Parents of children with a conduct disorder need better training on how to deal with the issue, according to the National Institute for Health and Clinical Excellence (NICE) and Social Care Institute for Excellence (SCIE).
Updated evidence-based guidance on treating children who display persistent antisocial behaviour states that many do not receive treatment because of the limited resources currently available, the high prevalence of the condition and the difficulty of engaging some families. Conduct disorders continue to be the main reason for referral to child and adolescent mental health services.
“A number of effective interventions have already been developed for children with conduct disorders and related problems. However, uptake of these programmes has been variable,” said professor Peter Fonagy, chief executive of the Anna Freud Centre and a member of the guideline development group.
The guidance recommends that all children with a possible conduct disorder be assessed for a co-existing mental health problem such as depression or post-traumatic stress disorder, or a neurodevelopmental condition such as autism or attention deficit hyperactivity disorder (ADHD). They should also be assessed for a learning disability and substance misuse.
Parent training programmes should be aimed at those with children aged between three and 11 years. Children aged between nine and 14 years should also be offered child-focused programmes, to improve their social and cognitive problem solving skills.
“All children can be naughty, defiant and impulsive from time to time, which is perfectly normal. But some children have extremely difficult and challenging behaviours that are outside the norm of their age,” said Fonagy.
Commenting on the updated guidance, Fiona, a mother of a child with a conduct disorder, said parents needed practical support and advice, such as what to say to calm a child when they are very distressed.
Bridget Robb, interim chief executive of the British Association of Social Workers, said the guidance was an “excellent response” to a significant issue, which detailed the need for crèche facilities, travel assistance and advocacy services to help parents engage with services.