Youth, Disabilities and Transitioning into Adulthood

     Youth, Disabilities and Transitioning into Adulthood

    

       There is a long history of ignorance towards people who have been afflicted by a disability that has led to such cruel acts as lobotomies, sterilization, imprisonment, parent blaming and general isolation and segregation. An introduction to the culture of disability plays a key role in transforming the outdated ideas about disability by those without disability. It is important that a person with a disability is defined as a person first and the disability is second instead of being labeled as disabled where the disability defines the person (Tower, 2003). “People with disabilities want to be treated like ordinary people, not elevated or reduced in status in comparison to others” (Tower 2003, p. 15). Those with a disability are stepping out of stigmatization by redefining their disability as a culture and as having power because their power is in difference and in great numbers speak as one voice. Yet this culture is no different than any other race, culture or religion that is discriminated against in our society. Those with disabilities tend to be among the highest unemployed, at the highest rates of poverty, and facing stigmatization that affects socio-economic status and well being.

                If the ignorance, labeling and discrimination of disability are not enough, Mendes and Snow (2014) suggest that there is a widespread deficit in preparing, transitioning and sustaining those afflicted with a disability as they transition out of care or simply into adulthood at the age of 18. Most care leavers were put into care due to abuse and neglect so transitioning out of care is an important step.  Transitioning into adulthood is a difficult and scary time for all youth yet poor outcomes are all too common youth with disabilities where difficulties are magnified greatly by their vulnerability. However, instead of aiding them to be able to live fulfilling lives, often people with disabilities are placed inappropriately in old age homes due to a lack of accommodations, resources and support. Mendes and Snow (2014) suggest that transition planning should exist in many domains of life which include things like housing, health, education, employment and social networking. Instead, transitions are not well planned, are inadequate, and the response to need is repeatedly driven by crisis rather than preplanning. In fact many people with disabilities who transition out of state care have few options and very often ask to be reunited with their biological families, many of whom have abused and neglected them in the past, too often resulting in incarceration or homelessness. In addition, those who have loving families also struggle to find information, resources, accommodation, financial assistance and general aid to ensure an independent, fulfilling and happy life for their children with a disability. To make matters worse, Menes and Snow (2014) suggest that many people with disabilities also have additional mental health issues and yet they are not aided to receive needed treatment in adulthood. As a consequence they have difficulty with simple life tasks like cooking, shopping, finances or retaining support and medical services. Greater collaboration between agencies is needed, especially between child protection and disabilities services and to ensure those who are transitioning out of care have preplanned and ongoing support and care to ensure their well being into adult life. In addition organizations need to ensure that information about planning for the future needs to be communicated years before children, families and state care facilities are expected to send youths into adulthood and the adult world.

                Finally, narrative approach which is a post modern, social constructionist approach helps those with disabilities reinterpret their stories with new and empowering narratives. Lambie and Milsom (2010) suggest that young people with disabilities are at far greater risk for many things including risk taking, low self esteem, gang involvement, substance abuse, bullying, teasing and incarceration largely due to the defeatist language and hopelessness of their dominant negative self narratives. One of the major goals of narrative therapy is to help clients to realize that our knowledge and realities are socially constructed and thus are constantly subject to change where one truth is not the truth but only one possibility. Our job as a social worker is to help clients find the positive attributes and aspects of who they are and the strengths they possess in their lives and help them to retell their dominant negative narratives forged by past language, history and culture in light of those strengths and positive attributes. Lambie and Milsom (2010) suggest that we need to deconstruct the dominant story, help the client define and externalize the problem, objectify and separate it from the person, look for strengths and positive attributes and then empower the client to reconstruct a new narrative using these once hidden and unearthed strengths and attributes to allow them to look at their lives from a different and more positive perspective.

