Conduct Disorder

What is it and how you can help

By: 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 management strategies to aid in daily function

Signs and 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 drug abuse Intentionally setting fires

Lying to get a favor or avoids things they have to do Running away Vandalizing or destroying property Children with CD tend to be impulsive, hard to control and not concerned about the feelings of others These children often make no effort to hide their aggressive behaviors They have a hard time making 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.

Teaching Strategies

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, and 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.

Intervention & Resources

Early Intervention and 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. Conduct Disorders - a website set up by parents of challenging children

Family Resources
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 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

Podcast on Conduct Disorder

Listen to the free Podcast on Conduct Disorder Released Feb 26, 2013; InsHealth: Clinical trials, Conduct Disorder 26 February 26, 2013 (This is a 28 minute Podcast if you have further interest in CD) Brief Synopsis: Dr Mark Porter puts the Pharmaceutical Industry in the spotlight as some clinical trials are criticized for testing new drugs against a much weaker rival so that the results appear much better than they really are. Kamran Abbasi and Dr Bina Rawal from the Association of British Pharmaceutical Industry discuss if the hurdles are being set too low, so that a new therapy comes out on top. And what if sustained periods of adversity in childhood are associated with permanent structural changes in brain development? So suggests new research into adolescents with Conduct Disorder - a controversial diagnosis given to 1 in 20 teenagers in the UK with aggressive or anti-social behavior. Mark Porter investigates.

Brief Summary

Click on the link below for a brief summary about Conduct Disorder. If you know a child in need, please have them seek treatment immediately. The sooner they can be treated, the better they can function in their lives and in your classrooms. What is Conduct Disorder?

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_r esources Medical/Disability Information for Teachers retrieved from: http://www.learnalberta.ca/content/inmdict/html/conduct_disorder.html Nurcombe B. Oppositional defiant disorder andconduct 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 Porter, Mark. Inside Health. Clinical Trials, Conduct Disorder. Podcast. iTunes. iTunes, 26 Feb. 2013. Retrieved from: https://itunes.apple.com/us/podcast/inshealth-clinical-trials/id263166507?i=134231578&mt=2 Williams, Kimberly. What is Conduct Disorder? Online video clip. YouTube. YouTube, 2 May 2012. Retrieved from:http://www.youtube.com/watch?v=g58qUHEq6fU