1.1 Introduction: The World Health Organization defines mental health ‘as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community‘ (WHO, 2013). Mental health problems refer to a wide range of difficulties, which vary in their persistence and severity. It refers to the child or young person’s symptoms and distress which are considered by a mental health professional to meet the clinical threshold for a specific mental disorder. Behavioural disorders
To live up life with full potential and effectively living a life, it should be filled with a lot of experience and willingness to do what is best for them and to the people around them, the individual should possess good mental health.
Children need to have a good mental health status if they are going to live up to their full potential and truly live a life that is filled with positive experiences and the willingness to do what is the best for themselves and the people around them.
There are numerous factors that can impact a child’s mental health status, both positively and negatively. Providing children with an environment that demonstrates love, compassion, trust, and understanding will greatly impact a child. So that they can build the stepping stones to have a productive life. Many children do not receive a proper and productive lifestyle throughout life. Some children have to deal with the childhood that is filled with anxiety, resentment, hatred, distrust, and constant negativity. They have a difficult time coping with their emotions.
Children with mental health issues will have a difficult time acclimating to different situations. Studies have shown that these children if left untreated by a mental health professional, will likely grow up and repeat these types of behaviors with their children. These children tend to have lower self-worth, negative feelings, perform poorly in school, and later become involved in unhealthy lifestyle decisions. However, when these children are properly treated they can learn how to live a more promising life. They can overcome many of the issues that affect them without their consent. These children can live happy and productive lives that are filled with love, harmony and great mental health status.
Mental health requires the development of cognitive, emotional and social skills for which educational settings make an ideal context. Educational settings promote mental health which provides children and adolescents with a sense of identity, self-respect, direction, and meaning in life, mastery, belonging, safety, social support, and participation in positive activities. Good mental health is associated with better educational and behavioral outcomes. A range of effective interventions is available to promote mental health and to prevent and reduce mental illness. However, very few children and adolescents receive such interventions in the school setting.
The behavioral outcomes of the children are associated with learning difficulties which are termed as learning difficulties, learning problems, learning disorders, etc.,
The mental illness develops much behavioral disorder among children. Behavioral disorders do not necessarily mean that a child or young person has a possible mental health problem or a Special Educational Need (SEN). Consistent disruptive or withdrawn behaviors can, however, be an indication of an underlying problem, and where there are concerns about behavior there should be an assessment to determine whether there are any causal factors such as undiagnosed learning difficulties with speech and language or mental health issues. The investigator found that there is a close affinity between disorder and learning disabilities and therefore the investigator decided to carry out the research in this conduct disorder and learning disabilities.
The way in which an animal or person behaves in response to a particular situation or stimulus is called behavior.
Behaviour can be defined as the way in which an individual behaves or acts. It is the way how an individual conducts herself/himself in a social context.
Behaviour should be viewed in reference to a phenomenon, an object or a person. It can be seen in reference to societal norms, or the way in which one treats others or handles objects.
Behaviour, therefore, is the way an individual acts towards people, and society or handles the objects. It can be either bad or good. It can be normal or abnormal according to societal norms. Society will always try to correct bad behaviuor and try to bring abnormal behavior back to normal. If the child is not behaving normal, it may be due to certain disorders.
1.3 Behaviour Disorders:
Child behavior problems can crop up from anything and everything and they can be anything. It is necessary to differentiate between mischievous children and child which behavior problems. Child behavior problems can occur in toddlers as well as in teenagers. Toddler behavior problems are a bit simpler as compared to the teenage behavior problems.
Behavioral disorders, also known as disruptive behavioral disorders are the most common reasons and the parents are told to take their kids for mental health assessments and treatment. Behavioral disorders are common also in adults. If left untreated in childhood, these disorders can negatively affect a person’s ability to hold a job and maintain relationships.
