Some mental disorders typically present themselves in childhood and are often identified when there is a disruption or recognizable difference in typical childhood development.

2.5.1 Disruptive, Impulse Control and Conduct Disorders

This group of disorders, often called disruptive disorders because they involve “disruption” of the child’s environment, includes a number of specific conditions that include aggression, impulsivity and problems with self-control, of varying degrees. Three of the more common disorders included in this group are discussed in more detail in this section: oppositional defiant disorder, intermittent explosive disorder, and conduct disorder. Each of these disorders is more frequently diagnosed in males than females (American Psychiatric Association, 2023).

Behaviors associated with this category of mental disorders include acts that threaten others’ safety or violate social norms – for example, fighting or destruction of property. These disorders are typically diagnosed in children, but the concerning conduct can persist into adulthood – evolving into other disorders (such as antisocial personality disorder) and sometimes resulting in criminal justice system involvement (American Psychiatric Association, 2021).

Disruptive disorders can be challenging to treat; however, focusing on these disorders while a person is still a child or adolescent decreases the chance that someone will continue down a path of disruptive behavior as an adult. Additionally, caution must be exercised when diagnosing, or considering a diagnosis of, any of the disruptive disorders, as studies have indicated a racial bias in these diagnoses – resulting in misdiagnoses that can impair treatment (Fadus et al., 2020).

2.5.1.1 Oppositional defiant disorder

Oppositional defiant disorder (ODD) is commonly diagnosed in children for whom mental health services are sought related to behavior problems. Symptoms of ODD, which typically appear in very young childhood, include anger or irritability, and defiant or vindictive behavior that is upsetting and disruptive, but not aggressive. Many children grow out of this disorder, but some are later diagnosed with a more serious version of the disorder: conduct disorder (American Psychiatric Association, 2021).

2.5.1.2 Conduct Disorder

Conduct disorder can be based on behaviors seen as early as preschool age, but generally these more serious behaviors emerge later in childhood. Symptoms of conduct disorder may include aggressive behavior, directed at people or animals, as well as 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 often involve law-breaking behaviors. Take a look at the video linked at figure 2.14 to hear a child psychologist very briefly summarize the diagnosis of conduct disorder.

What Is Conduct Disorder? | Child Psychology

Figure 2.14 is a one minute video highlighting information about childhood conduct disorder.

Conduct disorder is a childhood diagnosis; adults with similar symptoms would be diagnosed with antisocial personality disorder. About 40% of children with conduct disorder eventually meet the criteria for an antisocial personality disorder diagnosis (American Psychiatric Association, 2021).

2.5.1.3 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 and that cause problems. The outbursts are reactive and unplanned, often last a short period of time, and typically involve physical aggression or property destruction. Children diagnosed with this disorder must be at least six years old, but the behavior is generally observed a bit later, often into adolescence (American Psychiatric Association, 2023).

2.5.2 Neurodevelopmental Disorders

Neurodevelopmental disorders are disorders that change how the brain functions, and they present at the developmental stages in a person’s life – so in early childhood typically (Blain, 2022). Neurodevelopmental disorders are often recognized when children are delayed or do not meet expected developmental milestones. These developmental disorders may involve impairments in various areas of functioning: social, academic or occupational (American Psychiatric Association, 2013). Below are some of the neurodevelopmental disorder diagnoses that may be encountered in the criminal justice field.

2.5.2.1 Attention Deficit Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. Many people experience some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviors interfere with daily functioning. Examples of inattention may include overlooking details, making seemingly careless mistakes, difficulty sustaining attention, difficulty following through on instructions, and avoiding tasks that require mental concentration to complete. For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind typical development for their age.

ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in children who primarily have symptoms of inattention, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships. The way ADHD often shows up in the criminal justice field is through impulsivity as a contributing factor to offending behavior. Someone who is diagnosed with ADHD may struggle with impulse control, which can lead to engaging in actions that lead to interactions with law enforcement (Spielman et al., 2020).