I believe that difference is important yet I also find it to be a dichotomy of concern. First, difference causes isolation, discrimination, anger, war and strife and from the beginnings of time has separated peoples, cultures, religions, skin color and appearances. However, difference also allows us as a human race to grow, develop and learn from one another. I truly wonder that if we were all the same would we, or could we, ever evolve into higher beings? The trouble with difference is that we place value on it instead of seeing it from a perspective of neutrality and as a resource for all. Those very differences cause us to separate ourselves, identify as groups, and confine ourselves from each other. Here is the concerning and current dichotomy I feel we have; Difference can aid us in becoming a better group of beings who together can do wondrous things and yet it also separates us and forms division and often animosity, suffering and death.

As a social worker, I feel it is my job, my duty and more important my moral obligation as a human being to see all people as different and yet not divided but rather playing different and essential parts in the whole of humanity, while advocating on behalf of humanity to help them see this truth. Everyone is equal because everyone is needed, everyone is important, everyone has a part to play and everyone has strengths, value and uniqueness that need to be combined to create a greater whole. No person is an island and no person was meant to be. We are all connected and that connectedness needs to be nurtured and sustained and enhanced.

So as a social worker, how do I help facilitate this? I believe that one of the most important skills and advocacy requirements is to ensure the well being of our children, all of our children, and then to establish a well-defined transition into adult hood where they are ready and well equipped for a sustained and happy life into old age. Additionally it is important for all transitioning youth to see their incredible worth and the worth of every other youth on our planet and that difference is not only okay but it is necessary. We currently do a very poor job of this. If there is one thing I have seen during my placement is the very dire need across this province, and no doubt across this country, to ensure our children are given the right tools, resources and support to make that important and crucial successful transition into adult hood. We do such a great job protecting and serving our children but we leave the vulnerable virtually abandoned when they turn 18. The frightening result is that many of these young adults who come from out of home care return to the same destructive lives we have saved them from, or we leave a struggling family with very little or no support and minimal resources left to take care of themselves and their child’s future. As parents we would never do that to our children and yet as a society we do this regularly to our disabled and needful children. Even those who have the means, still struggle for resources, information and support in moving forward in transitioning their child with a disability into a meaningful adult life. This makes me angry as a parent and as a social worker because we seem to discard or devalue much of our youth, who are our very future!

My belief is that we need to aid these children in their transition to adulthood much more than we currently do. I have found that many of our children relay narratives which communicate low self esteem, hopelessness and a sense of defeatism which compounds the existing transitioning problem. I feel very strongly that these narratives need to be deconstructed, we need to search for the many strengths and attributes found in every child’s daily living, and to reconstruct those narratives to show these children that they are indeed special, valued, and can accomplish great things once they have a narrative that exemplifies their strengths, attributes and unique characteristics.

                I look forward to many years as a social worker helping children see their incredible value, strength and much needed role in our every changing world and then help them transition into the best people they can be in their adult lives.

References

Lambie G.W., & Milsom, A. (2010). A narrative approach to supporting students diagnosed with learning disabilities. Journal of counselling & development, 88, 196-203.

Mendes, P., & Snow, P. (2014). The needs and experiences of young people with disability transitioning from out-of-home care: The views of practitioners in Victoria, Austraila. Child and youth services review, 36, 115-123.

Tower, K.D. (2003). Disability through the lens of culture. In: International perspectives on disability services: The same but different. Yuen, Francis K. O. (Ed.); Binghamton, NY, US: Haworth Maltreatment and Trauma Press/The Haworth Press, pp. 5-22.

The effect of domestic violence on children in the context of child protection

The effect of domestic violence on children in the context of child protection

Introduction

Neglect, a category of child maltreatment that is inescapably linked to conditions of poverty and is the most common reason families are brought to the attention of child welfare agencies in Canada. However, also very prevalent are the lack of social supports, mental health problems, and particularly important but often overlooked, is the exposure to domestic violence (Davies, Krane, Collings & Wexler, 2007). In fact, “there is “extensive evidence that children of all ages are found to be affected by exposure to domestic violence” (Lewin, Abdrbo, & Burant, 2010, P. 129).