1.3.1 Behaviour Disorders Concept and it Genesis:
Human behavior is ever-changing. It is dynamic and not static. The major challenge to behavior analysis lies in dealing with the complexity of human behavior, especially in an applied settings where controls are impossible, impractical or unethical. Many of the variables contributing to the complexity of behavior stem from three general sources: a) the complexity of the human repertories, b) the complexity of the environment and c) individual differences.
The term ‘behaviour’ is sometimes used in a wide sense to cover all purposive activity (Mc Dougall, 1972). It will however be confined to its narrower and more usual meaning of the individual’s response to his social environment as expressed in his bodily movement. Jahoda (1958) maintains that there are three basic aspects of mental health i.e. `criteria of normality’ as follows:
- > Active adjustment, attempts at mastering the environment
- > Unity of personality, stable integration of experience and
- > Correct perception of the world and self-independent of personal needs
The individual or a person deviated from the above said normality is said to be behaviourally disordered or person’s behavior is not only strange and unusual but also annoying or upsetting than that individuals at risk of being called ‘abnormal’ or some that roughly equivalent to terms such as crazy, nuts, mentally ill, neurotic or queer (DSM- IV, 2000; Arunachalam, 2004; Arunachalam & Gopal, 2010).
Kauffman (2001) and Lam (1976) pointed out that the beginners of special education for mentally retarded and also beginners of special education for the students with behavior disorders. Since much importance was not given for the treatment of behavior disorders as mental retardation, the nineteenth century is considered as a period of ignorance and neglect regarding behavior disorders (Despert, 1965; Kanner, 1962; Rubenstein, 1948). This is clearly evident when Cole (1989) reported that during this time students with behavior disorders were sometimes confused with ‘mental defectives’ or moral imbeciles’ or ‘minor delinquents’. At the beginning of the twentieth century, the umbrella term ‘maladjustment’ came into usage. But later in 1955, the Underwood Report of United Kingdom acknowledged confusion and found it necessary to stress that maladjustment should not be equated with deviant behaviour, delinquency, oddness or educational sub-normality (Ministry of Education, 1955). So students who could have been described as ‘socially deprived’, ‘disruptive’, ‘disaffected’ or ‘mentally ill’ were categorized under ‘maladjusted’. Even though an uncertainty regarding the terminology prevailed almost up to the 1970s. In the United Kingdom, the Federal Government of United States brought forward the term ‘severe emotional disturbance’ from 1977 onwards. But after the first Individuals with Disabilities Education Act (IDEA) came up in 1978, the term `Emotional’ or ‘Behaviour Disorders’ came to be favoured (Nelson & Pearson, 1991). Similar problem aroused in the case of definition, which was undertaken by Bower and his colleagues. Bower (1960) adopted an empirical approach of studying the characteristics of a previously labeled group to develop criteria to guide the labeling of a non – labeled group. It was followed by Quay (1978) who led to the definition of four basic clusters of problem behavior, Researchers like Cullinan, Epstein, and Kauffman (1984) continued to add to the knowledge of the characteristics of students with behavior disorders.
Above all, Cole (1991) reported that The Council for Students with Behaviour Disorders (CCBD) in 1984 endorsed the term ‘behaviour disorder’ in the place of emotional disturbance stating with the given reasons:
- ➢ This term has far greater utility for education.
- ➢ This term is not associated exclusively with any particular theory of causation.
- ➢ The term will lead to a more comprehensive behavioural assessment that will be used in identifying such students.
- ➢ This is less stigmatizing.
- ➢ This term is a representative of a focus on educational responsibility.
- ➢ It is more descriptive, accurate and more useful to educators in identifying and planning appropriate educational placements for students.
1.3.2 Definition of Behaviour Disorders:
Behavior Disorders or BD are the conditions that are more than just disruptive behavior. They are related to mental health problems that lead to disruptive behavior, emotional and social problems. Attention Deficit Disorder (ADD) is an example of a behavior disorder. Children with behavior disorders typically need a variety of professional interventions including medication, psychological treatment, rehabilitation or possible other treatments.
