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Behaviour Basics

Tuesday, June 09, 2015

How do you deal with a child who has behavioural problems? Identifying and accepting the problem is just the first step. In the first of a two-part series on children’s conditions, Anindra Siqueira & Dev Goswami bring you a guide to help you deal with them

Many people believe that a parent should never outlive their child; that it is one of the most difficult things for a parent to endure. Another on the list is if their child develops psychological or behavioural conditions, which can range from common ones such as hyperactivity or learning disabilities to more heart-breaking ones such as schizophrenia. In the first of our two-part series, we shed some light on behavioural disorders that affect children. We also tell you what behaviour you need to look out for and what you can do to ease the stress for your child. Next week, we will be telling you more about a few neurological conditions.

The Common Ones
Dr. Shefali Batra, psychiatrist, counsellor, author and founder of MINDFRAMES, tells us that the most common psychological conditions are collectively known as anxiety neuroses. While separation anxiety is the most common condition, phobias, generalised anxiety and obsessive disorders are other conditions are frequently affect children. She tells us, “Oppositional defiance disorder (ODD), conduct disorder (CD), attention deficit hyperactivity disorder (ADHD) and mood disorders such as depression, form a large chunk of psychopathology — the study of mental illnesses. The early onset of schizophrenia, substance use disorders (addictions), bipolar disorder and pervasive developmental disorders such as autism and Asperger’s syndrome are some of the rarer disorders. Learning disorders or learning disabilities and attachment disorders are also included in the psychological disorders that affect children. However, eating disorders such as anorexia and bulimia nervosa affect them more during adolescence.”

What To Look Out For
Behaviour is a finicky concept. Sometimes, it can just be a simple case of bad behaviour, while at other times, your child could be suffering from a full-fledged disorder that requires medical intervention. While a parent almost always knows when something is wrong with their child, some of these conditions are too complex to understand and you will only be able to identify them if you have the basic know-how of what to look out for. Dr. Shefali tells us about the signs and symptoms of common behavioural disorders.

  • ODD It’s quite clear from the name;  oppositional defiance disorder is characterised by anger, defiance and the unwillingness to accept authority or go along with what others tell them to do, almost all the time. Dr. Batra explains, “Children who suffer from ODD are annoyed and resentful, lose their temper easily and blame others for their mistakes. It’s hard for them to be able to blend in an academic or social setting.”
  • CD Children who are violent and disruptive are said to have conduct disorders. Dr. Batra says, “Conduct disorder is typically characterised by a disregard for everyone else. Children who suffer from a conduct disorder may tease and bully others, push, hit or bite others and may also steal or set things on fire. These children are often labelled as ‘cruel’ by those who know them, as their negative behaviour is often extreme.”
  • ADHD Attention deficit hyperactive disorder is characterised by an impatience, the inability to wait for things and  difficulty focusing. Children who have ADHD also repeatedly get into fights without hostile intentions, make silly mistakes and answer questions before you  even finish asking them. Dr. Batra says, “This is a disorder with three different manifestations — inattention, hyperactivity and impulsion. There may be one, two or all three varieties of behaviour seen. Children with ADHD are frequently pulled up by school authorities.”
  • OCD Although this is a neurological condition (like ADHD), it manifests in a behavioural form. Dr. Batra tells us that children with OCD refuse to let go of irrational, upsetting or scary thoughts. To lessen the anxiety associated with these thoughts, they engage in a type of behaviour — for instance, they may insist that things take place in a certain order without any exception — that may seem out of the ordinary to other people. But, they are very important to them. Dr. Batra says that children with OCD usually suffer from depression too.
  • Mood disorders If children have mood disorders, they can be sad or irritable for prolonged periods of time for no apparent reason. Mood disorders cover a broad spectrum of conditions and are relatively easier to spot in a child.
  • Separation anxiety Dr. Batra says, “Although being separated from loved ones is always hard for children, it’s part of their development process. However, if a child becomes restless, especially when it comes to going to school, birthday parties, sleepovers or camps, then they may have separation anxiety.” Children fear such situations and may complain of headaches, stomach pain and sometimes, these fears can even manifest as actual physical symptoms.
  • Social anxiety Children who have social anxiety are extremely conscious of their social image and performance. They may be afraid of saying or doing things that they feel will be judged negatively. According to Dr. Batra, socially anxious children shy away from social situations as an escape mechanism. She says, “They are self conscious, even though they know that they needn’t be afraid. If left untreated, this behaviour is a sure shot harbinger of anxiety and depression in adulthood.”

