Common Behavior Problems of Children

Common Behavior Problems in Children These can be usefully classified into psychosocial disorders, habit disorders, anxiety disorders, disruptive behaviour and sleeping problems. Psychosocial disorders These may manifest as disturbance in: Emotions e.g. anxiety or depression Behaviour e.g. aggression Physical function e.g. psychogenic disorders Mental performance e.g. problems at school This range of disorders may be caused by a number of factors such as parenting style which is inconsistent or contradictory, family or marital problems, child abuse or neglect, overindulgence, injury or chronic illness, separation or bereavement.1 The child's problems are often multi-factorial and the way in which they are expressed may be influenced by a range of factors including developmental stage, temperament , coping and adaptive abilities of family, the nature and the duration of stress. In general, chronic stressors are more difficult to deal with than isolated stressful events. Children do not always display their reactions to events immediately although they may emerge later. Anticipatory guidance can be helpful to parents and children in that parents can attempt to prepare children, in advance, of any potentially traumatic events e.g. elective surgery or separation. Children should be allowed to express their true fears and anxieties about impending events. Young children will tend to react to stressful situations with impaired physiological functions such as feeding and sleeping disturbances. Older children may exhibit relationship disturbances with friends and family, poor school performance, behavioural regression to an earlier developmental stage, development of specific psychological disorders such as phobia or psychosomatic illness. It can be difficult to assess whether the behaviour of such children is normal or sufficiently problematical to require intervention. Judgement will need to take into account the frequency, range and intensity of symptoms and the extent to which they cause impairment. Habit disorders These include a range of phenomena that may be described as tension reducing. Tension reducing habit disorders Thumb sucking Repetitive vocalisations Tics Nail biting Hair pulling Breath holding Air swallowing Head banging Manipulating parts of the body Body rocking Hitting or biting themselves All children will at some developmental stage display repetitive behaviours but whether they may be considered as disorders depends on their frequency and persistence and the effect they have on physical, emotional and social functioning. These habit behaviours may arise originally from intentional movements which become repeated and then become incorporated into the child's customary behaviour. Some habits arise in imitation of adult behaviour. Other habits such as hair pulling or head banging develop as a means of providing a form of sensory input and comfort when the child is alone. Thumb sucking - this is quite normal in early infancy. If it continues it may interfere with the alignment of developing teeth. It is a comfort behaviour and parents should try to ignore it while providing encouragement and reassurance about other aspects of the child's activities. Tics - these are repetitive movements of muscle groups that reduce tension arising from physical and emotional states, involving the head, the neck and hands most frequently. It is difficult for the child with a tic to inhibit it for more than a short period. Parental pressure may exacerbate it while ignoring the tic can reduce it. Tics can be differentiated from dystonias and dyskinetic movements by their absence during sleep. Stuttering - this is not a tension reducing habit. It arises in 5% of children as they learn to speak. About 20% of these retain the stuttering into adulthood. It is more prevalent in boys than girls. Initially it is better to ignore the problem since most cases will resolve spontaneously. If the dysfluent speech persists and is causing concern refer to a speech therapist. Anxiety disordersAnxiety and fearfulness are part of normal development, however, when they persist and become generalised they can develop into socially disabling conditions and require intervention. Approximately 6-7% of children may develop anxiety disorders and of these 1/3 may be over-anxious while 1/3 may have some phobia. Generalised anxiety disorder, childhood onset social phobia, separation anxiety disorder, obsessive compulsive disorder and phobia are demonstrated by a diffuse or