Mental health also plays an important factor in family violence and there are many peripheral effects on children. “The negative effects of depression on parenting have been well documented and include lower attachment security, social-emotional problems, diminished child well-being, lower adaptive functioning, and child behavioral problems (Lewin et al. 2010, P 129). In addition, when parental drug or alcohol misuse co-exists with domestic violence there is a dramatic increase in the serious adverse effects on children in the home in all aspects of their lives. (Devaney, 2008, p 450)

Domestic violence critically affects children an almost every aspect of their lives. “Over time, a childhood history of family violence heightens the risk for impairments in emotional and behavioral functioning.” (Becker, Mathis, Mueller, Issari & Atta, 2008, p. 188).  Research consistently shows that children living with domestic violence have much higher rates of depression and anxiety, trauma symptoms and behavioural and cognitive problems, experiencing physical or sexual abuse, maladaptive behaviours in adulthood and risk for alcohol abuse and drug abuse (Devaney, 2008,), (Lewin et al. 2010), (English, Marshall & Stewart, 2003). Furthermore Domestic violence increases likely hood of incidence involving Child protective services and likelihood of child placement in foster care (English, et al.).

“Among “preschoolers (25–59 months) who were exposed to household violence, investigators found significant links among child behavior problems, marital violence, higher maternal stress, and impaired quality of the mother-child relationship” (Lewin et al. 2010, Pg 129)

The relationship between exposure to domestic violence in childhood is linked to low self esteem, social withdrawal, aggression, violence, and delinquency and  higher levels of externalizing and internalizing behavior problems in adolescence (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2010), (English, Marshall & Stewart, 2003).

A study of children with “concurrent exposure was found to have lower scores in math, reading, and general knowledge, along with poorer self-control and interpersonal skills” (Lewin et al. 2010, p. 129). Additional studies show that different forms of family violence often do co-occur, and that children who exposed to violence in the home are often are abused as wells as exposed to a variety of other risk factors known to increase internalizing and externalizing behaviors in adolescence yet rarely are these risk factors taken into account when in child protection matters (Moylan, et al. 2010).

Several studies have also found that “children were twice as likely to be physically abused by mothers or fathers" in households where there was battering and domestic violence (English, et al. 2003 p. 43). In addition, “between 45% and 75% of women in domestic violence shelters report that their children experienced one or more forms of maltreatment (English, et al.).

Domestic violence is now a recognised form of child abuse in parts of Australia and has become one of the most common reasons for notifying child protection services which has put enormous pressure on such organizations to ensure they respond appropriately (Potito, Day, Carson & O'Leary, 2009) and yet a “growing body of research informed literature has highlighted professional ignorance and avoidance of the issue of domestic violence within practice” (Devaney, 2008, p. 444).

Studies show that domestic violence on its own does not typically lead to intervention but rather, child protection agencies tend to act on other forms of maltreatment and other environmental risk factors instead. Ironically, spousal abuse is associated with an increase in individual and family problems, however the lack of any link between domestic violence and ongoing child protection services is quite surprising (Lavergne, Damant, Clément, Bourassa, Lessard, & Turcotte, 2011)

It is now commonly accepted that child abuse and domestic violence often co-occur in the same families (Potito, et al. 2009 p. 370) and  we can help protect children by understanding that there is an overlap between domestic violence and child sexual abuse by the same perpetrator (Kelly &, Mullender, 2000). As children are more affected by co-occurring domestic violence and maltreatment, it is important that the link between domestic violence and other family problems are taken into account at the crucial stage in initial child protection cases or they will not be taken into account when the casework is developed either. One study revealed that domestic violence was reported in close to 25% of risk situations and yet, fewer than 10% of casework plans contained references to domestic violence. By not addressing domestic violence in the casework plan the child’s likelihood of re-entry into the child protection system increases dramatically (Lavergne et al. 2011)

Family /Mothers /Fathers

In another recent study of 111 women over 30% of mothers reported the accidental injury of a child during a domestic violence incident, over 25% described the intentional injury of a child by an abusive partner during the child’s attempt to intervene to stop the abuse and 25% of the mothers reported their children were made to watch them as they were being physically or sexually assaulted. Child protection agencies report that domestic violence is involved in well over half of 50% of child protection cases of the known 156 children in New South Wales who died in 2007 (Potito, et al. 2009).

