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Behavioral Disorders

ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These behaviors usually begin before the child is 7 years old but may not be noticed until the child is in school.

Doctors do not know what causes ADHD but we do know what does not cause it. It is not caused by too much sugar, bad parenting or watching too much TV. Researchers who study the brain believe that some people with ADHD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior.

As many as 5 out of every 100 children in school may have ADHD. Boys are three times more likely than girls to have it. In fact, ADHD is one of the most common of all the children’s disorders.
There are three main signs, or symptoms, of ADHD. These are:

  1. Problems with paying attention, Children with this feature of ADHD:
    • Have problems paying close attention to details;
    • Can’t stay focused on play or school work;
    • Don’t follow through on instructions or don’t finish school work or chores;
    • Can’t seem to organize tasks and activities;
    • Get distracted easily; and
    • Lose things such as toys, school work, and books.
  2. Being very active (called hyperactivity). These children:
    • Fidget and squirm;
    • Get out of their chairs when they’re not supposed to;
    • Run around or climb constantly;
    • Have trouble playing quietly;
    • Talk too much;
  3. Acting before thinking (impulsiveness). These children:
    • Blurt out answers before questions have been completed;
    • Have trouble waiting their turn;
    • Interrupt others when they’re talking; and
    • Butt in on the games others are playing. (American Psychiatric Association, 1994)

These behaviors can cause a child to have many problems at home, at school, and with friends. Because of these problems, many children with ADHD feel anxious, depressed and unsure of themselves. These feelings are not symptoms of ADHD. They come from having problems again and again at home and in school.

There is no quick treatment for ADHD. However, the symptoms of ADHD can be managed. It’s important that the child’s family and teachers:

  • Find out more about ADHD;
  • Learn how to help the child manage his or her behavior;
  • Create an educational program that fits the child’s individual needs; and
  • Provide medication, if the parents and the doctor feel this will help the child.

School can be hard for children with ADHD. Success in school often means being able to pay attention and control behavior and impulses. These are the areas where children with ADHD have trouble.

There are many ways the school can help students with ADHD. Some students may be eligible to receive special education services under the Individuals with Disabilities Education Act (IDEA). Your child may be eligible for special education services. Supports or changes in the classroom (called adaptations) help many students with ADHD do better in school.

TIPS FOR PARENTS

  • Learn about ADHD. The more you know, the more you can help yourself and your child.

  • Acknowledge and encourage her strengths and talents.

  • Be specific, be consistent, and be positive. Set clear rules for your child. Tell her what she should do, not just what she shouldn’t do. Be clear about what will happen if your child does not follow the rules. Have a reward program for good behavior. Praise your child when she shows the behaviors you like.

  • Learn methods that will help your child manage her behavior. These include techniques such as charting, having a reward program, ignoring certain behaviors, using logical consequences, and time-out. These strategies can lead to more positive behaviors and cut down on problem behaviors. Your mental health professional or parent support group will have resources that can teach you about behavior management.

  • Talk with your doctor about whether medication will help your child. Your doctor is the best source of reliable information about medication. Unfortunately, many people rely on other sources, such as the media, for information. Recently, there has been a lot of publicity about children who are being over-treated with medication. This publicity has scared many parents away from a treatment that works. Being on medication does not mean that you or your child are ‘failures.’ ADHD is a medical disorder that can be helped by medication.

  • Pay attention to your child’s mental health (and your own!). Be open to counseling. It can help you deal with the challenges of raising a child with ADHD. It can help your child deal with frustration, feel better about herself, and learn new social skills.

  • Talk to other parents whose children have ADHD. Parents can share practical advice and emotional support. Call your community mental health center to find out about parent groups near you. CHADD (Children and Adults with Attention Deficit Disorder) is a national group that has chapters throughout the country.

  • Meet with your child’s school to work out an educational plan that will help her succeed in school. Both you and your child’s teachers should get a written copy of this plan.

  • Keep in touch with your child’s teacher. Tell the teacher how your child is doing at home. Ask how your child is doing in school. Offer support.

Oppositional Disorders

At some time or another, all children become oppositional. They may argue, throw tantrums, talk back to teachers and parents and intentionally disobey authority figures. In fact, at some ages, being oppositional is a normal developmental trait. Toddlers and young teens become oppositional from time to time to help them separate from their parents and gain their independence. Yet some children display oppositional behavior that is far out of line with other children, or causes severe problems at school or in the family. If this is the case, your child may be helped by treatment. Some common signs of oppositional disorder include:

  • Frequent temper tantrums or angry outbursts
  • Deliberately irritating or provoking others
  • Inability to learn from or take responsibility for own mistakes and behavior.
  • Lying to get out of trouble or to get attention
  • Refusing to comply with requests that other adults or teachers make.
  • Saying mean and hateful things to others on purpose.

TIPS FOR PARENTS

  • Set reasonable limits and consequences in the home. Learn techniques that will help you manage your own anger and frustration, because giving discipline when your are angry is not successful. If you are too angry to deal with a situation, take a time out.

  • Don’t try to bully, humiliate or threaten your child into behaving. This does not work and may only serve to create an environment where the anger feeds on itself. When a child is humiliated, he or she may feel threatened and compelled to fight back.

  • Don’t forget your child’s positive qualities. Adults tend to focus on the child’s negative qualities, because the child’s behavior is so often negative. Learn to recognize when your child does something positive and reinforce these things by giving praise and rewards that are important to the child.

  • Because parenting a child with ODD can be challenging and frustrating, it is important to get support for yourself and for other family members. Join a parent support group, a church group or some other activity that will help you gain back your emotional strength.

  • Take time out for yourself and your spouse. Make a special date with your spouse if you have to.

Conduct Disorders

A conduct disorder can be thought of as being at the further end of the spectrum of behavior disorders. Children with conduct disorders often violate the basic rights of others and break major rules. They may become involved in criminal behavior or behavior that is dangerous to them or to others. Unfortunately, many authorities don’t view children with a conduct disorder as having a mental health problem. Instead, they are seen as juvenile delinquents or as "bad" kids. Many of our children in juvenile justice facilities may have a conduct disorder. In fact, it is estimated that over half of all children in juvenile justice facilities are dealing with a mental health issue. Many are not receiving any treatment.

Symptoms of a conduct disorder include:

  • Aggressiveness toward others in a way that threatens them or hurts them. Examples include harming animals, bullying or assaulting others, use of weapons.

  • Destroying property by deliberately setting fires or breaking things, vandalism, breaking into homes or businesses.

  • Lying, stealing, shoplifting

  • Running away from home overnight, refusing to attend school.

These behavior problems are serious and can lead to long term consequences such as dropping out of school and jail time, so it’s important to get treatment for your child. If your child ends up in the legal system because of this disorder, you need to advocate for him to ensure he gets treatment while he is incarcerated.