The American Psychiatric Association (APA) in its Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV, 1994), Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition – Text Revision (DSM – IV- TR, 2000) and Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition (DSM-V, 2013) defined a disorder as “an impairment or dysfunction of the individual that causes distress to the person or increased risk of death, pain, disability or loss of freedom”. In addition, this syndrome or pattern must not be merely an exactable and culturally sanctioned response to a particular event. The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD – 10, 2002) published by the World Health Organization, Geneva defines, “disorder as the presence of hallucinations, delusions or a limited number of severe abnormalities of behavior such as gross excitement and overactivity, marked psychomotor retardation and catatonic behavior”.
The Encyclopaedic Dictionary of Psychology (Rom Harre & Roger Lamb, 1983) defines abnormal behavior as “the behavior resulting from stress or from a pathological condition”. Rimland (1969) defines behaviour disorder in terms of biological aspects such as “A biogenic mental disorder is a severe behavior disorder that results solely from the effects or biological factors, including both gene action and the effects of the physical-chemical environment”. Lippman (1962) defines behavior disorder in terms of psychodynamic aspects. A child suffers from emotional conflict whenever anything interferes with the satisfaction of its instructional drives and its frustration produces a state of tension”.
Definition of the National Mental Health and Special Education Coalition (1990): Emotional Disturbance is a disability characterized by behavioral or emotional responses in school which are so different from appropriate age, cultural or ethnic norms it will and affect the educational performance. Such a disability:
Is more than a temporary expected response to stressful events in the environment. It is consistently exhibited in two different settings, at least one of which is school-related.
Though the second definition was never passed, it is still the preferred definition among psychologists. Other disorders that contain classification systems Oppositional Defiant Disorder (ODD) and Mood Disorders (MD).
Ross (1980) defines that the psychological disorder is said to be presented “when a child emits behavior that deviates from an arbitrary and relative social norm that occurs with a frequency of intensity that authoritative adults in the child environment judge, under the circumstances, to be either too high or too low”. Rhodes (1970) defines behavior disorder in ecological perspectives such as “emotional disturbance is a reciprocal condition which exists when intense coping responses are released within a human micro-community by a community member’s typical behavior and responses. The triggering stimulus, the rejoinder of the micro-community and the ensuing transaction are all involved in emotional disturbances”.
The above definitions have clearly shown the multi-faceted nature of behavior disorders in children and adolescents. In fact, the children and adolescents find it difficult to cope with their family, peers and school activities. It not only affects them but also others in and around them. Their easy-going nature, carelessness and irresponsible attitude without thinking the consequences of their actions not only put them into trouble but also causing enormous disturbance to others. Most of the behaviour disorders in children and adolescents are socially disapproved and harmful to social harmony. Such disorders should be taken care at the early years itself. So that the deviant behavior can be channelized into pro-social behavior. Research studies estimated that around nine percent of school children (Jayaprabha, 2003) and ten to twelve percent of high school students who are in adolescent age (Shyamala, 2004) are experiencing various types of behavior difficulties. Research studies also noted that if childhood disorders are not remediated in the early years and continue up to adolescence, they will become antisocial in nature (Didge et al., 1995). Such behaviours are definitely harmful and jeopardize not only for the individual’s life but also for the life of the community. The high incidence of behavior disorders in students and their effect on student’s academic, social, inter-remediation are to be addressed by the parents and particularly by the teachers.
1.3.3 Type of Behavioural Disorders
Similar characters of behaviour disorders are grouped together is called classification. Each group called with a unique name. People tend to classify information about important things in life and compare new events to familiar ones. A new situation is not usually treated as it was totally unique. Important similarities and differences from familiar characters are focused on grouping and classifying the behaviour disorders.