If your child exhibits any of these conditions, don’t be alarmed. Sometimes children display a wide range of behaviour, not all of which is a psychological or neurological conditions. However, if you do suspect that your child suffers from a behavioural problem, make sure that you consult a psychologist “or psychiatrist.

What You Can Do
Treating psychological or neurological conditions is never easy, but ignoring them is definitely not the answer. Such conditions don’t go away on their own. In fact, if they are not addressed, behavioural disorders can go out of control. Dr. Batra tells us that there are several techniques used by psychiatrists, psychologists and counsellors to diagnose such conditions, which include having one-on-one interactions with the child and using puppets, music and computer-assisted programs.

Children with behavioural disorders are treated with therapies such as cognitive therapy. Cognitive therapy is used in conjunction with behavioural therapy to break the emotion-thought-behaviour cycle that leads to behavioural problems. However, since these conditions are accompanied by a certain pathology, Dr. Batra cautions against punishing the child for ‘bad’ behaviour. She says, “Punishment does not find a place in behaviour modification. Parent education and guidance forms an integral part of the therapy protocol, where we empower parents with essential skills to help their children.”

Tips For The Home
Let your child tumble, fall down and pick himself or herself up; only then will they truly understand the consequences of making mistakes and learn valuable life lessons from them — this is a sound piece of advice that is often recommended to parents. However, there is a minor, but important addendum to this. This tactic is effective only when your children are in their teens or are entering adulthood. When it comes to children who are as young as six-years-old, it’s important that parents do not encourage bad behaviour.

Remember however, that not all kind of bad behaviour is a sign of a behavioural disorder — just because your children bully their friends at school, doesn’t mean that they suffer from a disorder. It could, and usually is, simply bad behaviour that can be corrected with an intervention on your part.
If you notice any signs and symptoms that we’ve discussed above, you should seek an expert’s help, but Dr. Batra explains that most bad behaviour can be prevented or changed with good parenting techniques. She tells us to be wary of falling into the pitfalls of the two extremes — both, mollycoddling your child or being extremely strict (which could include shouting at or physically punishing them) can have negative consequences. She explains, “Disciplining is about preventing bad behaviour. In my parent guidance programs, I educate parents on appropriate discipline principles, scientific behaviour modification strategies and methods of democratic parenting in order to inculcate positive behaviour and prevent psychopathology.”

A Real Life Example
Dr. Batra tells us about the case of Varun, a five-year-old boy, whose situation perfectly demonstrates how pampering your child can lead to negative behaviour. Varun had reached a point where, since he was so used to getting his way by throwing temper tantrums, his mum had to deal with him urinating in a store because she didn’t agree to buy him what he wanted. Dr. Batra tells us that since Varun was pampered from an early age, he couldn’t grasp the idea of being denied anything. Every time his mother gave in to his tantrums, it reinforced his belief that by being angry or threatening to throw a fit, he would get his way. A behavioural therapy programme that he was in along with his mum, helped guide him and also taught her how to ignore his negative behaviour. Today, Varun realises that throwing tantrums won’t get him anything. He is now  very courteous.  But, it wasn’t easy — Dr. Batra tells us that it took her speaking with his entire family, including the nanny, to ensure that his temper tantrums weren’t encouraged by people giving in to his demands.

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