Childhood Behavioral Disorders

What are Childhood Disorders?

Childhood disorders are typically identified when significant changes in behavior, emotional regulation, social skills, or cognitive development that are not associated with normal stages of childhood development or other medical conditions. These changes must occur frequently over a long period of time, causing significant distress and impacting daily functioning.  The delays or disruptions in behavior, emotional regulation, thinking, and social skills are experienced at home, school, or other social settings.

Mental health and behavioral disorders in children can be difficult to identify, which can make getting help and appropriate treatment challenging. The earlier they can be identified and treated, the better the outcomes.

Common Types of Childhood Behavioral Disorders

Common childhood behavioral disorders or conduct disorders in childhood include:

  • Attention-deficit/hyperactivity disorder (ADHD). Compared to other children, children with ADHD experience difficulties with attention, focus, concentration, or hyperactivity, or a combination of types. Symptoms must be significant enough to impact daily functioning in the home, school, or other social settings.
  • Anxiety disorders. Anxiety disorders in children may appear as frequent worries, fears, or anxiety that affects daily functioning. Examples of anxiety disorders include generalized anxiety, separation/social anxiety, or obsessive-compulsive disorder.
  • Autism spectrum disorder (ASD). ASD is a neurological disorder that typically presents before age 3. ASD varies in severity and looks different between individuals, but typically manifests as issues with communicating, socializing with others, and emotional dysregulation.
  • Depression and other mood disorders. Depression can be defined as persistent sadness and loss of interest in things, significant enough that it impacts daily functioning at home, school, or other social settings. Bipolar disorder may lead to major mood swings, which present as depressive episodes or manic episodes (or both), and potentially result in risk-taking or self-destructive behaviors.
  • Oppositional Defiance Disorder (ODD). A pattern of angry or irritable mood, argumentative and/or defiant behavior, or vindictiveness toward people in authority lasting at least six months.
  • Post-traumatic stress disorder (PTSD). PTSD in children is a time of prolonged emotional distress connected to a traumatic event(s), which typically presents as nightmares, disturbing images or flashbacks, distressing memories, and reactivity (disruptive behaviors or emotional outbursts).
  • Eating disorders. In children, eating disorders are defined as a preoccupation with food, body image or an ideal body type, disordered thinking about weight and weight-loss, and unsafe eating and dieting habits that can be harmful and even life-threatening. Eating disorders typically lead to emotional, social, and physical dysfunction. 
  • Schizophrenia. This disorder is usually characterized by significant distortions in thoughts and perceptions which alter a person’s reality and lead to hallucinations, delusions, and marked behavioral changes.

Warning Signs of Behavioral and Conduct Disorders in Childhood

There are some common warning signs to look for if you believe your child is struggling with a mental health disorder or condition. Common warning signs include:

  • Persistent feelings of sadness and loss of interest
  • Difficulties in attention, focus, and concentration, or hyperactivity
  • Thoughts about harming oneself (self-harm or suicidal thinking)
  • New or excessive thoughts about death and dying
  • Withdrawing from or avoiding social interactions
  • Emotional or behavioral outbursts and reactivity (anger, irritability, impulsivity)
  • Major changes in mood, behavior, or personality 
  • Noticeable changes in eating habits
  • Abnormal weight loss or weight gain
  • Sleep disturbance
  • Frequent somatic complaints (stomachache, headache, chronic pain)
  • Changes in academic performance
  • Skipping school

Children are constantly developing, growing, and changing, which can make identifying a mental health disorder more difficult. Sometimes it can be hard to differentiate between normal childhood development versus symptoms that may indicate a mental health disorder.

Therefore, it is critical to speak with your child’s pediatrician as soon as possible if you notice any of the above warning signs or if significant changes in your child’s mood, behavior, social skills, or cognitive development have become more frequent over a sustained period. Your child’s pediatrician can help direct your next steps and connect your child with a mental health professional. An evaluation and assessment will be done to help determine the potential diagnosis and create an appropriate treatment plan.

Diagnosis of Childhood Behavioral Disorders

The first step for diagnosis is to reach out to your child’s pediatrician if you or another trusted individual notices any warning signs or changes in your child’s mental health. Once you have spoken to the pediatrician, it may be decided to refer your child to a mental health professional.

Mental health professionals include a mental health counselor, a behavioral specialist, a psychiatrist, a child psychologist, etc. Whichever mental health professional your child is referred to, he or she will make a diagnosis based on symptoms, symptom frequency, symptom duration, and whether the symptoms are affecting your child’s daily functioning or normal life activities. Typically, a diagnosis is made within the first 1-3 (sometimes more) sessions.

A mental health professional will do an initial intake and take time to evaluate and assess your child’s mental health and provide a diagnosis if your child meets specific criteria. A parent, both parents, or legal guardian will accompany the child to his or her appointment and often, the mental health professional will meet with the parent and child together, individually with the client, or sometimes with the parent alone for part of a session.

Barriers to Treatment

There are several barriers to treatment. Childhood is a time of normal development, growth, and change. Sometimes it can be difficult for caregivers to distinguish between healthy development and symptoms of a mental disorder or condition. Additionally, children often have a hard time articulating their emotions, thoughts, or the reason why their behaviors have changed. Furthermore, especially with children, caregivers may worry about the stigma that still surrounds mental health.

It is critical that anytime a caregiver notices a warning sign or has concern for a child’s mental health, they reach out to the appropriate supports. The sooner the mental health disorder or behavioral condition is identified and appropriately diagnosed, the sooner a mental healthcare professional can pursue appropriate treatment for your child, which often leads to better outcomes.

Treatment for Child Behavioral Disorders

There are multiple treatment options for childhood mental or behavioral disorders. As a caregiver, it is important to remember that the earlier you get your child treatment, the better the treatment outcomes. Some of the most common treatments include:

Psychotherapy

Psychotherapy, also referred to as talk therapy, is one of the most common treatment options for mental health disorders. However, because children tend to struggle with articulating their emotions or understanding their behaviors, mental health professionals may use play therapy or other alternative therapies, as well as sometimes involving a parent, both parents, or a legal guardian in the sessions to help children navigate the therapeutic process and experience improvement. Psychotherapy allows children a safe space to be able to express their thoughts and feelings and work toward healthy change, growth, and healing.

Medication

Medication for childhood anxiety disorders can be an effective and safe form of treatment when a mental healthcare provider or medical professional determines that it is appropriate. Medications can be used to help treat anxiety, depression, ADHD, mood disorders, and many other mental health conditions. Your child’s provider will discuss the benefits, side effects, or any potential risks before prescribing the medication.