2.5.2.2 Autism Spectrum Disorder

Autism spectrum disorder (ASD) 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 symptoms generally appear in the first two years of life. Autism is known as a “spectrum” disorder because there is wide variation in the type and severity of autism traits that people experience (figure 2.15).

Figure 2.15 is an illustration created by an autistic person, sharing some of the common traits of autism.

People with ASD may be seen as having difficulty with social communication and interaction, restricted interests, and repetitive behaviors. An autistic person, for example, may avoid eye contact and/or display facial expressions that do not match what is being said. Repetitive behaviors may include repeating words or phrases. Sensitivities can include changes in routine or response to sensory input (i.e. light, clothing, sound, or temperature). Neurodiversity – the recognition that peoples’ brains operate differently and their behavior may reflect that – is certainly not always a negative, though. Consider how many of these autistic traits may be seen as strengths, such as passion and focus.

2.5.2.3 Intellectual Developmental Disorder (Intellectual Disability)

Intellectual disability is a term used when there are limits to a person’s ability to learn and function at a standard level in daily life. Levels of intellectual disability vary greatly. People with intellectual disability might have a hard time letting others know their wants and needs, and taking care of themselves. Most people with intellectual disability experience a milder form of this disorder, and this may appear simply as difficulty making decisions or coping with stressful situations. Attempts to cope with distress may involve techniques like avoidance (Hartley & MacLean, 2008).

Intellectual disability is diagnosed based on a problem that starts any time before a child turns 18 years old. This disorder is evidenced by learning and development that is slower than that in other children; it may take longer for a child with intellectual disability to learn to speak, walk, or perform other daily activities, and they may have trouble learning in school. Intellectual disability can be caused by injury, disease, or a difference in the brain. For many children, the cause of their intellectual disability is not known. Some of the most common known causes of intellectual disability – like Down syndrome, fetal alcohol syndrome, fragile X syndrome, and other genetic conditions – happen before birth. Others happen while a baby is being born, soon after birth, or when a child is older; these might include injury, stroke, or certain infections.

People with intellectual disabilities are vastly overrepresented as both victims and offenders in the criminal justice system. Studies indicate that people with intellectual disability are the group most likely to experience violent victimization overall, and children with intellectual disability are four times as likely as other children to be sexually abused (Davis, 2011). As offenders, or accused offenders, people with intellectual disability are especially vulnerable to wrongful convictions and re-abuse within the system (Davis, 2009). This is for myriad reasons – including inability to understand their rights; compromised ability to communicate with counsel and participate in a criminal defense; and false confessions arising from life-long training to please authority figures.

2.5.2.4 Fetal Alcohol Spectrum Disorders

Fetal alcohol spectrum disorders (FASD) are diagnosed when a person was exposed to alcohol in utero. A person born with FASD may have neurodevelopmental impairments as well as slight to severe physical traits, with one commonly recognized trait being unusually smooth skin between someone’s upper lip and nose (Mayo Clinic, 2018). Neurological impairments commonly found in fetal alcohol spectrum disorders include learning disabilities, impulsivity, hyperactivity and poor judgment. These impairments can also increase one’s likelihood of being involved in the criminal justice system (Fast & Conry, 2009). Estimates of FASD in the criminal justice system suggest a significant overrepresentation. While the general population includes somewhere five percent of people impacted by FASD, the numbers in the criminal justice system may be much higher as studies indicate people with this condition may be 40 times more likely to have criminal justice involvement (Brown et al., 2022).

2.5.3 Mental Disorders Identified in Childhood Licenses and Attributions

“Mental Disorders Identified in Childhood” by Kendra Harding is licensed under CC BY 4.0.

Facts About Intellectual Disability | CDC Used “What is an Intellectual Disability” copied verbatim.

Figure 2.14 What Is Conduct Disorder? | Child Psychology by Howcast is licensed under Standard YouTube License.

Figure 2.15 Common Autistic Traits by MissLunaRose12 is licensed under CC BY-SA 4.0