Child protection workers in the UK also found that the male abuser was invisible or absent during contact with the family, were not being recorded in case files, were frequently absent during assessments and not included in the intervention processes. If domestic violence was noted, any inaction was explained as not being a part of state intervention but is a private matter to be resolved by the couple. In addition, there was a tendency to regard breakdowns in the family as the woman’s private problem which she must resolve on her own. The interventions that do occur focus on the role of the woman as a mother and her responsibility for the protection of the children but not on her needs to deal with domestic violence. They found that women were held to different standards than men where women were held as the primary responsible individual for the child’s safe environment and the responsibility for ending the violence negating the male’s responsibility for perpetrating the abuse. Women were often given ultimatums to leave the home in order and keep her children or stay and lose them. Very often workers noted the outside child protection organizations the reluctance of women in domestic violence to seek assistance from child protection in fear of having their children removed from their care. (Humphreys & Absler, 2011)

“In a list of nine risk factors cited by a social worker’s report domestic violence was not mentioned, yet the woman had been assaulted and her house ‘trashed’ only a few days prior to the report for a child protection being written. The social worker had been shocked at the time at the level of damage that she saw when she visited the flat: the furniture had been ripped with a knife. Later, it came to light that the woman had been assaulted. The social worker said: I can’t imagine why it is not in the report. . . . I can only think that I didn’t think it is the type of thing that is relevant to the child protection particularly making decisions about care proceedings. They’re not interested in domestic violence” (Humphreys & Absler, 2011 p. 466)

“They [social workers] wanted my children . . . I was black and blue, being told that I was going to lose the most important thing and precious thing in my life. . . . I had to fight for three days and prove that I wasn’t having my husband back for me to keep my children (Denise)” (Humphreys & Absler, 2011 p. 466)

It is disturbing that “underlying discourses holds women accountable for their ‘failure to protect’ their children, and continues to ignore the impact of men’s violence on women and children or hold men responsible for their behaviour (Humphreys & Absler, 2011 p. 469). “While the majority of child care is still undertaken by women it is inevitable that they will be implicated if children receive inadequate or inappropriate care” and unfortunately “it is their caring role that remains under scrutiny” (Turney, D., 2000 p. 52)

Unfortunately mothers are both idealized and demonized and holding them exclusively responsible for a child’s care has lasting psychological consequences. In addition, studies clearly show that a woman’s inability to mother is often related to her own childhood traumatic events, and many times due to domestic violence. The effects of unrealistic cultural standards and ideas for women can be confronted by the social worker by developing a mothering narrative giving rise to a deeper appreciation of the conditions, a more accurate evaluation of a given child’s situation and allowing a mothers’ interpretation to become a meaningful component of the professional judgement (Davies, Krane, Collings, & Wexler, 2007).

It is also important as social worker to keep in mind that child welfare client’s perception of child abuse or good parenting may differ dramatically from those of child protection organizations. These differences can often be intensified by social class and race ability and age. Therefore in order for a child protection worker to understand a clients’ subjective experience of mothering and risk to the child, they must connect with women whose lives and world views may be considerably different from their own. There is no question that for child protection workers, the main focus is ensuring the safety and well-being of the children at risk. However too often child protection workers become blinded by the idea that the child is the primary client and leaving the issues and needs of the parents, which are often the cause of the intervention in the first place, as secondary (Davies et al. 2007).

instead of accusing blaming and demonizing the mother for the child’s welfare in domestic violence a safety plan might be adopted where the child protection worker explores the mother’s supports, options and available resources as well as who she can call, where she can go, and what other needs can be set in place to help thereby promoting her resilience (Davies et al. 2007).

Interventions

Child welfare workers are faced with dichotomy of administering both care and control, being mandated to investigate child maltreatment and intervening the private lives of families when a child is at risk. Child protection workers know they may need to exercise their mandate in court by removing a mother’s children from her care using the very information a mother presented to her worker towards a case against her in court (Davies et al. 2007).

