Toddlers having tantrumsWhat is the difference between normal childhood tantrums and behavior indicative of an ongoing problem in preschool children? A new study from Washington University School of Medicine in St. Louis investigated the markers of conduct disorder, a disorder characterized by defiant and disruptive behavior. They identified several symptoms that set conduct disorder apart from typical toddler behavior.

Study co-author Joan Luby, MD, professor of child psychology, explains that disruptive behavior is not normally something clinicians view as a risk factor. “Previously, we did not understand the empirical differences between normal disruptive behaviors in preschoolers—like temper tantrums, for example—and behaviors that signal problems. If you went to your pediatrician and said, ‘My 3-year-old is having tantrums,’ the pediatrician wouldn’t tell you to see a psychiatrist.”

Conduct disorder is characterized by “high-intensity” defiant behavior and aggression, which can include destroying property, problems with peers, and deceitfulness. The researchers explain that the intensity of defiant behavior is what separates conduct disorder from run-of-the-mill temper tantrums. High-intensity behaviors:

  • Are frequent.
  • Occur in a variety of contexts.
  • Last for a long time.

The findings suggest that, for preschoolers with high-intensity symptoms, conduct disorder is likely to persist into elementary school. For school-aged children, conduct disorder can affect peer relationships and academic achievement.

Identifying the symptoms of conduct disorder and distinguishing it from typical toddler behavior is a critical part of helping children with conduct disorder get early treatment. The researchers recommend that children with the symptoms of conduct disorder be referred to mental health professionals for evaluation and interventions.

This research is published in The Journal of Pediatrics.

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