Tag: CD

The Secret Next Door (Child on Parent Violence)

Annie watched in horror as Charlie, red-faced with rage, snatched a picture frame off a wall and slammed it against the bedpost. The glass shattered. He picked up a long shard and brandished it like a dagger. Stalking towards Annie, he growled, “I’m gonna kill you.”

This type of abusive behavior in relationships is far too common. 29% of women and 10% of men in the US will experience domestic violence in their lifetimes. Child protective services investigates more than three million reports of abuse and neglect annually. However, Charlie and Annie’s altercation isn’t included in either of these statistics.

That’s because Charlie is a 13-year-old boy. And Annie is his mother.

What the parents living next door may be hiding

Like Annie, I’m the mother of a son who acts out. Both our boys are products of the foster care system, adopted as toddlers, and who are diagnosed with Reactive Attachment Disorder (RAD) and Conduct Disorder (CD), serious behavioral disorders. They have both received medication and thousands of hours of treatment, but nothing has helped.

When Annie and I tell friends, family, and mental health professionals about our sons’ behaviors, we are met with disdain and disbelief. In the same way many sex abuse victims are treated, parents like us are blamed and shamed into silence. We have been forced underground, into private Facebook groups where we find non-judgemental support from thousands of other parents in similar situations.

Four years ago, Lillyth Quillan founded the online parent support group, Parents of Children with Conduct Disorder. She says, “More than 1,000 families have come together to share their stories; to know they are not alone. They are emotionally raw and shredded to the marrow at how they’ve been treated and not believed by close friends and family.”

How many families this affects

The general public assumes these situations, where children are violent towards their parents, are isolated to a handful of sensationalized episodes of Dr. Phil.

This is simply not the case.

While the anecdotal evidence of children with serious disorders abusing their parents is abundant, quantitative data is desperately lacking. This is why I recently surveyed more than 200 parents of children diagnosed with, among other behavioral disorders, RAD and CD. This type of informal survey is an invaluable way to begin to understand the scope of the problem.

According to my survey, Are You In An Abusive Relationship? more than 90% of the respondents are in chronically abusive relationships – and the abuser is their child.

  • 93% say their child threatens them, other family members, or pets with physical violence.
  • 65% say their child grabs, hits, kicks, or otherwise physically assaults them.
  • 71% say their child hides their behavior from others and blames them for their outbursts.

These aren’t merely numbers; each one is a tragic story. Here are just a few of the examples shared anonymously by survey respondents:

“My son purposely hurts the cat to get my attention.”
“My daughter attacked me with a steak knife.”
“My son choked me and broke my wrist.”

Anonymous parents

These findings show that it is alarmingly common for children with serious behavioral disorders to abuse their parents.

When children abuse their parents

Intentional Child to Parent Violence (I-CPV) is deliberate, harmful behavior by a child to cause a parent physical or psychological distress. These are purposeful behaviors intended to gain control over, and instill fear in, parents. I-CPV takes many different forms and varies in severity. It is often chronic and usually directed at the child’s mother figure. [1]

One surveyed mom has a moon-shaped scar on her forehead from her 14-year-old daughter grabbing her by her hair and slamming her face onto the stove. Another mom says her son tried to push her down the stairs and makes homicidal threats towards her.

Parents like these sustain physical injuries and may develop mental health disorders including PTSD. They are isolated from friends and family. Their marriages can become irreparably damaged. They frequently lose jobs and friends. Other children in the home suffer secondary, if not primary trauma.

Without highly specialized treatment, the child perpetrating the abuse will not get better. Far too often, it becomes necessary to have them institutionalized, or end up incarcerated, for the safety of their siblings, parents, and themselves.

Hypervigilance – and fear – are common for parents in these situations. One mom describes how, “Before my son was taken to the hospital, then jail, and then a treatment center, I had to sleep with my door locked and a chair jammed under the knob because he knows how to pick locks.” She suffers with PTSD after years of chronic abuse.

Why children abuse their parents

While there is no one clear “cause” leading to antisocial behaviors like I-CPV, there are a number of underlying factors to consider. Perhaps the most significant is “developmental trauma,” a term coined by leading expert, Dr. Bessel van der Kolk, MD. When a child is chronically neglected or abused at a young age, their brain development may be impacted, causing long-term issues sometimes including physical aggression. This is called Developmental Trauma Disorder (DTD) and is commonly diagnosed as CD or RAD.

