About conduct disorder

Conduct disorder is a serious mental health condition.

Children and teenagers with conduct disorder behave in extremely challenging ways. For example, they act aggressively, hurt other people, break serious rules, and steal or destroy things. This behaviour makes it hard for them to do ordinary things like go to school and get along well with family members, friends, peers and teachers.

Conduct disorder can start at as early as the preschool years, but it can also start during adolescence.

Conduct disorder isn’t common.

Signs of conduct disorder

Children with conduct disorder behave in extremely challenging ways. Their behaviour:

• interferes with daily activities and relationships
• happens very often
• goes on over a long period – for example, 6-12 months.

Children with conduct disorder behave in several of the following ways. They:

• act aggressively and hurt others – for example, they’re violent towards parents, siblings or teachers, or they use weapons
• are physically cruel to animals or kill animals
• force people into sexual activity
• break serious rules – for example, they sneak out of the house, stay out late, run away from home or truant
• steal things and behave dishonestly – for example, they lie or steal money from family members, break into houses, steal cars, scam others or shoplift
• destroy things – for example, they set fire to things or destroy public property.

Children with conduct disorder might also:

• blame others for their behaviour
• not feel guilty after hurting someone or doing something illegal
• see other people’s behaviour as threatening towards them, even when it isn’t
• seem irritable or easily frustrated
• have temper outbursts
• do risky things like have unprotected sex, train surf or use alcohol and other drugs
• self-harm or attempt suicide.

Most children and teenagers behave in challenging ways sometimes. If your child’s behaviour is occasionally challenging, you probably don’t need to worry. But if there seems to be a pattern of challenging behaviour, it’s important to get help.

Concerned about conduct disorder: getting a diagnosis

If you’re concerned that your child might have conduct disorder, talk to your GP as soon as possible.

The GP will be able to give you a referral to a paediatrician, psychiatrist or psychologist with expertise in childhood behaviour and mental health conditions. These health professionals can assess your child and diagnose conduct disorder.

The diagnosis process might include interviews with you, your child and other people in your child’s life, like teachers. Your health professional might observe your child’s behaviour and get you to do some questionnaires.

Your child might also need a speech and language assessment, academic assessment or intellectual assessment.

Health professionals might also assess your child for other conditions that often occur alongside conduct disorder, like oppositional defiant disorder, attention deficit hyperactivity disorder (ADHD), childhood depression, teenage depression, childhood anxiety and teenage anxiety.

An early diagnosis is important, because diagnosis leads to treatment and support. And treatment for conduct disorder works best if children start it early and stick to it. With early treatment and support, children can develop social, emotional, behavioural and thinking skills. Later in life, treatment and support help teenagers and young people stay mentally well, get and keep a job, build a support network, stay safe and keep out of trouble.

Professional treatment and support for conduct disorder

If your child shows signs of conduct disorder or has been diagnosed with conduct disorder, they’ll need treatment and support from a health professional trained in child and adolescent mental health.

Treatment aims to help your child change their behaviour. It works best when you or other carers are involved. Treatment might include the following:

• Parent programs – these help you learn to interact with your child in gentle and consistent ways. They also help you learn to use positive behaviour strategies like positive attention.
• Family-based programs – these help you build a positive and warm relationship with your child. They also support you while you’re using positive behaviour strategies with your child.
• Child-focused programs – these often happen in a group setting and will probably focus on helping your child develop problem-solving and other skills.

Treatment will aim to help your child:

• learn  to communicate with others in healthy ways
• build social skills and friendship skills
• develop healthy relationships and community networks
• manage their behaviour, emotions and stress
• see things from other people’s perspectives
• sort out conflict constructively
• attend school regularly, learn and be safe.

It’s important to talk with your child’s teacher about the positive behaviour strategies that you use with your child. The teacher can use the same strategies when your child is at school.

Your child’s health professionals might also recommend treatment for any other conditions your child has.

Your child might be able to get Medicare rebates for up to 10 sessions with a mental health professional each calendar year. To get these rebates, your child will need a mental health treatment plan from a GP or a referral from a psychiatrist or paediatrician.

Looking after yourself when your child has conduct disorder

Guiding children and teenagers with conduct disorder towards new ways of behaving is a big and important job. If you look after yourself mentally, physically and emotionally, you’re more likely to have the energy you need to stay calm and respond to your child in warm and positive ways.

Looking after yourself involves:

• making sure you have a support network
• managing stress, anger or mental health problems
• making time for things you enjoy
• practising self-compassion, which means being kind to yourself even when things aren’t going well
• eating well and staying physically active and resting when you can
• getting support for your own mental health from a counsellor or other professional.

Sharing support, advice and experiences with other parents can be a big help. You could try starting a conversation in an online forum or joining a parent support group.

Looking after siblings of children with conduct disorder

It’s important to keep an eye on siblings who might be affected by your child’s challenging behaviour or by any conflict or violence that’s happening in your home. If your other children are distressed or you think their mental health is being affected, talk with your GP or another health professional as soon as possible.

You can help your other children feel safe, secure and loved by:

• encouraging them to share their feelings about their sibling and letting them know their feelings are valid
• spending special one-on-one time with them
• having clear rules and expectations about behaviour in your home – for example, it’s never OK to hit another person.

It’s also important to develop a safety plan with a health professional. A safety plan can cover things like:

• what to do if a sibling is behaving in an extremely challenging or harmful way – for example, speak calmly, go somewhere safe and so on
• where to go – for example, safe places at home or other places
• who can help – for example, a neighbour who can call police if they hear violence or friends who can collect your other children.

It’s important to talk with your other children about the safety plan, so they know where to go, who to call for help and how to call 000. You might need to adapt what you say for children of different ages.

Teenage violence in the home is never OK. If you or your other children are experiencing violence in your home, talk to your health professional, call the National Domestic Family and Sexual Violence Counselling Service on 1800RESPECT (1800 737 732) or use 1800RESPECT online chat.

Risk factors for conduct disorder

Conduct disorder might be caused by a combination of genes and environmental factors.

Risk factors linked to conduct disorder include:

• a family history of conditions like conduct disorder, oppositional defiant disorder or ADHD
• exposure to family violence
• experience of physical abuse
• a parent who uses harsh discipline
• a parent who has problematic alcohol and other drug use or has a mental illness that isn’t well managed.