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CONDUCT DISORDER

A recent question from a distraught parent:

“What do I do, or how do I handle, a 12-year-old boy who constantly lies to the point he believes himself and that he has done nothing wrong when he has in fact been caught red-handed with videos, tape recordings and serial numbers on cash?

“His response is, ‘I don’t care about that! I didn’t do it!’ Besides taking away liberties, TV, radio, etc. what else can be done? If this were 20 years ago a good spanking would be in order, but with the laws today that is not an option. I am at the end of my rope and very worried about him. He is in counseling but I have not had much feedback from tests or been given any suggestions that have worked.”

It’s tough to tell whether this is just an obnoxious pre-teenager or whether the parents are dealing with a conduct disorder. I suspect it may be the latter because of the repetitive stealing and lying.

There are several varieties of the disruptive behavior disorders, all of which can be hell for the parents. They range from the oppositional child who is sometimes or often hard to manage, to the child who breaks important social rules by lying or cheating, to the child who breaks societal laws by stealing or demonstrating violent behavior. These disorders are 3 to 4 times more common in boys than in girls. Up to 9% of boys who repeatedly break societal rules are considered to fall into the conduct disorder group. Some of these children will later be diagnosed with an antisocial personality disorder.

Children under age six may lie and steal and cheat because they are not developmentally ready to internalize social and societal rules. But by age 8 or 9, and certainly by age 12, children do know right from wrong and further know that everybody – family, school, and society – expect them to follow these rules. Alas, kids who have a conduct disorder cannot seem to follow the rules unless they get help.

Counseling is in order both to make a diagnosis and to help the child and family by identifying specific strategies which can help change the unacceptable conduct. Some strategies include building social skills by identifying strengths, encouraging personal responsibility, helping the child with problem-solving skills, utilizing community resources to provide clubs, sports, and activities as we know these such social activities can promote prosocial behavior.

One of the most important strategies is providing help for the parents. You can’t solve your child’s behavior problem on your own, and you can’t ignore it either as it will escalate. Get counseling yourself.

There are no quick cures and the problem may actually get worse before it gets better but stay the course. Nagging won’t work but be sure your child knows that these behaviors are unacceptable every time they occur. Work with the teacher and counselor to provide maximum possible consistency in how adults treat this boy. Spanking is not the answer even if there were no laws against abuse. A child like this might well hit you back.

Be patient and set reasonable goals: one author suggests baseline frequency of behaviors minus one is a reasonable goal. This means if he has been stealing every week and goes to stealing only every other week progress is being made.

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