Understanding Behavioural Problems in Children

Every child throws a tantrum now and then. It is part of growing up, learning boundaries, and making sense of the world. But what happens when these behaviours become frequent, intense, or start affecting a child’s ability to function at home, school, or with friends? That is when we enter the territory of behavioural problems-a concern that affects approximately 12% of children from preschool through age 12. Understanding these problems is the first step toward helping children thrive.

What are behavioural problems in children? 🔗

Behavioural problems in children refer to patterns of emotional and conduct difficulties that go beyond what is considered typical for a child’s age and developmental stage. These are reactions and symptoms often caused by emotional disturbances, environmental maladjustments, or a combination of both. They represent a child’s struggle to cope with internal feelings or external circumstances.

It is important to distinguish between normal developmental behaviour and a genuine behavioural problem. All young children can be naughty, defiant, and impulsive from time to time, which is perfectly normal. However, when these behaviours become persistent, severe, and occur across multiple settings, they warrant closer attention. A behaviour observed only at home might be related to a specific family dynamic, whereas problems observed across two or more settings are significant and deserve further evaluation.

Types of behavioural problems 🔗

Mental health experts typically categorize childhood behavioural problems into two broad categories: externalizing and internalizing problems.

Externalizing problems 🔗

These are behaviours directed outward and are usually more visible to parents and teachers. They include aggression, oppositional behaviour, defiance, hyperactivity, and conduct issues. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorders are among the most common behavioural issues seen in preschool and school-age children.

Around one in 10 children under 12 years are thought to have oppositional defiant disorder (ODD), characterized by frequent arguments with adults, refusal to follow rules, and deliberate attempts to annoy others. Conduct disorder (CD) is estimated to affect about 5% of 10-year-olds and involves more serious behaviours like aggression toward people or animals, destruction of property, and violation of rules.

Internalizing problems 🔗

These are directed inward and may be less obvious to observers. They include anxiety, depression, withdrawal, and psychosomatic complaints. Internalizing behavioural problems manifest as depression, anxiety, withdrawal, and psychosomatic diseases. Children with internalizing problems may appear quiet or compliant but struggle internally with overwhelming emotions.

Causes and contributing factors 🔗

Behavioural problems rarely have a single cause. They typically result from a complex interplay of individual characteristics and environmental influences. Frequent behavioural problems often occur because of the combination of genetic vulnerability and exposure to environmental triggers.

Child-related factors 🔗

Several factors within the child can contribute to behavioural difficulties. Boys are much more likely than girls to experience behavioural disorders, though whether this is genetic or linked to socialization experiences remains unclear. Temperament also plays a role-children who are difficult to manage or aggressive from an early age are more likely to develop behavioural problems later.

Developmental delays, learning difficulties, and intellectual disabilities increase risk significantly. Children with intellectual disabilities are twice as likely to have behavioural disorders. Additionally, problems with reading and writing are often associated with behaviour problems.

Environmental and family factors 🔗

The environment in which a child grows shapes their emotional and behavioural development profoundly. Warm and supportive family environments typically promote healthy emotional development and contribute to positive behavioural patterns. Conversely, hostile and indifferent family environments may lead to emotional problems and behavioural abnormalities.

Neighbourhood socioeconomic status, including high unemployment rates and high rates of receiving public welfare benefits, has a significant influence on behavioural problems in children. A Canadian study found that a weak sense of community in a neighbourhood increases the likelihood of maternal depression and family dysfunction, which then raises the risk of inappropriate child-rearing practices.

The critical role of parenting and home environment 🔗

Research consistently demonstrates that the quality of parenting and the home environment significantly impact whether behavioural problems develop or persist. Children exhibit internalizing and externalizing symptoms as a result of harsh, aggressive, and intrusive parenting. When mothers and fathers are cooperative and supportive, the risk of emotional and behavioural problems decreases substantially.

Supportive parenting practices 🔗

Sensitive parenting with young children provides an emotional climate that offers security and confidence. Parents who promote reasonable regulations and self-initiation in social interactions help children develop better emotional regulation. This sensitive caregiving leads to early brain maturation and healthy cognitive and behavioural development.

Research on family environments shows powerful protective effects. At-risk adolescents who had good relationships with their parents were found to be four times less likely to engage in delinquent behaviour compared to peers without such relationships. Families marked by skilled parenting and high cohesion successfully moderate various developmental risks, including poverty and exposure to violence.

