There are many different views on how to treat children/teens with CD (Conduct Disorder). Some researchers have indicated that food preservatives, high caffeine contents and foods that contain high amounts of sugar, though are not the cause of CD, certainly can exasperate the defining behaviours of CD. (Bilgiç, A., Türkoğlu, S., Özcan, Ö., Tufan, A., Yılmaz, S., & Yüksel, T. 2013). It is suggested that should a diet consisting of fresh foods, minimizing foods with sugars and caffine, will help to lower out bursts and impulse control issues amongst children diagnosed as having CD.

 

Conduct Disorder is solely a mental disorder, therefore the family dynamic is often the most contributing factor. The best forms of treatment for children as diagnosed with CD is to try and catch it early on in childhood. If a child begins exhibiting CD as child onset, should the caregivers wait for treatment, most cases with lead to adult personality disorders. However, should a caregiver recognize the early precursors to this disability, treatment options are not only helpful, but can result into certain children overcoming their disability. If a child early on (3-6yrs of age), can be diagnosed, psychologists with help within the family dynamic. Doctors will look at the overall function of the child's family unit, and help to educate the parents on achieving more conducive parenting skills. For instance, if a parent tends to ignore a child when they have these increasingly aggressive outbursts, hoping it will just pass, or if parents rely on inconsistent coercion, rather than reinforcement, in a family climate high in negative exchanges, a doctor would show the parents better communication skills to have with their child, to help alleviate the behaviour pattern. Psychologists will also look at the overall family dynamic, and see where improvements can be made to also help the parents to receive help they may need. A look at a family history of mental disorders will also be looked at, as well as possible physical issues leading to this disorder of conduct. If extreme cases of abuse is noted as a factor, children will be removed from the home, in order to be kept safe from abusive caregivers.

 

 

 

 

 

 

 

 

 

Educators will also be asked to be a part of the child's treatment. If a lack of teaching conduct at home is found, it will also become part of the school curriculum to help teach these children more constructive and more positive ways of handling themselves. "We’re not curing them, all we can do is teach them strategies to cope with the big, bad world." (Healthy Children.org. Disruptive Behavior Disorders, Nov 21, 2015). says an educator when asked about teaching children with Conduct Disorder.   A child with CD will be very disruptive in the classroom, so teachers and educational assistants, along with the parents, will devise a plan to help teach all proper forms of classroom and peer conduct. For instance, if a child with a mild or moderate form of CD tends to communicate by throwing objects across the classroom when not wanting to participate in reading, the child may be asked to go to an isolated room with an EA, (Educational Assistant) where there are less objects, and no one to harm while they try and  read. 

 

In more severe forms of CD, children will need to be isolated more often, and require more one on one teaching with EA’s. This will help to keep other children safe, as well has helping the CD child to learn more effectively. Many parents and educators tend to become increasingly frustrated with children who exhibit severe forms of CD. Sadly, most of these children tend to drop out of school, and this tends to lead to criminal and violent adult behaviours. 

 

 

 

 

 

 

 

 

 

 

Pharmacotherapy is also another tool in which to help more severe cases of CD. There is no formal drug that has been created for CD specifically, however, certain drugs along with the proper therapy and education, has been known to limit certain impulse control issues which leads to aggressive behaviors. Further studies are needed to evaluate the role of pharmacotherapy for conduct disorder. Most studies have involved children/teens that have more than one mental issue, such as depression, ADHD with their CD. Therefore, the medications they have been prescribed have often been the treatment based on the other underlying issue. Medications like Stimulants, anti-depressants, lithium, anticonvulsants and clonidine (Catapres) have all been used in the treatment of conduct disorder. 

 

Stimulant medications like Dextroamphetamine (Dexedrine) and Methylphenidate (Ritalin) are the most promising drugs used in the treatment of conduct disorder. However, there is no consensus concerning stimulant effectiveness in conduct disorder. Stimulants were used in small studies, and were shown to be effective in the reduction of aggression, but mostly with patients who also had ADHD as a disability.  

 

Although not widely used, at times certain anti-depressants were also shown to reduce aggressive patterns in children. However, certain caution is required with prescribing anti-depressants, as there have been links to cardiotoxic effects in children who are taking them. The most often prescribed anti-depressants have been, Bupropion, and Fluoxetine (Prozac). They specifically target selective serotonin reuptake inhibitors (SSRIs), which can be very helpful in treating children who have CD with depression.  

 

Clonidine has also demonstrated a significant reduction in impulsivity and aggressive outbursts. However, there are side effects of low blood pressure, bradycardia, and depression. The drugs can be lowered to help regulate these effects, however if a child already has depression, this drug could exasperate it further, which may not be the best course of action.                                                                                                                                                                                                                                                   

 

Lithium and anticonvulsants are also a more restricted form for drug intervention. Lithium contains anti-aggressive properties, however blood work must be taken bi-weekly until levels are stable, and then monthly to ensure no toxicity is present.  

 

Monitoring and the toxicity associated with lithium treatment may limit the use of this agent. Anticonvulsants have also been used to reduce aggression. The side effect profile and monitoring requirements provide similar limitations to the anticonvulsants.

 

The best and most effective way found however, is with regular therapy with a psychologist, PMT (Parent Management Training)  a positive and supportive role from parents, and with help from educators to help teach more effective ways of dealing with all types of situations. (Lahey, B. B., & Waldman, I. D., 2012). Other known effective ways to help teach better examples of positive interactions, is with behavioral therapy including role playing and reversal. It can show a cognitive change in perceptions of situations. A child with CD tends to not realize how their actions are affecting others, therefore with behavioural therapy with reversal, it can show how their behavior has negative effects.                                                                                                                                                         

 

                                                                                                         

 

 

 

This video shows an example of how reversal role play is used

to help a teen understand the effects of their behaviour.