specific anxiety predictably caused by certain situations. School phobia occurs in 1-2% of children of which an estimated 75% may be suffering some degree of depression and anxiety. Management is by treating underlying psychiatric condition, family therapy, parental training and liaison with school to investigate possible reasons for refusal and negotiate re-entry. Disruptive behaviour Many behaviours, which are probably undesirable but a normal occurrence at an early stage of development, can be considered pathological when they present at a later age. In the young child many behaviours such as breath-holding or temper tantrums are probably the result of anger and frustration at their inability to control their own environment. For some of these situations it is wise for parents to avoid a punitive response and if possible to remove themselves from the room. It is quite likely that the child will be frightened by the intensity of their own behaviour and will need comfort and reassurance. While some isolated incidents of stealing or lying are normal occurrences of early development they may warrant intervention if they persist. Truancy, arson, antisocial behaviour and aggression should not be considered as normal developmental features. Attention deficit hyperactivity disorder This is characterised by poor ability to attend to tasks, (e.g. makes careless mistakes, avoids sustained mental effort) motor overactivity (e.g. fidgets, has difficulty playing quietly) and impulsiveness (e.g. blurts out answer, interrupts others). For the diagnosis to be made, the condition must be evident before age 7 years, present for >6 months, seen both at home and school and impeding the child's functioning. The condition is diagnosed in 3-7% of school-age children. Methylphenidate (initiated by specialists only) is a stimulant medication that provides reduction of symptoms, at least in the short term.2 Management usually includes family therapy (a programme of behavioural modification for the child and the parents), although further research confirming its benefits is needed. 3,4,5 Essential fatty acids may alleviate some symptoms.6 Sleeping problemsSleep disorders can be defined as too much or too little sleep than is appropriate for the age of the child. By the age of 1-3 months the longest daily sleep should be between midnight and morning. Sleeping through the night is a developmental milestone but at the age of 1 year 30% of children may still be waking in the night. Stable sleep patterns may not be present until age 5 years but parental or environmental factors can encourage the development of circadian rhythm. Sleep disturbance can have a deleterious affect on the cognitive development of children, as well as the functioning of the parents. One study of 2-3 year olds found a significant link between sleep disturbance and emotional and behavioural disorders.78 Regular bedtimes, quieter activities and the creation of marked differences between the sounds, activities and light levels associated with night time sleeping and daytime activities may help to encourage better sleep patterns. A solid evidence base now supports the use of behavioural treatments in infants and pre-school children (under 5).9 All of these are based on the objective of the parents gaining control of the bedtime routine. They include unmodified extinction (ignoring the child's cries but monitoring for illness or injury), modified extinction (ignoring the child for a specified period of time) and positive routines (doing some quiet pre-sleep activity and ensuring that falling asleep is associated with a positive parental-child interaction).10 One study found that parental interventions that encourage independence and self-soothing were associated with extended and more consolidated sleep compared to more active interactions that were associated with shorter and more fragmented sleep.11 Hypnotherapy has been found to be of benefit in school-age children.12 The BNF for Children states that the use of hypnotics, except for occasional short-term treatment of night terrors and sleep-walking, is never justified.13 However, it is recognised that the treatment of paediatric insomnia is an area that needs further research. Melatonin is sometimes of benefit in sleep disorder associated with visual impairment, cerebral palsy, attention deficit hyperactivity disorder and autism. It is unlicensed for this indication and specialist supervision is recommended for initiation and monitoring. Other links include memory loss and obesity.