A child’s well being in turbulent and violent households who are known to Child protective services are predominantly affected by their relationship with their primary caregiver up to the age of 6. In their later years children the dependence on the primary caregiver weakens and is replaced by the growing influences of other adults and peers, thus at least partially mediating the effects of earlier domestic violence and buffered by new positive relationships (English, et al. 2003). This highlights the importance of ensuring a safe and loving haven for the children in alternative care if this becomes necessary.

There are several studies that show interventions and treatments that include the mother and or father in domestic violence greatly increases the likely hood of reducing both the parents and the child’s internalizing and externalizing difficulties with the most common interventions targeting emotional, cognitive and behavioral difficulties (Becker, et al. 2008).

“It is commonly held that children are best cared for in the context of their own families, and that substitute care often results in devastating effects. The broken attachments and recurring disruption endemic to long-term substitute care suggests that, where possible, it is better to support children in their homes. (Davies et al. 2007 p. 24)

Disagreements between social workers and their clients are common and resolving them is not easy because the child protection worker holds a position of power and authority in the relationship with their clients and must often make difficult and intrusive action for the safety of a child. The willingness of the child protection worker to develop familial and trusting relationships with clients is shadowed by the fear that if further invasive interventions are required, the interventions may be seen as a betrayal. Also a client’s powerlessness in these situations can induce further resistance to interventions which is further influenced when the court system becomes involved and dampening the relationship between child protection worker and the client (Davies et al. 2007).

Where child protection action and intervention requires more intrusive interventions, for example the placing the child in substitute care as well as the return to the home from substitute care, attending to the mothering narrative must remain central by exploring the emotional and material ramifications of the intervention and return of children which can a very traumatic for both mother and child giving rise to confusion, guilt, shame anger or even relief and happiness (Davies et al. 2007).

 

References

Becker, D., Mathis, G., Mueller, C., Issari, K., Atta, S. 2008.  Community-based treatment outcomes for parents and children exposed to domestic violence. Journal of Emotional Abuse. 8, 1-2, p. 187-204.

Davies, L., Krane, J., Collings, S., Wexler, S. 2007. Developing mothering narratives in child protection practice. Journal of Social Work Practice. 21, 1, p. 23-34.

Devaney, J., 2008. Chronic child abuse and domestic violence: children and families with long-term and complex needs. Child & Family Social Work. 13, 4, p. 443-453.

English, D., Marshall, D., Stewart, A., 2003. Effects of Family Violence on Child Behavior and Health During Early Childhood. Journal of Family Violence. 18, 1, p. 43-57.

Featherstone, B. 1999. Taking mothering seriously: the implications for child protection.. Child & Family Social Work. 4, 1, p. 43-53

Humphreys, C., Absler, D., 2011. History repeating: child protection responses to domestic violence. Child & Family Social Work. 16, 4, p. 464-473

Kelly, L., Mullender, A., 2000.  Complexities and contradictions: Living with domestic violence and the UN convention on children's rights. International Journal of Children's Rights. 8, 3, p. 229-241

Lavergne, C., Damant, D., Clément, M., Bourassa, C., Lessard, G., Turcotte, P., 2011. Key decisions in child protection services in cases of domestic violence: maintaining services and out-of-home placement.  Child & Family Social Work. 16, 3, p. 353-363.

Lewin, L., Abdrbo, A., Burant, C., 2010. Domestic Violence in Women with Serious Mental Illness Involved with Child Protective Services. Issues in Mental Health Nursing. 31, 2, p. 128-136.

Moylan, C., Herrenkohl, T., Sousa, C., Tajima, E., Herrenkohl, R., Russo, M., 2010. The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence. 25, 1, p. 53-63.

Potito, C., Day, A., Carson, E., O'Leary, P., 2009.  Domestic Violence and Child Protection: Partnerships and Collaboration. Australian Social Work. 62, 3, p. 369-387

Turney, D. 2000. The feminizing of neglect.  Child & Family Social Work. 5, 1, p. 47-56.

