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What's the Matter with Kids Today?

It is a familiar call to a familiar address. The dispatcher puts in out on the air as a family disturbance; 123 Problem Street, premise history for same. 15 year old WMJ versus father. Verbal only, no weapons, unknown alcohol or drugs. RP is the adolescent's mother; she is crying and states she is afraid the situation will escalate. She reports her son is out of control. You brief your new beat partner on scene. Jason (the subject) frequently has verbal arguments with Dad. Dad is as much of a hot head as Jason. Mom is simply wishy-washy and always tearful. She consistently wants Jason to be taken to a behavioral health hospital; Dad insists that he needs to be at juvenile hall. You enter the home, and it is the same story. Jason is calm, smirking at this father. Dad is beat red and immediately demands that you do something now. Mom is a shrinking violet on a corner love seat.

This time the fight is over Jason's violation of the behavioral contract he had established with his therapist and parents. He did not do his homework right after school; which meant he was grounded. Jason decided it was his choice and right to attend the high school basketball game this evening anyway. Jason threatened to pound Dad if he stopped him from leaving the house. Dad wanted him arrested for terrorist threats. Mom wanted him go to back to the hospital (previously a voluntary admission) because Jason was obviously a danger to others. She again tells you that Jason has been diagnosed with oppositional defiant disorder. Jason states that his father should be arrested because he used force (held his wrists) when Jason tried to leave the house. You send your partner back in service, and try to deal with this mini crisis at the Williams household solo.

What is Oppositional Defiant Disorder?

Everyone has heard the buzz acronym ODD, but what does that mean, and how many kids have it? It is important to remember that all children, even the best behaved, will be oppositional at times. This is especially true if they are tired, hungry or upset. They may talk back, disobey, or defy parents or other authoritarians. This is not abnormal. Being able to question and stand up for oneself is essential for everyday living.

On the other side, are kids who show a consistent pattern of angry and verbally aggressive behaviors. Their wrath is usually aimed at parents and other authority figures, most frequently at school. At this extreme, mental health professionals frequently give the child or adolescent the diagnosis of oppositional defiant disorder (ODD). The diagnosis is only given if the behavior substantially affects the social, family and academic life of the child or adolescent. It is one of the most common mental health disorders found in kids.

Signs and Symptoms of ODD

  • frequent temper tantrums
  • excessive arguing with adults
  • often questioning rules
  • active defiance and refusal to comply with adult requests and rules
  • deliberate attempts to annoy or upset people
  • blaming others for his or her mistakes or misbehavior
  • often being touchy or easily annoyed by others
  • frequent anger and resentment
  • mean and hateful talking when upset
  • spiteful attitude and revenge seeking
  • possible drugs and alcohol abuse
  • the symptoms are usually seen in multiple settings, but may be more noticeable at home or at school.

The exact rate of ODD is unknown, as most kids display some of the above symptoms at times. It is estimated that up to 16% of the child/adolescent population meet the diagnostic criterion for oppositional defiant disorder. For many children, ODD does improve over time. Follow-up studies have demonstrated that approximately two out of three children diagnosed with ODD, who received treatment, will be symptom-free after three years. Children presenting with ODD symptoms should be evaluated for possible other psychiatric disorders including: attention-deficit hyperactivity disorder (ADHD), learning disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. Treatment usually consists of a combination of parenting classes, family therapy, and behavioral therapy for the child or adolescent, and school based programs. Medication alone is not effective; however, it may be helpful if the kid is also experiencing symptoms of ADHD or a mood disorder.

However; studies have also shown that approximately 30% of children who were diagnosed with ODD will go on to develop a conduct disorder.

What is a Conduct Disorder?

In many ways, conduct disorder is simply a more severe and aggressive form of ODD. The basic features of a conduct disorder (CD) are a persistent pattern of behaviors which violates the social rules and rights of others.

The common thread that separates conduct disorder and oppositional defiant disorder are safety concerns. If a child has CD there are safety concerns. Children with ODD are an annoyance, but not particularly dangerous. Children with CD represent a real threat to people, animals, the community, school, and possessions. Physical aggression is a hallmark of CD; as is destruction of property. Additionally, the child frequently feels no remorse for his/her deeds. Conduct disorders often leads to an adult antisocial personality disorder and the associated criminal behaviors. It can be considered the larval form for the psychopath.

Children or adolescents with conduct disorder will demonstrate some of the following behaviors:

Aggression to people and animals

  • bullying, threatening or intimidating others
  • initiating physical fights
  • use of a potentially lethal weapon (e.g. a bat, brick, broken bottle, knife or gun)
  • physical cruelty to people or animals
  • aggravated assault
  • forcing sexual activity on unwilling partner

Destruction of Property

  • deliberately sets fires with the intention to cause damage
  • deliberately destroys other's property

Deceitfulness, lying, or stealing

  • breaking and entering residences, businesses, vehicles.
  • chronic lying to obtain goods, or favors or to avoid obligations
  • shoplifting

Serious violations of rules

  • staying out all night despite parental objections
  • runaway behavior
  • truancy from school

It is more common for males with a conduct disorder to continue with problems into adulthood than females. However, females with a conduct disorder often face more major consequences related to their behaviors. Girls with CD abuse substances 6X more, cigarettes 8X more, have poorer health, are twice as likely to contract sexually transmitted diseases, have twice the number of sexual partners, and are 3X more likely to become pregnant than their non CD peers.

Kids with CD should obtain a comprehensive psychosocial evaluation. Many children with a conduct disorder may have treatable coexisting conditions such as mood disorders, anxiety, PTSD, substance abuse, ADHD, learning problems, or thought disorders. The earlier treatment is initiated, the better their response to the treatment. However, a lot of the adolescents with CD end up in custody for their criminal behaviors.

Tips for Law Enforcement Officers

You will undoubtedly be involved with a call related to a problematic child. Sometimes the kid is really out of control; sometimes the parents forget that it is their job to raise their children. The reality is that you can not fix their problems in fifteen minutes when it took them fifteen years to create this situation. Some parents will want you to take the child away, find someone to deal with him/her, and then have the child return as a perfect angel. Let's face, it that is not going to happen!

In most of these family disturbance calls there has been no crime, and the child doesn't represent a danger to self or others so there is little you can do other than mediate and give referrals. Speak to the kid separately and remind him that until he is eighteen his parents are in control. The harder part is talking to the parents. Explain why you can not simply remove the child from the home, despite their demands. Reinforce that the child is not possessed, criminal, or acutely mentally ill. Remind them that they are as much of the problem as the child. Parents can't start setting limits and consequences when a kid starts high school; that should have been done 13 years ago. Make the help appropriate referrals for both the child and parents. There are effective local programs to provide parenting skills and help family members negotiate expectations and rules. Try to role model calmness, active listening, and assertiveness for the child and the parents. If you suspect possible child abuse or neglect contact CPS and report your concerns.

Part of growing up is learning to be independent. Normal adolescence includes challenging parents and authoritarians within limits. It also involves learning to say no, and make individual decisions. Let's face it, no one reading this article was a perfect child or teen. By learning healthy negotiation skills kids will not enter an unfriendly world as a victim of crime.

Remember to treat your children well; they eventually pick your nursing home.