What are behavior disorders?
Behavior disorders or problems are one of the main reasons why parents turn to health professionals. They are characterized by serious, repetitive and persistent misbehavior. It goes far beyond being a “naughty child” or a “rebellious teenager.”
The most recent longitudinal studies show that children with predominantly hyperactive-impulsive typeare at increased risk for behavior mproblems and/or disorders, as well as learning difficulties, substance abuse and self-harm in adolescence and adulthood.
The comorbidity rate between ADHD and other disorders is high, that is, ADHD often co-occurs with other psychiatric disorders in the same individual.
In addition, studies suggest that 40% to 60% of children diagnosed with ADHD will suffer from an additional condition called oppositional defiant disorder (ODD) at some point in their lives.
Studies indicate that 1.5% to 3.4% of young people may suffer from this problem, with boys being 3 to 5 times more likely to have ODD than girls.
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Oppositional defiant disorder (ODD)
Oppositional defiant disorder is a type of disorder included in the DSM-V, one of the so-called disruptive, impulse-control, and conduct disorders.
ODD is defined as a pattern of angry/irritable mood, argumentative/defiant behavior exhibited during interaction with at least one individual who is not a sibling.
Children with ODD argue and refuse to follow any command given by adults, there for etesting parents and teachers limits.
ODD is more common in boys than in girls.
Intermittent explosive disorder (IED)
Intermittent explosive disorder is a mental disorder characterized by explosiveepisodes of reactive, aggressive behaviorthat are out of proportion to the situation, which result inproperty damage and/orserious physical harm to others and themselves.
Conduct disorder (CD)
Conduct disorder is a moreseveretype of behavior disorder, and up to 40% of children with oppositional defiant disorder (ODD) may eventually develop conduct disorder.
Conduct disorders are characterized by a recurring and persistent pattern of behavior involving the violation of others’ basic rights and age-appropriatesocietal norms or rules.
Conduct disorders typically occur in late childhood orearly adolescence when children, sick of persistent fighting with parents and teachers, choose to defy them. These children and youngsters do not respect others’ rights and can end up becoming juvenile delinquents.
An intervention model for the treatment of behavior problems in children with ADHD
An effective intervention for the treatment would include the following steps:
- Psychoeducation. In this first step, it is important for children to be aware of their situation and to explain the whole intervention process that is about to take place to their parents.
- Autogenic training. During this period, we will work with the children in self-control strategies to provide them with useful tools to face the problems that arise. We can choose from a number of strategies, depending on the child developmental stages. We can teach the Turtle Technique, the stoplightsystem, etc.
- Tokeneconomy. Both the children and the parents are explained how this system works; the children need to understand very well what target behavioris to be reinforced and what the reward will be if they succeed.
At this stage, it is important to explain the concept “ceiling effect” to parents. This “ceiling” prevents children from providing appropriate responsesat all times. Their delayed brain maturation makes it very difficult for them to exhibit timely behaviors.
It is necessary to keep in mind that ADHD is associated with delayed maturation of the cerebral cortex of more than two years.
It is unfair, yet very common, when children with ADHD also develop some type of behaviordisorder. The good news is that this comorbidity disappears when they reach adulthood. However, the most effective way to avoid these disorders is to regularly monitor the child’s behavior and to turn to a mental health specialist at the earliest warning sign. Family involvement in these cases is essential for any successful intervention with the child.
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