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Don’t call me naughty, but help me out!

By Rinam Prasla

My son has been expelled from the school because of his delinquent behaviour. At home too he misbehaves and does not obey rules and requests. We scold him, punish him, and lock him in a room but he continues his bizarre attitude. I don’t understand what to do? I am so upset for him.

This was the voice of a mother whose 11 years old child is very naughty. Now you must be thinking that every child is naughty or misbehaving in one way or another. It is true, but; this case is serious that requires attention and which is something beyond naughtiness.

There are few children whose behaviour is consistently disturbing. They become aggressive easily and try to harm others without having guilt. Parents consider this attitude as an outrageous behaviour. Moreover, they consider their child to be responsible for his/her behaviour and as a result they blame them, scold them and punish them as in the given scenario. However; the child is not the culprit, but; a victim of a mental illness. Yes, such emotional and behavioural problems in children that are persistent in nature are collectively known as conduct disorder, which is a common mental illness. There are few warning signs through which this can be diagnose and parents are the one who can play a vital role in its management.

American Psychiatric Association (2000) defines conduct disorder as a psychiatric disorder that occurs in childhood and adolescence, which is characterized by a longstanding pattern of violations of rules and antisocial behaviours. Conduct disorder has become a major health and social problem; it is the most common psychiatric problem diagnosed among the children. Although, the child with conduct disorder is offensive externally, yet; his/her self esteem is very low and they experience an internal distress such as anger, frustration, guilt that becomes explicit in their behaviour.

Although, it is a medical diagnosis, but; parents are the one who can identify it first and intervene appropriately in order to save their child from repercussions. How parents could identify that their child is suffering from this illness? According to American Academy of Child and Adolescent Psychiatry (2004) there are four groups of warning signs through which this disorder can be detected. First, the child may show aggression towards people and animal. He/ she may bully or threaten other, may initiate physical fights with peers or may become vindictive to people and animal.

Secondly, the child may cause destruction of property. Child may deliberately set fire with an intention to cause harm or may intentionally destroy other’s property.

Thirdly, they may deceive or lie for gaining benefits or avoiding obligations. They may steal items without confronting the victim. Lastly, they may violate the rule in which they often stay out at night, despite; parental restrictions.

According to the criteria suggested by American Psychological Association there should be at least three specific conduct disorder behaviours present for at least six months to make the diagnosis (Searight, Rottnek and L.Abby, 2001). Hence, if any three of the above stated signs are present in any child for more than six months then it’s an alarming sign for parents to intervene.

Once, the child has been diagnosed by the parents then, the next important step is to deal with such child and to take actions promptly. The key aspect, which is important for parents, is to consider this problem as a disease, rather; as a problem in character. This disorder is not very different from diarrhea, fever or other physical problems, but; the only thing which is different is the involvement of emotions and behaviour. If parents consider it as a disease then only it will help them to accept it.

Usually as a health care professional I have observed and read that parents punish their children or insult them so often that it further reduces their self-esteem and provokes their behaviour. Physical punishment which is the most commonly used by the parents is a form of power assertion that has been identified as one of the most ineffective strategies for establishing moral values (Straus and Stewart, as cited by Kerr, Lopez, Olson and Sameroff, 2004).

Despite of being cruel and irritable, there are many other ways through which parents can deal with such children. Firstly, parents should monitor their child’s activities on daily basis. This can be done by contacting his/her teachers and friends at least once a day. Furthermore, they may also observe their child’s behaviour at home and any pertinent changes that occur in it. Another way could be to ask their child about his/her day in an assertive, yet; caring way. Secondly, parents should learn good communication skills. Parents should be able to communicate clear, direct and specific rules, requests or expectations (Searight, Rottnek and L.Abby, 2001). Moreover, during the interaction child’s respect and integrity should be maintained and blaming and insulting approach should be discouraged. If any requested task is not initiated by the child with in few minutes then it should be followed by a verbal reminder. Even if the child does not obey then, for the third time the request should be accompanied with a reasonable consequence. Parents should make sure that the chosen consequence is practical and not vague for example, “If you have not finished setting your cupboard in fifteen minutes, you will lose one-half hour of free time with your friends tonight.” Besides, consequences parent-child interaction should also include rewards. Rewards should be tangible, specific and always provided promptly when the child finishes the required task. Thirdly, parents should reinforce the laws and rules clearly, concisely and timely. The essential feature is the consistency of reinforcement. Without, uniformity the child will not be able to obey or follow the rules. In addition, parents should also co-ordinate with school teachers so that consistency in the reinforcement of rules is achieved at home as well as at school.

A part, from the above interventions, it is important to approach specialized health care personnel timely before the disorder get worsen. Parents can approach to a psychologist or psychiatrist who may prescribe medicines and may administer few therapies. If medicines have been prescribed by the doctor then parents should ensure their administration timely with correct dose. Moreover, it should not be discontinued without doctor’s consultation.

In conclusion, the key aspect which needs to be understand is to consider this disorder as a health problem rather, a delinquent behaviour. As parents, it is essential to identify such problems in children and to observe its pattern. Moreover, to intervene promptly is the major intervention which can be done by understanding our child and communicating in a clear, concise and caring manner. In addition, by taking the child to a doctor or psychologist we can help him/her to get out of this problem. Lastly, as parents we are the one who can help our children to lead a normal life.