Some mental disorders typically present in childhood and are identified when there is a disruption or recognizable difference in typical child development. If childhood disorders do not resolve, they may evolve into adult disorders, persist into adulthood, or remain unidentified until adulthood.

Disruptive, Impulse-Control, and Conduct Disorders

This group of disorders, often called disruptive disorders because they involve the “disruption” of the child’s environment, includes a number of specific conditions. Three of the more common disorders included in this group are briefly discussed in this section: oppositional defiant disorder (ODD), conduct disorder, and intermittent explosive disorder. The rare disorders of pyromania and kleptomania, which relate to fire-setting and stealing, are also in this category. Disruptive disorders can be challenging to treat; however, focusing on these disorders while a person is still a child or adolescent is helpful (American Psychiatric Association, 2024b).

Each of these disorders, except kleptomania, is more frequently diagnosed in males than females (American Psychiatric Association, 2024b). Caution must be exercised when considering a diagnosis of any of the disruptive disorders, as studies reveal racial discrepancies in these diagnoses due to systemic and provider biases. White children are more likely than Black or Hispanic children to receive diagnoses of Attention-Deficit/Hyperactivity Disorder (ADHD), a neurodevelopmental disorder discussed later in this chapter, while Black children are significantly more likely to be diagnosed with disruptive disorders (Fadus et al., 2020). Black children are also less likely to be diagnosed with trauma, anxiety, or depression, even though those symptoms are often at the root of perceived behavior issues that are misunderstood by white authority figures and mental health professionals (Richtel, 2022). Misdiagnoses perpetuate racist stereotypes, improperly label children, and impair effective treatment—all problems with lasting and damaging consequences.

Oppositional Defiant Disorder

ODD may be diagnosed in children receiving mental health care for excessive behavior problems. Symptoms of ODD, which typically appear in young childhood (preschool or early elementary school), include anger or irritability and defiant or vindictive behavior that is upsetting and disruptive, but not aggressive. Most children grow out of this disorder, but some are later diagnosed with a more serious version of the disorder: conduct disorder (American Psychiatric Association, 2024b).

Conduct Disorder

Conduct disorder can be based on behaviors seen as early as preschool age, but these more serious behaviors typically emerge later in childhood. Symptoms of conduct disorder may include aggressive behavior directed at people or animals, destruction or theft of property, and serious rule violations, such as running away from home. These behaviors cause significant problems in all areas of life and may involve law-breaking behaviors. About 40% of children with conduct disorder eventually meet the criteria for an antisocial personality disorder diagnosis (American Psychiatric Association, 2024b).

Take a look at the video in figure 2.18 to hear a child psychologist very briefly summarize the diagnosis of conduct disorder.

https://www.youtube.com/watch?v=g58qUHEq6fU

Intermittent Explosive Disorder

Intermittent explosive disorder involves impulsive, angry outbursts—such as temper tantrums or fights—that are out of proportion to the triggering event. The outbursts are reactive and unplanned, rather than goal-directed, and often last a for short time. Outbursts typically involve physical aggression or property destruction. Children diagnosed with this disorder must be at least 6 years old, but the behavior is generally observed a bit later, often in adolescence (American Psychiatric Association, 2024b).

Neurodevelopmental Disorders

Neurodevelopmental disorders are disorders involving brain function that present at the developmental stage in a person’s life—typically in early childhood. These disorders can cause differences in social, cognitive, and emotional functioning (Blain, 2022). Attention-deficit/hyperactivity disorder, autism, and intellectual developmental disorder are all examples of neurodevelopmental disorders.

Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder, commonly known as ADHD, is a neurodevelopmental disorder diagnosed when a person has significant problems with inattention or impulsivity. Many people experience some lack of focus, but for people with ADHD, the problem interferes with daily functioning. Examples of inattention may include difficulty following through on instructions and avoiding tasks that require mental concentration to complete.

ADHD symptoms can appear as early as preschool age and can continue through adulthood. Symptoms of ADHD may be mistaken for emotional or disciplinary problems, or they may be missed entirely, preventing proper diagnosis. Adults with untreated ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

Available treatments for ADHD (medications, therapy, and education) are effective in reducing symptoms and improving functioning.