Children with behaviour disorders exhibit a spectrum of troubling behaviours. In fact, more than a hundred characteristics have been attributed to children with behaviour disorders. These children have been described as cantankerous, disruptive, lacking in social skills, disliked, rejected, generally difficult and by many other unsavory terms. Generally, such children demonstrate behaviours that do not compare favourably with those shown by normal children; behaviours that generally unacceptable to the child and to those in the environment; behaviours that are comparatively high in number and behaviours that interfere with the child’s academic and social performance.
Classification system is a systematic phenomenon. Biologists have classification systems for living organisms, chemical scientists classify the elements and physicians classify physical dysfunction. Similarly, their systems that exist to classify behavior disorders. These systems describe categories or dimensions of problem behaviours. Historically the classification of abnormal behavior focused primarily on adult disorders. Until relatively and recently there has been no extensive classification scheme for child and adolescent behavior disorder. The most widely used classification system of behavior disorders are:
- ➢ American Psychiatric Association’s Diagnostic and Statistical Manuals of Mental Disorders (DSM)
- ➢ International Classification of Diseases (ICD) developed by the World Health Organisation (WHO), Geneva.
- ➢ 0-3 is a system developed to classify mental disorders of very young children (Zero to Three, 1995) by National Centre for Clinical Infant Programmes.
The DSM classification system is the dominant system in the world. The DSM is a categorical approach to classification and thus accepts a view that the difference between normal and pathological is one of kind rather than one of degree. It also says that distinctions can be made between qualitatively different types of disorders.
The DSM is an outgrowth of the Original Psychiatric Taxonomy developed by Kraepelin in 1883, from which children’s disorders have been omitted. DSM – I (1952) contained only two categories of childhood disorders: Adjustment reaction and Childhood Schizophrenia. DSM – H (1968) added the category of behavior disorders of childhood and adolescence which was subdivided into six kinds of disorders. The next two revisions, DSM – III (1980) and DSM – III R (1987) expanded appreciably the number of categories specific to children and adolescents.
In DSM – IV (1994) all disorders are classified in one of two major groups called Axis. In Axis – I, the clinician indicates any existing clinical disorder or other condition that may be a focus of treatment. Axis- II, mental retardation or a personality disorder and its presence are indicated. These two Axes represent the diagnostic categories that are the core of the DSM system. In addition to these two Axes, it is recommended that each individual be evaluated in three other arenas, and hence a fuller picture is created. Any current medical condition that is relevant to understand or treatment in the youngsters is indicated in Axis – III. Axis – IV is used to indicate any psychological or environmental problem that may affect diagnosis, treatment or prognosis. Axis – V is for reporting the clinician’s judgment of the individuals’ overall levels of functioning. The following are the major DSM-IV’s (1994), DSM -IV- TR’s (2000) and DSM-V (2013) categories described as a diagnosis in childhood or adolescence.
Mental Retardation: This disorder is characterized by significantly sub average intellectual functioning (an IQ of approximately 70 or below) with onset before age 18 years and concurrent deficits or impairments in adaptive functioning. Separate codes are provided for mental retardation and severity unspecified.
Learning Disorders: These disorders are characterized by academic functioning that is substantially below that is expected, given to the person’s chronological age, measured intelligence and age appropriative education. The specific disorders included in this section are reading disorder, mathematical disorder, disorder of written expression and learning disorder not otherwise specified.
Motor Skills Disorders: This includes developmental co-ordination disorder, which is characterized by motor co-ordination that is substantially below the expected, given to the person’s chronological age and measured intelligence.
Communication Disorders: These disorders are characterized by difficulties in speech or language and include expressive language disorder, mixed receptive and expressive language disorder, phonological disorder, stuttering and communication disorder not otherwise specified.
Pervasive Developmental Disorders: These disorders are characterized by severe deficits and pervasive impairment in multiple areas of development. These include impairment in reciprocal social interaction, impairment in communication and the presence of stereotyped behavior, interests, and activities. The specific disorders included in this section are: Autistic disorder, Rett’s disorder, Childhood disintegrative disorder, Asperger’s disorder and Pervasive developmental disorder not otherwise specified.