What is Conduct Disorder?

A friend was diagnosed with Conduct disorder. What does that mean?

First, it’s important to know that all children will have short periods of bad behavior. However, when things start to get out of hand, it may be evidence that there is more that needs attention. Children can get irritable and even hostile when they are tired, or they may argue with parents or disobey other authority figures to show their independence and are that they are growing up. Children may also lie to get out of trouble. Most of this behavior is fairly normal as children learn to navigate the world but when it becomes regular and persistent and starts getting them into trouble at home, at school, or with other kids, they may have what we call a disruptive behavior disorder.

Conduct Disorder can be diagnosed in a child or youth who has repeatedly and consistently shown a number of severely aggressive and anti-social behaviors that continue for 6 months or longer. It is diagnosed in childhood and adolescence, and is characterized by a pattern of antisocial behavior and defiance of rules where basic rights or age-appropriate norms are violated and has difficulty behaving in socially acceptable ways. Often these youth are viewed as simply being “bad” rather than diagnosed as having a mental health problem.

The child exceedingly misbehaves against people, animals or property and can be characterized as quarrelsome, destructive, threatening, physically cruel, deceitful, disobedient, or dishonest. This may include stealing, intentional injury, forced sexual activity, vandalism and/or lying. These behaviors are referred to as antisocial behaviors and are often seen as the precursor to Antisocial Personality Disorder.

Children displaying the disorder before the age of 10 (called childhood-onset type) are more likely to continue the behavior over time and are more likely to be boys. However if symptoms appear after age of 10 (adolescent-onset type) the disorder appears equally in girls as it does boys.

It is also argued that some children may not have conduct disorder, but are actually engaging in typical developmentally appropriate disruptive behavior. This is particularly true of teenagers that are testing out the world around them, trying to understand it, and where they fit into their environment. This is a natural time of emerging adulthood where a person learns independence and who they are as a person. Not surprisingly, a greater number of adolescent-onset conduct disorders are diagnosed than childhood-onset disorders, suggesting that there is an exaggeration of normal behaviors that are typical in adolescence, such as rebellion against authority figures and rejection of conventional values.

There appears to be a relationship among Oppositional defiant disorder, Conduct disorder and Antisocial personality disorder. Oppositional defiant disorder may precede conduct disorder as a weaker variation of the disorder. Additionally, most adults with antisocial personality disorder were previously diagnosed with conduct disorder. Although these relationships are common, these patterns do not occur in all people diagnosed with these disorders.

A child is diagnosed with oppositional defiant disorder when he or she shows signs of being hostile and defiant for at least 6 months and may start as early as the preschool years, while conduct disorder generally appears when children are older. However, Oppositional defiant disorder and conduct disorder do not occur together.

Conduct disorder appears in up to 10% of the population but, the prevalence of incarcerated youth with the disorder is between 23% and 87%. Also, for approximately 25-30% of boys and 50-55% of girls, having ADHD is the condition most commonly associated with conduct disorders.

 Furthermore, it seems that there is a relationship between substance use and conduct problems, such that aggressive behaviors increase substance use, and in turn, substance use tends to increases aggressive behavior. Children with conduct disorder generally begin substance use and abuse earlier than those without the disorder and tend to use multiple substances.  Almost all adolescents who have a substance use disorder have conduct disorder traits but about half of the adolescents lose their conduct disorder symptoms after successful treatment of the substance use.

Empathy is being able to recognize feelings of others. However a child diagnosed with conduct disorder often displays a lack of empathy because they are unable to place themselves in the other person’s shoes. Therefore they are unable to understand the consequences of their actions towards others.

Another factor of conduct disorder is a lower level of fear. If a child does not learn how to handle fear or distress the child will be more likely to lash out at other children. If the caregiver is able to teach children at risk better empathy skills, the child will have a lower incident level of conduct disorder.