Children experience behavior problems both in and out of the classroom. Read on to learn about these behavioral problems and what you can do as a parent.

Parents whose children exhibit signs of poor behavior can become frustrated and do not know what they can do to help correct their child's behavior. They find that grounding their children for getting into problems at school does not always help the situation, and sometimes causes their behavior to deteriorate further. Fortunately there is help for students who have behavioral problems.

Cheating

Cheating can start as a minor problem but left unchecked will develop into a major issue. According to the American Academy of Pediatrics, www.aap.org, cheating often is due to the competitiveness of the American culture and often starts during early childhood when a child is confronted with the competitive nature of games and sports. If a child is presented with homework and sports that are too complex for them to understand and to handle, they may develop a habit of cheating as a self-defense mechanism to help them prevent failure and embarrassment.

The American Academy of Pediatrics recommends that parents deal with each cheating episode by teaching the child that cheating is wrong and discussing how they might have handled the situation differently. Also, discuss the stress and pressures the child is facing and make sure you, the parent, doesn't have too high expectations for your child in school and in sports. Most importantly, too severe of a punishment rarely works to correct the cheating habits.

ADD and ADHD

Attention Deficit Disorder, also known as ADD, and Attention Deficit and Hyperactivity Disorder, more commonly known as ADHD, can occur in up to 20% of children, reported a 1999 study conducted by the U.S. Department of Health and Human Services.

Children who have these disorders often have problems focusing their attention and are easily distracted. Other symptoms include difficulty taking turns, remaining still, and keeping quiet. All of these symptoms must be present in both the school and home environment in order for a child to be properly diagnosed with ADD or ADHD.

One of the most widely-used treatments for these disorders is drug therapy. The most common drug prescribed to youth who have ADD/ADHD is Ritalin. Ritalin helps calm children and is effective in 70 percent of those treated. As with any medication, however, there can be some negative effects. Ritalin is classified among 'Schedule II' controlled substances, all of which have a high drug abuse potential. Therefore, if a child is taking Ritalin, it is important to discuss the dangers of drug abuse. Additionally, discuss with them why they are taking the drug to ensure they know that taking drugs will not solve all of their life problems.

Help is Available

Many children with cheating and ADD/ADHD problems enroll in tutoring programs. Students with cheating problems can benefit from tutoring because it increases their confidence in their academic skills. Since low self-esteem and the excessive feeling of pressure is what causes students to cheat, an increased self-confidence and mastery of skills will help combat against this negative behavior.

Tutoring helps ADD/ADHD students because they will learn and master the skills they have been missing in class. Since these students have problems focusing, they do not learn the complete reading and math lessons that are being offered at school. Many tutoring programs use interactive activities and games that keep the child focused. Additionally, the one-on-one attention will keep the ADD/ADHD student tuned in to their tutoring lessons.

If your student is exhibiting these or other behavioral problems, it is recommended that you schedule an appointment with their school counselor. Your family and the counselor can discuss the different variables at play and which treatments can best help them.

After consulting the school counselor, you may want to see a your child's physician who can refer you to a child psychologist. These psychologists specialize in behavioral problems that may be similar to those your child is exhibiting.

Remember that the goal is not to punish or embarrass your child, but to correct the behaviors. Once you implement counseling, tutoring, and/or other treatment, your child can excel in school and have a more promising future.

An angry child makes for unpleasant situations whether in public or in the privacy of your own home. When a child participates in bad behavior, it can result in injury for both themselves and others and can evoke feelings of embarrassment. Most of the time these disruptive behaviors do not last long and will stop as your child continues to grow and develop. Some problem behaviors continue to linger, however, and cause a family distress. Find out common problem areas children have and encourage good behavior with positive reinforcement.

Physical Aggression

Biting, hitting and throwing items at other individuals include some of the physical forms of aggression children can demonstrate when they are young. While toddlers may bite things in an explorative manner, older children should understand that biting people or things is harmful and not safe. Research found in the article "Dealing with Biting Behaviors in Children" from the Clearinghouse on Early Education, suggests removing the offending child away from the situation and explain why the behavior is not valued.

Temper Tantrums

As children develop, they begin to experience changes in their emotions. Preschool-aged children may throw temper tantrums in which they demonstrate emotional outbursts. The University of Pittsburgh published a special report labeled "Understanding Common Problem Behaviors in Young Children." It states that temper tantrums, excessive clinginess or socially withdrawn behavior is common among young children. While most of these behaviors should stop over time, some negative behaviors that worsen indicate that a deeper issue may be at hand.

Personal Agression

Children who suck their thumb, grind their teeth, pull their teeth or rock or bang their heads include some of the negative habits that puts parents and other adults on edge. What may look like self-aggression is typically a bad habit a child formed and will most likely grow out of it. The article "Bad Habits, Annoying Behavior," published by the University of Michigan Health System, states that calling attention to the offending behavior, shouting or disciplining a child usually does not stop the habit. Instead, they suggest to offer praise and encouragement when the child ceases the behavior.