Attention Deficit and Disruptive Behaviour Disorders: This section includes attention-deficit / hyperactivity disorder, which is characterized by prominent symptoms of inattention and/or hyperactivity-impulsivity. Sub types are provided for specifying the predominant symptom presentation: Predominantly inattentive type, predominantly hyperactive-impulsive type and the combined type.
Also included in this section are the disruptive behavior disorders: Conduct disorder is characterized by a pattern of behavior that violates the basic rights or others or major age-appropriate societal norms or rules: Oppositional defiant disorder is characterized by a pattern of negativistic hostile and defiant behavior.
This section also included attention-deficit/hyperactivity disorder not otherwise specified disruptive behavior disorder.
Feeding and Eating Disorders: These disorders are characterized by persistent disturbances in feeding and eating. The specific disorders included are pica, rumination, anorexia nervosa, and bulimia nervosa disorder.
TIC Disorders: These disorders are characterized by vocal and/or motor tics. The specific disorders included are Tourette’s disorder, Chronic motor or vocal tic disorder, Transient tic disorder and Tic disorder not otherwise specified.
Elimination Disorders: This grouping included encopresis the repeated passage of faces into inappropriate places and enuresis, the repeated voiding of urine into inappropriate places.
Other Disorders of Infancy, Childhood or Adolescence: This grouping is for disorders that are not covered in the sections listed above.
➢ Separation anxiety disorder: It is developmentally inappropriate and excessive anxiety, concerning separation from home or from those to whom the child is attached.
➢ Selective mustim: It is a consistent failure to specific social situation despite speaking in other situations.
➢ Reactive attachment disorder: It is markedly disrupted and developmentally inappropriate social relatedness that occur in most contexts and is associated with grossly pathogenic care.
➢ Stereotypic movement disorder: It is repetitive, seemingly driven and interferes with normal actives and at times may result in bodily injury.
Personality Disorders: It is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment. The personality disorders included in this section are listed below: Paranoid personality disorder: It is a pattern of distrust and suspiciousness.
Schizoid personality disorder: It is a pattern of detachment from social relationships and a restricted range of emotional expression.
➢ Schizotypal personality disorder: It is a pattern of acute discomfort in close relationships, cognitive in perceptual distortions and eccentricities of behavior.
➢ Antisocial personality disorder: It is a pattern of disregard for and violation of the rights of others.
➢ Borderline personality disorder: It is a pattern of instability in interpersonal relationships, self-image and affects and marked impulsivity.
➢ Histrionic personality disorder: It is a pattern of excessive emotional and attention-seeking.
➢ Narcissistic personality disorder: It is a pattern of grand, need for admiration and lack of empathy
➢ Avoidant personality disorder: It is a pattern of social inhibition, feelings of inadequacy and hypersensitivity of negative evaluation
➢ Dependent personality disorder: It is a pattern of submissive and clinging behavior released to an excessive need to be taken care of
➢ Obsessive-Compulsive personality disorder: It is a pattern of preoccupation with orderliness, perfectionism, and control
According to the DSM – V (2013) one more type is included i.e. Disruptive Mood Dysregulation Disorder (DMDD): children with extreme behavioral dyscontrol but non-episodic irritability no longer qualify for a diagnosis of bipolar disorder.
The common disorder among children is Disruptive Behavior Disorder which can be identified and minimized by controlling the external factors by their parents and teachers. So the investigator proceeds the disruptive behavior disorder since the present investigation is based on conduct disorder.
Use reference for citation:
- Jawahar, P. (2016). Co Morbidity of conduct disorders and learning disabilities of upper primary children in relation to academic performance. Alagappa University. Retrieved from: http://hdl.handle.net/10603/201864