular disorder and factors contributing to it,
but may include:

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 doctor (for a referral to a specialist service below)

Paediatrician

Child psychologist

Child psychiatrist

The Specialist Childrens Services, Department of Human Services Tel. 1300 650 172

The Resource Centre for Child Health and Safety (CHAS) Tel. (03) 9345 6429

Attention Deficit Hyperactivity Disorder Association of Victoria Tel. (03) 9890 2144 or 1800 233
842

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.

Things to remember

Some children have extremely difficult and challenging behaviours that are outside the norm for
their age.

These problems can result from temporary stressors in the childs life, or they might represent
more enduring disorders. The most common disruptive behaviour disorders include oppositional
defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder
(ADHD).

Boys are more likely than girls to suffer from behavioural disorders.

Treatment options include parent management training, cognitive behaviour therapy,

medication and treatment for associated problems.

Child Behavior Disorders

All kids misbehave some times. And some may have temporary behavior problems due to stress. For
example, the birth of a sibling, a divorce, or a death in the family may cause a child to act out. Behavior
disorders are more serious. They involve a pattern of hostile, aggressive, or disruptive behaviors for
more than 6 months. The behavior is also not appropriate for the child's age.
Warning signs can include

Harming or threatening themselves, other people or pets

Damaging or destroying property

Lying or stealing

Not doing well in school, skipping school

Early smoking, drinking or drug use

Early sexual activity

Frequent tantrums and arguments

Consistent hostility towards authority figures

If you see signs of a problem, ask for help. Poor choices can become habits. Kids who have behavior
problems are at higher risk for school failure, mental health problems, and evensuicide. Classes or
family therapy may help parents learn to set and enforce limits. Talk therapy and behavior therapy for
your child can also help.
Rely on teachers.
They have great ideas for how to handle shyness, especially in the classroom.
Know that it will change.
Shyness is something kids often outgrow, or at least learn to handle. My child was often the one
plastered to my leg at birthday parties and during the first days of school. Now, he is much more
comfortable in new situations. However, he is still cautious and doesnt jump in with out checking
things out.
Think about positives of being introverted.
Kids who are shy often enjoy meaningful relationships, tend to make careful decisions, and are often
better at creating and working alone.
Dont push.
Scolding your child for being shy wont change your child. In fact, it will lead to anxiety and may only
serve to make a child feel bad about himself.
Child Mental Health
It's important to recognize and treat mental illnesses in children early on. Once mental illness develops,
it becomes a regular part of your child's behavior and is more difficult to treat.
But it's not always easy to know when your child has a serious problem. Everyday stresses can cause
changes in your child's behavior. For example, getting a new brother or sister or going to a new school
may cause a child to temporarily act out. Warning signs that it might be a more serious problem include

Problems in more than one setting (at school, at home, with peers)

Changes in appetite or sleep

Social withdrawal or fear of things he or she did not used to be not afraid of

Returning to behaviors more common in younger children, such as bedwetting

Signs of being upset, such as sadness or tearfulness

Signs of self-destructive behavior, such as head-banging or suddenly getting hurt often

Repeated thoughts of death

To diagnose mental health problems, the doctor or mental health specialist looks at your child's signs
and symptoms, medical history, and family history. Treatments include medicines and talk therapy.
NIH: National Institute of Mental Health
Suicide
Suicide is the tenth most common cause of death in the United States. People may consider suicide
when they are hopeless and can't see any other solution to their problems. Often it's related to
serious depression, alcohol or substance abuse, or a major stressful event.
People who have the highest risk of suicide are white men. But women and teens report more suicide
attempts. If someone talks about suicide, you should take it seriously. Urge them to get help from their
doctor or the emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-TALK
(8255). It is available 24/7.
Therapy and medicines can help most people who have suicidal thoughts. Treating mental illnesses and
substance abuse can reduce the risk of suicide.
NIH: National Institute of Mental Health
Depression
Depression is a serious medical illness that involves the brain. It's more than just a feeling of being
"down in the dumps" or "blue" for a few days. If you are one of the more than 20 million people in the
United States who have depression, the feelings do not go away. They persist and interfere with your
everyday life. Symptoms can include

Sadness

Loss of interest or pleasure in activities you used to enjoy

Change in weight

Difficulty sleeping or oversleeping

Energy loss

Feelings of worthlessness

Thoughts of death or suicide

Depression is a disorder of the brain. There are a variety of causes, including genetic, environmental,
psychological, and biochemical factors. Depression usually starts between the ages of 15 and 30, and is
much more common in women. Women can also getpostpartum depression after the birth of a baby.
Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder.
There are effective treatments for depression, including antidepressants and talk therapy. Most people
do best by using both.
NIH: National Institute of Mental Health