Impact of criticism and rejection 🔗

Youngsters with less warmth, acceptance, or a high level of rejection and criticism from parents develop a poor self-image and negative cognitive style. This negative self-concept creates a cycle where children act out, receive more criticism, and feel even more insecure. The result is often escalating behavioural problems.

A circular pattern can develop in young families. Children often respond to stress with stubbornness, back talk, and aggressiveness rather than with crying. If parents react by scolding, yelling, or spanking, children may escalate their negative behaviours, which leads to even more forceful parental reactions-creating a destructive cycle.

Assessment and evaluation 🔗

Proper assessment of behavioural problems requires a comprehensive, multi-faceted approach. When assessing children with behavioural problems, a detailed clinical evaluation is necessary to identify child, family, and environment-related factors, including developmental or health problems and social stressors contributing to the behaviour.

Components of assessment 🔗

Assessment typically involves several key elements. Parents are interviewed by the clinician to describe the behaviour, determine when it started, and provide examples of events that preceded and followed specific behaviours. The evaluation considers the child’s developmental stage, family dynamics, and environmental context.

Assessment through detailed history taking and observation of a child’s behaviour are indispensable sources of information. This includes general medical, developmental, family, social, educational, and emotional history. Physical and neurological examination should assess vision, hearing, motor skills, and cognitive function.

Screening tools 🔗

Several standardized tools help clinicians evaluate behavioural problems. Common behaviour screening tools include the Behavioral and Emotional Screening System (BESS) for ages 3-18 years, the Pediatric Symptom Checklist (PSC), and the Ages and Stages Questionnaire-Social Emotional (ASQ-SE) for children from birth to 5 years. These instruments help identify which children need more in-depth clinical intervention.

Parents and teachers typically complete questionnaires rating how a child behaves in various situations. These assessments identify behaviour patterns and potential reasons behind the behaviours. They look at how children interact with their world rather than providing right or wrong answers.

Why early intervention matters 🔗

The importance of addressing behavioural problems early cannot be overstated. As many as 50% of preschool behavioural problems can become chronic and persist into adolescence and adulthood, leading to conditions like oppositional defiant disorder and conduct disorder, which are associated with substance misuse, family violence, and crime.

Starting treatment early for behaviour problems is important and is most effective when it fits the needs of the specific child and family. The first step is talking with a healthcare provider, and a comprehensive evaluation by a mental health professional may be needed for proper diagnosis.

Management approaches 🔗

Effective management of behavioural problems typically involves multiple strategies working together. Initial management often involves helping parents learn effective behaviour strategies to promote desirable behaviours in their children. A structured and rewarding environment promotes positive behaviour.

Treatment options vary depending on the nature and severity of the problems. Treatment may include parental education, family therapy, cognitive behavioural therapy, social training, and anger management. For some children, encouragement to excel in particular talents helps build self-esteem, which many children with behavioural problems lack due to repeated failures.

Parents play a central role in treatment. Parents should spend at least 15 to 20 minutes daily in pleasurable activity with the child and call attention to desirable behaviours. Consistent parental responsiveness helps children develop security and independence.

When to seek professional help 🔗

While many behavioural issues resolve with appropriate parenting strategies, some situations require professional intervention. Attempts at self-injury, threats of suicide, violent behaviours, or severe withdrawal that creates an inability to carry on normal routines must be regarded as emergencies. In such cases, immediate attention through a mental health clinic or crisis centre is essential.

Consider seeking help when behavioural problems persist despite consistent management strategies, when the child is at risk of physical harm, when behaviours hinder the child’s functioning and development, or when family dynamics become significantly affected.

What do you think? How do you distinguish between normal developmental behaviour and a genuine behavioural concern in children you know? What role do you believe the home environment plays in shaping children’s behaviour?

References

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC6482425/
2. https://www.betterhealth.vic.gov.au/health/healthyliving/behavioural-disorders-in-children
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC5803568/
4. https://link.springer.com/chapter/10.1007/978-981-15-1831-7_2
5. https://www.researchgate.net/publication/381538093_The_Influence_of_Family_Nurturing_Environment_on_Children's_Emotions_and_Behaviors
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC9678477/
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC2671853/
8. https://www.merckmanuals.com/professional/pediatrics/behavioral-concerns-and-problems-in-children/overview-of-behavioral-problems-in-children
9. https://www.understood.org/en/articles/types-of-behavior-assessments
10. https://www.cdc.gov/children-mental-health/about/about-behavior-or-conduct-problems-in-children.html
11. https://www.pacer.org/cmh/learning-center/does-my-child-have-an-emotional-or-behavioral-disorder.asp