Autism Spectrum Disorder

Autism spectrum disorder is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is considered a developmental disorder because signs generally appear in the first two years of life. People of all genders, races, and ethnicities can be diagnosed with autism, though misunderstandings about the disorder present a barrier to proper diagnosis in some groups, including females and people of color (Autistic Self Advocacy Network, 2024a). Autism is known as a “spectrum” disorder because there is wide variation in the type of autism traits that people experience.

People with autism may present as having difficulty with social communication and interaction, as well as having restricted interests and repetitive behaviors. An autistic person, for example, may avoid eye contact or display facial expressions that do not “match” what is being said. Repetitive behaviors may appear as repeating words and phrases, for example. People with autism may be particularly sensitive to changes in routine or to sensory input (e.g., clothing or sounds). The neurodiversity movement, which recognizes and celebrates that all peoples’ brains operate differently, reminds us that these differences are certainly not always negative (Autistic Self Advocacy Network, 2024b). Consider how many autistic traits may be seen as strengths, such as passion and focus (figure 2.19). If you are interested in learning more about autism, consider exploring the informative web page of the Autistic Self-Advocacy Network (ASAN) [Website], whose motto is “nothing about us without us.”

Intellectual Developmental Disorder (Intellectual Disability)

Intellectual developmental disorder, formerly known as intellectual disability, starts any time before a child turns 18 and is characterized by differences in intellectual ability or intelligence, including learning or problem-solving, and in everyday life skills (often called adaptive behaviors) (National Institutes of Health, n.d.). Generally, intellectual developmental disorder is diagnosed when a person has an I.Q. below 70 and significant limitations in their daily functioning. The most common causes of intellectual developmental disorder are genetic causes, such as Down Syndrome, or events during pregnancy or birth that impact brain development. Intellectual developmental disorder is the most common developmental disorder (Special Olympics, n.d.).

People with intellectual developmental disorders are vastly overrepresented as both victims and offenders in the criminal justice system (Prison Policy Initiative, 2024). This group is especially vulnerable to wrongful convictions. This is for myriad reasons, including the fact that many individuals with this diagnosis may not be able to understand their legal rights (such as the right to refuse to speak with authorities without a lawyer present) and may have a compromised ability to communicate with counsel or participate in their own defense. Additionally, people with intellectual disability may have adaptively become accustomed to pleasing authority figures, including police, placing them at risk of offering false confessions (Davis, n.d.). As we saw in Ethan Saylor’s story, which introduced this chapter, people with intellectual disabilities and other developmental disorders are certainly vulnerable to victimization by police—with terrible outcomes—when they interact or respond to directives by authority figures in atypical ways.

Fetal Alcohol Spectrum Disorders

Fetal alcohol spectrum disorder (FASD) is an umbrella term for a range of physical, cognitive, and behavioral disorders caused by prenatal alcohol exposure. These conditions can impact a diagnosed person in different ways, and impacts can range from mild to severe. Neurological impairments commonly found in FASD include learning disabilities, impulsivity, hyperactivity, and poor judgment. Physical problems might cause unusual facial features and impact systems including vision and hearing.

It is estimated that approximately 1 to 5 percent of U.S. first-grade children have FASD, but this disorder is significantly overrepresented in the criminal justice system. Some studies indicate people with FASD may be 40 times more likely to have criminal justice involvement than people without FASD (Brown et al., 2022).

Licenses and Attributions for Mental Disorders Identified in Childhood

Open Content, Original

“Mental Disorders Identified in Childhood” by Anne Nichol is licensed under CC BY 4.0.

Open Content, Shared Previously

“Attention-Deficit/Hyperactivity Disorder” by Anne Nichol, licensed CC BY 4.0, is adapted from Attention-Deficit/Hyperactivity Disorder by the National Institute of Mental Health, which is in the Public Domain.

“Autism Spectrum Disorder” by Anne Nichol, licensed CC BY 4.0, is adapted from Autism Spectrum Disorder by the National Institute of Mental Health, which is in the Public Domain. Modifications include revising and expanding.

“Fetal Alcohol Spectrum Disorders” by Anne Nichol, licensed CC BY 4.0, is adapted from Fetal Alcohol Spectrum Disorders by the National Institute on Alcohol Abuse and Alcoholism, which is in the Public Domain.

Figure 2.19. Common Autistic Traits by MissLunaRose12 is licensed under CC BY-SA 4.0.

All Rights Reserved Content

Figure 2.18. What Is Conduct Disorder? | Child Psychology by Howcast is licensed under the Standard YouTube License.