Challenging Behaviour
Many children present with troublesome behaviours at some point in their development. For a minority defiance, disruptiveness, and aggression can become so severe that they impair other aspects of functioning, compromise relationships, and risk causing conflict with parents, teachers and peers. Disruptive behaviours of this kind are among the most common reasons for referral to CAMHS.
Common Behavioural Problems That Can Put Adolescents at Risk of Harm
Typically, adolescents exercise their independence by questioning, and sometimes breaking, rules. Professionals must distinguish occasional errors of judgment from a degree of misbehaviour that requires formal intervention; the measures generally being The severity and frequency of the worrying behaviours or events e.g: regular drinking, frequent episodes of fighting, truancy, and theft are much more significant than isolated episodes of the same activities. Other warning signs might include deterioration of performance at school and running away from home or care . Of particular concern are adolescents who cause serious injury or use a weapon in a fight or behave so recklessly that they put themselves and others at risk of serious injury or death.
Adolescents tend to lie for a variety of reasons, not least - to escape punishment for or to get to do what has been forbidden. Because of the intense need and desire for freedom at this age, lying seems to occur more frequently. but to some extent it is normal behaviour. Lying is initially a very appealing avoidance strategy for adolescents but becomes increasingly complex over time ( i.e. maintaining a lie). The "easy way out" may become a minefield, a source of severe stress for teenagers who have got so deeply into lying that they feel trapped in a world of dishonesty and fabrication.
Lying can also be a psychological defence mechanism by which a young person can deny and distort reality not just to others but to themselves in order to manage or avoid feelings of guilt and shame. This may be particularly salient in young people that have been drawn into criminal behaviour or have been victims of abuse, exploitation and neglect.
Young people that are aggressive are often found to be over-sensitive with a low threshold for perceiving and understanding aggression in others thus they react with hostility and aggression to a perceived threat that may not, in reality, exist. Such children may have poor problem solving skills and tend to be highly impulsive or lack consequential thinking. Aggression in children and young people can result from exposure to adult displays of anger, aggression and violence which they in turn may display when physicially or psychologically hurt or threatened. Aggression is also associated with:
Conduct Disorder
Attention Deficit Disorder
Specific Learning Disabilities
Developmental Delay
Risk Factors
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Individual Factors (The Child) |
Temperamental factors in the child may set them on a developmental pathway towards aggression and violence from a young age. Other factors may include: impulsivity, lack of empathy, a tendencey to externalise ( a belief that factors beyond the young person's control are responsible for their behaviour), a history of being a victim of violence. |
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Peer Group Factors |
A young person's peer group may place them at risk for violence: The principles of modeling and social learning are at work when young people socialise with others who use violence and aggression to achieve desired outcomes and some violent or antisocial behaviours may be required by the group in order for the individual to be accepted as a member e.g. in gang contexts. |
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Family Factors |
Parents that demonstrate poor self-control and aggressive and violent behaviour model this behaviour for their children. The child's own aggressive behaviour may develop over time as they negotiate a family system characterised by harsh, inconsistent discipline; poor supervision; inadequate parental modeling; and overall poor management of the child's behaviour. Children that grow up in such environments have little opportunity outside of school to learn positive ways to respond to conflict. Families can also contribute to a young person's aggressive behaviour by accepting their child's use of such behaviour as a problem solving strategy e.g. encouraging a child to hit first or hit back if he or she is teased or bullied. Other family contexts may have a high tolerance of their child's anti-social, disruptive or aggresssive behaviours. |
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School Factors |
Learning difficulties or struggles within education mean that school can represent a stressful environment for a child and may also contribute to feelings of powerlessness and low self-esteem. Crowded school environments may also be stressors that can trigger aggression and violence between students and may be especially stressful for children with autism spectrum disorders, social communication deficitis and sensory sensitivities. For children that have experienced unboundaried and chaotic home lives, school rules will inevitably be constantly tested and resisted. |
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Community Factors |
Living in gang affected communities, communities with poverty, poor housing low-employment, high crime rates lack of or non-existent community service, recreation, job training and poor public transportation have been correlated with youth violence, victimisation and exploitation. |
Missing Children and Missing Incidents do not conform to a single Model. Unauthorised Absences are not now recorded by Police as a part of the Management, Recording and Investigation of Missing Persons (National Policing Improvement Agency, 2010) Nevertheless a pattern of absences may be associated with CSE, Criminmal Exploitation, and Gang Involvement.