Definition from the Diagnostic & Statistical Manual of Mental Disorders

(DSM IV – TR)

 A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months: 

Aggression to people and animals 

-           often bullies, threatens, or intimidates others 

-           often initiates physical fights 

-          has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)

-           has been physically cruel to people 

-          has been physically cruel to animals 

-          has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) 

-          has forced someone into sexual activity 

Destruction of property 

-          deliberately engaged in fire setting to cause serious damage

-          deliberately destroying others' property

Deceitfulness or theft 

-          has broken into someone else's house, building, or car 

-          often lies to obtain goods or favors or to avoid obligations (i.e., "cons" others) 

-          has stolen valuable items without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery) 

Serious violations of rules 

-          often stays out at night despite parental prohibitions, beginning before age 13 years 

-          has run away from home overnight at least twice while living in parental or parental surrogate

-          home (or once without returning for a lengthy period) 

-           is often truant from school, beginning before age 13 years 

·         The disturbance in behavior causes clinically significant impairment in social, academic or occupational functioning.

·         If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

Young people may be diagnosed with conduct disorder if they have displayed three or more of the following symptoms in the past 12 months, with at least one symptom also present in the past six months:

Children with conduct disorder or oppositional defiant disorder also may experience:

·         Higher rates of depression, suicidal thoughts, suicide attempts, and suicide

·         Academic difficulties

·          Poor relationships with peers or adults

·         Sexually transmitted diseases

·         Difficulty staying in adoptive, foster, or group homes; and

·         Higher rates of injuries, school expulsions, and problems with the law.

Other factors that may make a child more likely to develop conduct disorder include:

·         Early maternal rejection

·         Separation from parents, without an adequate alternative caregiver

·         Early institutionalization

·         Family neglect

·         Abuse or violence

·         Parental mental illness

·         Parental marital discord

·         Large family size

·         Crowding

·         Poverty.

What can be done to help?

Conduct Disorder is harder to treat than Oppositional Defiant Disorder and becomes worse as a child gets older. This makes early intervention extremely important.  Behaviors are hard to change after they have become learned so the earlier the conduct disorder is identified and treated, the better the chance for success. Most children or youth with conduct disorder are probably reacting to events and situations in their lives so it is important to look for the signs and try to understand the reasons why this may be happening to try and improve the situation. Getting help is a good way to start.

For children and youth:

·         Get to know about behavioral disorders by getting accurate information from your library, hotlines, community sources, or go online

·         See your family doctor

·         Talk with a mental health or social services professional, teacher, counselor, psychiatrist, or psychologist specializing in childhood and adolescent disorders.

·         Get training for the child in problem solving skills for the children

·         Get training for the child in social skill, and anger management

·         Monitor children's activities peer group influences nonschool hours promote curfews.

·         Encourage involvement in structured and supervised activities sports, like scouting, art, recreational programs at churches, schools or youth groups helps protect children from negative peer influences

·         Discuss and demonstrate clear and specific parental communication techniques.

·         Introduce rewards for desirable behavior.

·         Introduce realistic, clearly communicated consequences for noncompliance.

·         Establish a daily routine of child-parent activities.

It also extremely important to focus on other conditions the child may have. Children who have AD/HD, depression, anxiety and substance abuse to name a few, tend to lose symptoms of disruptive behavior when other problems are successfully treated

For parents:

Parents of children with conduct disorder are more likely to exhibit stress, anxiety, depression, substance abuse or antisocial personality traits. Various parental problems which may include mental disorders, high stress or marriage and financial problems can greatly influence a child's behavioral problems as well as inconsistent parenting, harsh discipline or lack of discipline, impaired parental attachment and minimal supervision can also greatly affect a child’s well being and behavior. Therefore it is just as important to address parent issues as well as the child’s issues because many of these things can be triggers for conduct problems in children.

o   Training in social skills, anger management

o   Training for parents on how to handle child and adolescent behavior

o   Training in problem solving skills for parents

o   Help with parental mental health issues and other personal coping skills

Changing parenting practices can help the child and benefit the family as a whole. If the parents, particularly the mothers, are unable to develop new ways of parenting, their children may go on to develop the more serious conditions.