Conduct Disorder

Sara Mitchell Sherman

What is Conduct Disorder?

Conduct disorder is a set of ongoing emotional and behavioral problems that occur in children and teens. Problems may involve defiant or impulsive behavior, drug use or sometimes criminal activity. The sooner the treatment for conduct disorder is started, the more likely the child will learn adaptive behaviors and avoid potential complications. The sooner the treatment for conduct disorder is started, the more likely the child will learn

Symptoms
Breaking rules without clear reason Cruel or aggressive behavior toward people or animals (for example: bullying, fighting, using dangerous weapons, forcing sexual activity, and stealing) Not going to school (truancy -- beginning before age 13) Heavy drinking and/ or heavy drug abuse Intentionally setting fires Lying to get a favor or avoid things they have to do Running away Vandalizing or destroying property Children with conduct disorder tend to be impulsive, hard to control, and not concerned about the feelings of other people These children often make no effort to hide their aggressive behaviors. They may have a hard time making real friends.

Treatment
There is no real test for

diagnosing Conduct Disorder. The diagnosis is made when a child or adolescent has manifested three or more of the behaviors listed previously in the past 12 months, with at least one criterion present in the past 6 months. Medication and family approaches have been utilized with varying degrees of success. There is no one medication or treatment of choice. Behavior therapy attempts to provide a high level of structure which is generally needed by children with CD. Behavior therapy helps the child make crucial cause and effect connections that he or she has not been able to do previously, either through lack of experience or inherent lack of capability. Behavioral plans should be coordinated between school and home for maximum effectiveness. Treatment is often conducted in the context of the family and the family may require assistance, ranging from education about basic parenting skills to management strategies for the disturbed child. Treatment may also include medication in some children, such as those with difficulty paying attention, impulse problems, or those with depression.

Teaching Strategies
The best way to treat a child with Conduct Disorder in and out of the classroom is with behavior management techniques. Use a consistent approach to discipline and following through with positive reinforcement of appropriate behaviors. Give respect to earn respect.
Meet with the student and parents early in the school year to discuss how the school can support this student's needs related to CD. Develop consistent behavior expectations. Communicate with parents so that strategies are also consistent at home. Apply established consequences immediately, fairly and consistently. Establish a quiet cooling off area. Provide a positive and encouraging classroom environment. Give praise for appropriate behavior and always provide timely feedback. Provide a 'cooling down' area/time out. Avoid confrontation and power struggles The physical placement of the student with conduct disorder should be chosen carefully (e.g., who to sit beside, physical distractions, room to move, proximity to the teacher). Create a Behavior Contract. List two behaviors - positive and the reward, negative and state the consequence. This could be a self evaluation for more mature students and a great way to document behaviors for parents and administrators. Create a Problem Solving worksheet. What was the problem, what was the result, what are ways the problem could have been solved and prevented, in the future the student will... Again a great way to document behaviors for parents and administrators. The student needs to be accountable for their actions/reactions.

References
Chandler, James, MD, FRCPC: Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in Children and Adolescents: Diagnosis and Treatment retrieved from: http://www.klis.com/ chandler/pamphlet/oddcd/ oddcdpamphlet.htm#_Toc121406172 Conduct Disorder - National Library of Medicine retrieved from: http:// www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0001917/ #adam_000919.disease.symptoms Conduct Disorder Support & Resources retrieved from: http://www.aboutourkids.org/ families/ disorders_treatmentsaz_disorder_guide/ conduct_disorder/support_resources Medical/Disability Information for Teachers retrieved from: http:// www.learnalberta.ca/content/inmdict/ html/conduct_disorder.html Nurcombe B. Oppositional defiant disorder and conduct disorder. In: Ebert MH, Loosen PT, Nurcombe B, Leckman JF, eds. Current Diagnosis & Treatment Psychiatry. 2nd ed. New York, NY: McGraw Hill;2008:chap 36

Early Intervention & Safety

Early intervention is key to helping a child or adolescent with CD. Once detection of the disorder is made it is important to begin treatment right away to be successful. The safety of a child or adolescent with Conduct Disorder is of great concern. Because these children may be vandalizing or setting fire to property even in your own home - you may not feel safe as well. It is a challenge for parents, siblings or foster parents to live with someone who suffers from Conduct Disorder. It is crucial that these children seek treatment. ConductDisorders.com - Site set up by parents of challenging children

Child, Adolescent and Family Branch Division of Service System Improvement Center for Mental Health Services Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road, Room 6-1035 Rockville, MD 20850 Tel: (240) 276-1887 www.mentalhealth.samhsa.gov/cmhs/ ChildrensCampaign The American Academy of Child and Adolescent Psychiatry 3615 Wisconsin Ave., N.W., Washington, D.C. 20016-3007 Tel: (202) 966-7300 Fax: (202) 966-2891 www.aacap.org Conduct Disorder Children With Oppositional Defiant Disorder

Family Resources