Sharp describes 5 “Missing Scenarios” and a “Missing Continuum” (Sharp, 2012).The 5 Missing scenarios are described thus:
1. Run Away: The missing person is not in control of their environment and what is happening within it and responds to an immediate pressure by leaving.
2. Push Away: The missing person is forced to go missing because the behaviour of their social network means that they feel that they must leave e.g. where sexual or physical abuse of children happens within the family.
3. Throw Away: The missing person is thrown out of their own home, often by parents as a response to some form of misdemeanour.
4. Fall Away: This refers to people that have drifted out of contact with their families and social networks.
5. Take Away: The person is forced out of contact as a consequence of kidnap for criminal purposes (e.g. sexual or physical violence) as well as abductions (including stranger and parental).
The Relationship Between Going Missing and Exploitation of Children and Young People
The Missing Continuum and Missing Scenarios suggest different vulnerability factors and consequently different opportunities for predators to exploit young people.
Exploitation (e.g. child sexual exploitation, criminal exploitation, gang involvement, and radicalisation) operates in two directions: children may be vulnerable to exploitation due to “Push Factors” (the need to get away from someone, somewhere or something) which may be located within their home environment or social networks (e.g. Domestic abuse, abuse and neglect, school problems, bullying) and “Pull Factors” (the need to get to someone, somewhere or something) and these factors may be offered by the abuser in the context of grooming (the illusion of love and affection, supply of drugs, or psychological coercion and emotional blackmail) (Sharp, 2012)
Nationally, the majority of missing Incidents concern children missing from home (National Policing Improvement Agency, 2010, Sharp, 2012). Significantly, the majority of Missing Cases were not open social care referrals at the time of the Missing Incident. The number of incidents may also be much higher as many missing from home incidents go unreported to Police.
The status of children is also an important consideration in developing a fuller picture of Missing Children and those at risk of CSE: Looked After Children are more likely to be reported missing to the Police than those missing from home, they are also more likely to go missing repeatedly (National Policing Improvement Agency, 2010).
Incidents of migrant children (unaccompanied asylum-seeking children) going missing from local authority care may be linked to serious organised crime such as Trafficking (National Policing Improvement Agency, 2010,Sharp, 2012). These factors need to be clarified locally as they may have an effect of prevalence statistics and interpretation of patterns of Missing Incidents.
There has been little research regarding Exit Strategies for young people trying to escape exploitation but it is possible, in some cases, that going missing results from a need to escape abusers and threats of violence. Sharp observes that in some cases females have been used by abusers to infiltrate refuge services to access CSE victims and draw them back into the network (Sharp, 2012).
What is clear is that Children that go missing are vulnerable to CSE and other forms of exploitation. However, children that are being exploited are very likely to go missing at some point and repeatedly thereafter. Thus CSE, Gang Involvement, Exploitation, and Radicalisation is both a cause and a consequence of missing episodes and it may not always be possible to separate missing incidents from exploitation. You can go straight to the Exploitation of Children Page from HERE
Truancy
Truancy can become a significant problem during adolescence. Young peopole who truant often get ready for school, even going as far as registeration and then leave the school premises. Persistent truants often exhibit other behavioural difficulties and often truant in pairs or groups. Those that truant alone are in a minority but are at greater risk of becoming involved in criminality.
On average, 20 schools per week suffer arson attacks.
School Arson costs £100 million a year
It is estimated that 50% of school arson goes unreported.
Fire related behaviour is on a continuum of severity from normal fire-interest at one end to firesetting at the other.
There are 3 sequential stages to the development of the behaviour:
Fire Interest
Fireplay
Firesetting
Most children will not progress beyond fire interest whilst others may develop a pattern of risky and dangerous firesetting behaviour. It is helpful however to devfine the level of fire related behaviour as it can better articulate the degree of risk and potential harm.