While developmental trauma can explain much of RAD, not all children who are violent towards their parents have a trauma background. Some children from nurturing families are diagnosed with CD. Psychologist Stanton E. Samenow, PhD specializes in working with juvenile offenders and says early identification of emerging antisocial behaviors is key. He points to a study that found “aggression at age 8 is the best predictor of aggression at age 19, irrespective of IQ, social class or parents’ aggressiveness.” [2] He believes, regardless of environment and parenting, children become antisocial by choosing the bad behaviors that eventually become an entrenched pattern.

As a parent, I don’t believe these are mutually exclusive views and find both to be informative. My son has a history of developmental trauma. As a result he struggles with impulsivity, attachment, and cause-and-effect thinking. At the same time, his behavior is not involuntary. He is making a choice when he acts aggressively and knows right from wrong.

Why families can’t get help

Even once parents understand the complexity and seriousness of the abuse taking place, there is nowhere to turn for help. Unfortunately, the systems designed to protect victims of other types of abuse don’t have a mandate to protect the victims of I-CPV.

Most domestic violence shelters are for intimate partners, and, for example, offer no help to a mother whose son or daughter beats her. Advice commonly given to victims of domestic violence simply doesn’t work. Take for example the following from the online article, “What to Do if You Are in an Abusive Relationship“:

1. Talk with someone you trust
Parents are rarely believed by friends, family, teachers, and mental health professionals. Instead, they’re blamed for their child’s misbehavior and labeled bad parents. One mom says, “My son can be incredibly sweet and charming when he wants to be. My friends, his teachers – my own mother – don’t believe my 9-year-old son is dangerous because he’s so good at hiding his behavior.”

2. Call the police if you are in immediate danger
Parents receive little assistance from police, especially if their child is under the age of 16. They also hesitate to press charges knowing incarceration is not the “treatment” their child needs. One mother called 911 after her son beat her. The officer said to her son, “It’s okay, Buddy, you’re not in trouble. Let’s talk.” The next time her son beat her, she ended up in urgent care.

3. Make a plan to go to a safe place such as a shelter
Despite their child’s abusive behaviors, parents are still legally and morally responsible for them. Even if parents want to seek safety, their hands are tied. “If I were treated this way by a man,” says one mother, “I would have left long ago. But because this is my daughter, my options are limited.”

Unfortunately there are no good solutions for these parents, and no quick and easy cures for their children. Few therapists and mental health professionals are equipped to offer the highly specialized treatment needed. While there are promising advances in neuroscience, emerging treatments are not accessible for most families. They’re expensive, rarely covered by health insurance, and unavailable in most areas.

Out of all the families she’s worked with, Quillian says only one family has ever received appropriate treatment. “One. One family experiencing what I believe to be the absolute bare minimum of care. One.”

What needs to change

I-CPV isn’t merely talk-show fodder. It’s happening behind closed doors in your neighborhood. It’s happening in Annie’s home. It’s happening in mine.

While the US lags behind, there appears to be growing awareness of I-CPV in the UK where a new domestic abuse bill includes I-CPV. US citizens can support these families by asking their legislators to draft similar legislation which would not only provide legal remedies, but more importantly, facilitate funding for research, prevention and treatment.

We need viable treatment options for our children, as well as resources to combat the violence and destruction we face in our daily lives,. We need help and the support of our communities. That begins with a national dialogue about I-CPV and viable treatment options for serious behavioral disorders.

Parents deserve the same support and understanding that all victims of abuse deserve. Until then, they will suffer physical and psychological harm while their child faces a lifetime of relational, educational, financial, and legal struggles.

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.

What is Conduct Disorder?

I stand in the bathroom stall of the courthouse, texting a friend. “I can’t do this,” I write and lean my head against the cold partition of the stall.

“You’ve got this,” she replies. “Breathe, Honey.”

I hear the restroom door open and a singsong voice I recognize as my daughter, Debbie, quietly calls my name. I quickly pull my feet up, trying to be invisible. “I know you’re in here, you stupid bitch. Come out, come out, where ever you are.”

My breath halts and my pulse pounds in my ears. Be still, be quiet, I think. Maybe she will go away.

Footsteps approach as door after door of the stalls bang open. I quake in fear as the steps come nearer until I see her shoes in front of my door. 

“You can’t hide forever,” Deb says in a lilting, singsong voice. She quickly tells me how plans to murder me and what she will do with my body before setting it and my home on fire. She reminds me that she has had months to perfect her plan, while in juvenile detention, without my interference. 

I don’t respond.

