Conduct disorder in children and teenagers

About conduct disorder

Conduct disorder is a serious mental health disorder.

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.

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
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 extreme childhood behaviour. 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 has been diagnosed with conduct disorder, professional treatment and support is essential. It will involve a management plan for your child.

The management plan will aim to help your child:

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

The management plan will include therapy like behaviour therapy or cognitive behavioural therapy.

It should also include strategies for managing your child’s behaviour and encouraging positive behaviour, both at home and school. Your child’s health professionals will talk with you, your family members and your child’s teachers about these strategies.

As part of the management plan, your child’s health professionals might recommend treatment for any other conditions your child has.

The management plan will also include support for you and other people in your child’s life. This support will help you understand the causes of your child’s behaviour and stay connected with your child so they feel secure and loved.

Your GP will probably talk with you about a mental health treatment plan for your child. If you have a plan, you can get Medicare rebates for up to 10 sessions with a psychologist. If your child is referred to a paediatrician or psychiatrist, you can get Medicare rebates for these appointments.

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
looking after your physical health by eating well and staying physically active and trying to rest when you can.

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 acceptable behaviour in your home – for example, it’s never OK to hit another person.

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

what to do if a sibling is behaving in an extreme 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 the 1800RESPECT online chat service.

Risk factors for conduct disorder

It’s hard to say why children develop conduct disorder. But it might be a combination of genes and environmental factors.

Some risk factors linked to conduct disorder include temperament or extreme stress or trauma that affects children’s relationships with their family or community. This trauma might include being exposed to neighbourhood violence or being abused. It might also include having a parent who uses harsh discipline, has problematic alcohol and other drug use or has a mental illness.