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Fire Interest |
Begins age 5-9 and the interest is almost universal among children. It includes the desire to play with matches, interest in fire related themes, making attempts to watch fires, and lighting matches over combustibles. Children may express curiosity e.g. asking questions about fire or incorporating fire scenarios into play. Most children experiment with fire but may lack the ability to coprehend the inherent dangers. Interest usually starts to diminish around the age of 9-10 beyond which such behaviour may indicate the need for further investigation. |
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Fireplay |
When interest extends beyond experimentation it may be considered "fireplay" and is potentially serious, occurring mostly in boys between 5-9 years. It may include collection of and experimentation with incendiary materials to see which are the most flammable or produce the most exciting effects. First time fire-play seldom produces significant fire, however the probability for subsequent fireplay increases and the frequency and severity of the fires may iescalate. |
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Firesetting |
Young people over the age of 10 should have learned the rules of fire safety and prevention and should be capable of engaging in fire-appropriate activities. The continuation of inappropriate behaviour may indicate the risky and dangerous behaviour that is termed "Firesetting". The most concerning firesetting is when a child sets fires on their own, in an aggressive or angry manner or in an attempt to harm others. |
Risk Factors
Young people may show a general pattern of behaviour e.g. impulsive, overactive, mischievous, frequent outbursts of temper and destructive behaviour. Otehr particular risk factors have also been cited:
Single parent family
Absent father (including families where the parents are to gether bu the father is absent and single parent families where no contact with the father is maintained)
High level of marital discord
Overprotective parent who administers inappropriate harsh punishment
Parental Mental Illness
Social Isolation
Low self esteem
Abuse
Early fire modelling within the family
Activity: Watch the Video from Teachers TV "School Matters: Firesetters". Make a note of examples of behaviour that might demonstrate a child's progression for Fire Interest to Fire play and finally to Fire Setting. What motivates some of the children in this programme i.e. what function does the behaviour have for them?
Definitions
In general suicidal behaviour comprises 2 seperate phnomena but with a marked degree of overlap between them.
Intentional Suicide: Includes individuals who intentionally kill themselves (suicide0, or have harmed themselves with the clear intention of ending their lives, but unexpectedly survive (attempted suicide).
Deliberate Self Harm: This describes people who intentionally harm themselves but in the reasonably secure belief that death will not result from their action.
Suicide
Suicide occurs relatively rarely under the age of 15 years, although prevalence is likely to be underestimated because of reluctance of coroners to assign this verdict. A large proportion of open verdicts (“undetermined cause”) are, in fact, suicides. Suicide rates are far higher in male than female adolescents. Until the past five or six years in England and Wales suicide rates were rising substantially in 15-19 year old and 20-24 year old young men, but then they began to fall somewhat in the older age group. The lack of change in female suicide rates may reflect differential effects of social change on gender roles.
Psychological postmortem studies of suicides show that a psychiatric disorder (usually depression, rarely psychosis) is present at the time of death in most adolescents who die by suicide. A history of behavioural disturbance, substance misuse, and family, social, and psychological problems is common. There are strong links between suicide and previous self harm: between a quarter and a half of those committing suicide have previously carried out a non-fatal act.
Deliberate Self Harm
The term deliberate self harm is preferred to “attempted suicide” or “parasuicide” because the range of motives or reasons for this behaviour includes several non-suicidal intentions. Although adolescents who self harm may claim they want to die, the motivation in many is more to do with an expression of distress and desire for escape from troubling situations. Even when death is the outcome of self harming behaviour, this may not have been intended.
Possible Motivations Underlying Self Harm in Adolescents
To die
To escape from unbearable anguish
To change the behaviour of others
To escape from a situation
To show desperation to others
To change the behaviour of others
To “get back at” other people or make them feel guilty
To gain relief of tension
To seek help
Source: BMJ. 2005 Apr 16; 330(7496): 891–894.
Factors Associated With Repeated Self Harm
Previous self harm
Personality disturbance
Depression
Alcohol or drug misuse
Chronic psychosocial problems and behaviour disturbance
Disturbed family relationships
Alcohol dependence in the family
Social isolation
Poor school record
Risk Factors
Common characteristics of adolescents who self harm are similar to the characteristics of those who commit suicide. Physical or sexual abuse may also be a factor. Recently there has been increasing recognition of the importance of depression in non-fatal as well as fatal self harm by adolescents. Substance misuse is also common, although the degree of risk of self harm in adolescents attributable to alcohol or drug misuse is unclear. Knowing others who self harm may be an important factor. factor.
Difficulties or disputes with parents
School or work problems
Difficulties with boyfriends or girlfriends
Disputes with siblings
Physical ill health
Difficulties or disputes with peers
Depression
Bullying
Low self esteem
Sexual problems
Alcohol and drug abuse
Awareness of self harm by friends or family
Features of Self Harm That Indicate Potential Suicidal Intent
Conducted in isolation
Timed so that intervention is unlikely (for example, after parents have gone to work)
Precautions to avoid discovery
Preparations made in anticipation of death (for example, leaving indication of how belongings to be distributed)
Adolescent told other people beforehand about thoughts of suicide
The act had been considered for hours or days beforehand
Suicide note or message
Adolescent did not alert others during or after the act
Source: BMJ. 2005 Apr 16; 330(7496): 891–894.