Tiring of her game, Deb’s voice acquires the hard edge I’ve come to associate with rage. “Get out here, you bitch. I hate you. I want to see you scream as you die. Your precious boy will die, you will all die.” I cower behind the door as her diatribe continues; the words increasingly vulgar.

Suddenly the door into the hall opens and a new voice speaks. “Deb, are you in here?”

I hear Deb whisper, “Shit.” Then she begins to sob. 

“Baby, what’s wrong? What happened?” I recognize the newcomer as Deb’s caseworker.

Still sobbing, Deb says, “I saw Mommy come in here. I just wanted a hug. She hates me.” She wails and sobs as though her world has just ended. “Why doesn’t she love me, Miss C?” 

Debbie is only 14. Debbie has Conduct Disorder.

What is Conduct Disorder?

The DSM-5 (the manual used by mental health professionals to make diagnoses) defines Conduct Disorder (CD) as “a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated.”

Children with Conduct Disorder (CD) may exhibit behaviors such as:

  • bullying, threatening, or intimidating others
  • initiates physical or verbal altercations
  • physically or verbally cruel to others
  • physically cruel to animals
  • steals
  • forces someone into sexual activity or is sexually aggressive
  • frequently lies
  • deliberately sets fires or destroys property
  • lack of empathy
  • lack of remorse
  • grandiose thinking
  • highly manipulative
  • rages (or “tantrums”) lasting 25 minutes or more
  • inability to learn from mistakes
  • lacks critical thinking skills/has difficulties understanding abstracts
  • shallow affect
  • superficial charm/has a public and private demeanor
  • lack of fear

Recent scientific studies indicate CD is in part due to abnormal brain activity, as well as an under development of the amygdala and prefrontal cortex. The amygdala is known to be responsible for controlling aggression as well as the perception of emotions. The prefrontal cortex handles executive functions such as controlling short-sighted or reflexive behaviors in order to plan long-term goals, make informed decisions, and exhibit self-control.

But what does all of this really mean?

In simple terms it means that the child with Conduct Disorder has a brain that is structurally different from that of a neuro-typical child. Because of this difference, the child with CD does not respond to rules, discipline, and societal norms the way a typical child does.

Conduct Disorder is evidenced by some, or all, of the behaviors listed above. The spectrum of behaviors is wide and varies between mild to severe. The tendency to lie, manipulate, and gaslight are strong and seemingly innate behaviors.

Standard parenting techniques are not effective. Discipline, rewards for good behavior, star charts, and other techniques fall short of managing behaviors long- term. Conduct Disorder transcends race, ethnicity, environment, location, and socioeconomic backgrounds. Unlike attachment disorders CD is not always due to trauma, abuse, or neglect. However, many children diagnosed with Reactive Attachment Disorder (RAD) at younger ages are ultimately diagnosed with CD as teenagers. CD can manifest at 2 years old or 15 years old, and any age in between.

There are an estimated 7 million children in the U.S. alone with Conduct Disorder. This translates into approximately 1 in 10 children affected.

For families affected by CD, it can mean very little in terms of treatment. Children with Conduct Disorder do not respond well to traditional talk therapy. In general, these children will use the counselor to further manipulate caregivers. Some go so far as to employ triangulation, in which the counselor becomes the unwitting accomplice of the child to further demoralize caregivers. Medication cannot relieve the symptoms of CD but it may be prescribed for co-morbid diagnoses such as ADHD.

At present there are very few viable inpatient treatment centers for children with Conduct Disorder. Many programs state that CD is treated at their facility, however most apply standard practices toward the treatment of other mental illnesses to CD. This is highly inappropriate and may lead to further issues for both the child and family living with CD.

Often, families feel vilified and become isolated due to the harsh judgment they face. Family and friends lack understanding of what is happening and drift away, unable to provide support for something they seldom witness. Parents beg doctors and mental health professionals for help, only to be mocked and treated with derision. The community, hearing of the child’s disrespect and abusive nature when the police are called, make assumptions about the parents: too lenient, too strict, not enough activities, too many activities, set boundaries, spank him/her, it’s all because of poor parenting, they say. All this does it further isolate families who are living in a constant war zone, created by someone they love and for whom they are legally responsible. Love does not cure Conduct Disorder (CD), nor does being a model family.

If there are no treatment options available, what can be done?

Fortunately, CD is being researched more in recent years. Unfortunately for those living with CD, viable treatment options are still years in the making. The founders of Compass for Conduct Disorder realized the need for community support programs, resources for parents/caregivers, and early childhood detection and intervention.

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.