Conduct Disorder (CD) – Early detection

First published by Milk & Hugs, and republished with permission.

The Worry…

Early childhood is a wondrous time of life, for both children and parents. Watching young minds form and bodies grow is one of the true joys of parenthood. As parents, we want the best for our children. We have dreams of who they will become, the type of life they may have. Ultimately, we want the best life for our children. What happens when our child is ill or has some sort of problem? We want to fix it. We are proactive and determined to find the solution.  But what happens when our child is still very young and our concerns sound vague (and perhaps a bit ridiculous) even to ourselves? How do we respond to the pediatrician who gives us that patronizing smile while telling us the child is just being a child, we are worrying over nothing, the child will “grow out of it.”

The first thing to know is to always trust your instincts, whether your child is 2 minutes or 20 years old. Instincts have served us well from the beginning of time and will continue to do so. It doesn’t matter if the child in question is your first or your fifth, trust your instincts.

What is normal?

Some things children will grow out of as they develop and mature. Toddlers are very self-centered and their demands on our time and attention are unlimited. Eventually toddlers grow into more reasonable beings as they learn how to express themselves. They learn it is much more fun to play with another child and share toys than to hoard all of the toys for themselves. They learn that hot stoves burn and that burns hurt. They learn that “no” actually has meaning and isn’t just a weird sound mom or dad makes all day.  

Between the ages of birth to four or five, a lot is going on developmentally. While that is wonderful, it can be a confusing time for parents. What is “normal” childhood behavior and what should be of concern? How do we bring it to the attention of others without sounding paranoid? Hopefully, this article will provide a few answers for parents of young children who are dealing with some behaviors that are the cause of concern.

…but is it really normal?

We’ve all heard the horror stories surrounding “the terrible twos.” This phase of your child’s life can actually span anywhere from a year old to as much as 30 months old. Tantrums can occur for numerous reasons and may include whining, crying, screaming, hitting, kicking, biting, and throwing things. A study published in 2003 suggests that nearly 75% of tantrums last five minutes or less. Most children under the age of five have one to three tantrums a day with varying degrees of severity. How do we know when to be concerned?

Donna Christiano’s recent Healthline article mentions these indicators as reasons for concern:

  • tantrums that consistently (more than half the time) include hitting, kicking, biting, or other forms of physical violence toward the parent or caretaker
  • tantrums in which the child tries to injure themselves
  • frequent tantrums, defined as tantrums that occur 10 to 20 times a day
  • tantrums that last longer than 25 minutes, on average
  • an inability of the child to ultimately calm themselves

Children with these behaviors may have conduct disorder. Learn more about Conduct disorder here.

When other parents talk about Conduct Disorder

In addition, parents from an online Conduct Disorder support group have described the tantrums more as “rages” due to the level of anger and violence the child displays. One mother states that her 3 year old daughter will scream, hit walls, hit other people, bite, kick, and destroy whatever she can get into her hands, for hours on end.

Parents in this same support group have provided a list of other behaviors they noted in their young children which were causes for alarm:

  • deliberately cruel to people or animals
  • early sexual aggression (age 2 and above)
  • manipulative (age 3 and above)
  • flat affect
  • superficial charm (age 4 and above)
  • inability to relate actions to the consequences that follow, such as time out
  • discipline causes further rage in the child, has no effect on behavior

What can you do?

What can you do if your child exhibits some of these more extreme behaviors? The first thing is to document the behaviors in a notebook or journal that is used exclusively for this purpose. Note the behavior, total elapsed time of the behavior (if a tantrum/rage, state the total time from beginning until the child is calm), date and time of the event. Also document your actions/responses.

Try to remove emotion and extra information from the list. It’s difficult to notice these specifics under stress but at least make note of the time, you can document the rest later. You are gathering documentation that will be much needed further down the road. At the beginning of the notebook, write down when these behaviors first began (age or date if you remember). Most of the time it has been so gradual that you cannot put an exact date to the first unsettling event but you can likely pinpoint an approximate age. Physicians like to see six to eight weeks of data. This can be difficult to do if your child is having 10 – 20 tantrums/rages per day. Do the best you can while remembering that documentation is your friend.

The Doctor Visit

After you have several weeks of information, take your child to his or her pediatrician. In a calm and confident manner, state what behaviors are of most concern to you. Have a list prepared and bring your notebook with you. Be concise and do not use vague language; no sort of, kind of, maybe, like, etc. Always speak with authority with regard to your child’s behaviors. Speaking in this manner shows that you are not an insecure parent who just needs a little patronizing from your child’s pediatrician.

Remaining calm indicates that you’re not some hysterical parent in over his or her head. Knowledge and a confident attitude are part of your tools to utilize in order to obtain an appropriate response from your child’s doctor. If you do not receive the assistance you need or feel that your concerns have been brushed aside, ask for a second opinion. Keep looking for answers and help until you find it.

Compass for Conduct Disorder is a nonprofit organization whose goal is to provide resources, services, and hope for those living with CD. In addition to a parent/caregiver support group, Compass also provides an information and awareness group, parent advocacy, crisis buddies, the Compass Peer Network for professionals to exchange information relating to CD, and an awareness raising campaign. In the planning stages is the Compass Child and Family Support Center, which will be geared toward children ages 2 to 5 showing early signs of Conduct Disorder, and their families.

If you have a child with Conduct Disorder, Compass for Conduct Disorder is a place to find support, resources, and community.

Website: www.compassforcd.org
Facebook: @CompassforCD
Twitter: @CompassforCD
Compass Cares: A Conduct Disorder Support Community
Compass for CD Information and Awareness


Karen Huff is the mother of four children, one of whom has Conduct Disorder.

She is the President for Compass for Conduct Disorder and an admin for the Compass Cares support group, as well as for the Compass for CD Information and Awareness group. 

Connect with her on Facebook and Twitter.


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