Behavior Disorders

According to Johns Hopkins, behavior disorders “constitute behaviors that consistently ‘break the rules,’ disrupt the lives of those around them and defy authority.” Although oppositional or defiant behavior is common in very young children and teens, in severe cases it can require professional assessment and intervention. Behavior disorders can be classified into two distinct categories. In oppositional defiant disorder, the rules broken are those that occur at home and at school. These can include regular temper tantrums, failure to accept responsibility for inappropriate behavior, and frequent defiance of parents and teachers. In conduct disorders, behaviors are often aggressive and threatening to others, like people and animals. Other behaviors include bullying, lying, stealing and truancy.

Diagnosing a behavior disorder requires a qualified mental health professional to gather information about the child, their behavior, and environment. No single test can diagnose a child as having a behavior disorder, and other problems, like ADHD, trauma, and anxiety, can have similar symptoms. Evaluations include a combination of in-office testing procedures; questionnaires completed by parents, teachers, and children; and clinical observations. Diagnostic evaluations not only help the parents and teachers of a child with behavior disorders better characterize that child’s difficulties, but they also can help the child more clearly and accurately understand their own personal strengths. Recognizing symptoms and seeking help early will lead to better outcomes for both affected children and their families.

The type, duration, and frequency of supports will vary depending on each child and their needs. Evidence-based supports include school-based evaluations for Individualized Education Plans (IEPs) or 504 Plans that provide the child or adolescent with modifications or accommodations can be beneficial. Functional Behavior Assessments and Safety Plans are important for understanding the relationship between the child’s motivations, behaviors, environment, and consequences and establishing a common protocol across teachers and classrooms for managing behaviors. Often children and teens with behavior challenges benefit from having a safe adult to speak with at school, time with a mental health provider to teach coping and mindfulness skills, and a menu of coping skill options to use during the school day (e.g., deep breathing, fidgets). They often thrive when given more control over their environment. Opportunities to instill choice in where a child sits or modality for completing assignments are important to include. Offering leadership opportunities, such as a classroom job, can also help increase healthy behaviors.

Regarding academics, providing extended time, reducing workload, and offering a separate space for testing can help children and teens. Sometimes, children will need time with a special education provider to close any academic knowledge or skill gaps. In cases of high school refusal or severe behaviors, alternate options for schooling may be appropriate (e.g., online school, Affective Needs programs). Outside therapy with a trained mental health provider is recommended. Cognitive Behavioral Therapy and family therapy are appropriate treatment modalities, although play therapy and expressive therapies, such as art therapy, can also be helpful.

Explore the types of therapy provided at WCP. Research suggests that including medication alongside behavioral interventions can increase their effectiveness. Although including medication is always the caregiver’s decision, in many cases medication can give the brain the “boost” it needs to better learn and apply the skills gleaned in other interventions. Speaking with a child psychiatrist, pediatrician, or other trained healthcare provider is essential for deciding the best type and dose of medication.

Other posts about behavior disorders can be found on the WCP blog.

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