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NICE guidelines on conduct disorders 'alarming'


Experts have expressed “alarm” over guidance from health officials which they claim risks “stigmatising” young people and limiting access to vital support and services.

The Association of Educational Psychologists (AEP) warned the guidelines published last month on conduct disorders in young children could result in antisocial behaviour being treated purely “as a medical issue”.

In March the National Institute for Clinical Excellence (NICE) issued a raft of recommendations to help parents deal with children who have repeated behavioural problems.

Kate Fallon, general secretary of the AEP, said: “I’m frankly disappointed and somewhat alarmed by the position NICE appears to have set out: namely that difficult behaviour by children should be regarded as some sort of ‘disorder’, and that such behaviour should be considered primarily in a medical context.

“All behaviour is a form of communication, which is something that NICE appears to have overlooked.

“There are countless explanations for a child’s behaviour, and many of these may be excluded if behaviour is viewed as some form of medical ‘problem’ - which in itself can be enormously damaging to a child’s sense of self-worth if they believe, or are led to believe, that there is something wrong with them.”

The AEP is calling for intervention by education and health professionals from a range of disciplines, and allege NICE’s recommendations could cause situations which are “highly damaging for children’s self-worth”.

NICE guidelines on “conduct disorders in children and young people”, developed with the Social Care Institute for Excellence, said behaviour such as stealing, fighting and vandalism “is a serious but frequently unrecognised mental health problem”.

Professor Gillian Leng, the watchdog’s deputy chief executive, went on: “Conduct disorders, and associated antisocial behaviour, are the most common mental and behavioural problems in children and young people - around half of children with a conduct disorder not only miss out on parts of their childhood but go on to have serious mental health problems as adults.

“The new NICE guideline is the first national clinical guideline in this area and includes a number of recommendations to support healthcare professionals to accurately diagnose and treat conduct disorders.”

She added that the guidance aims to “significantly improve the lives of young people with a conduct disorder”.

According to NICE, conduct disorders develop as children get older, affecting 7% of boys and 3% of girls aged five to 10 years old, and 8% of boys and 5% of girls aged 11 to 16 years old.

The AEP is the trade union and professional association of educational psychologists in the UK.


Readers' comments (2)

  • michael stone

    'namely that difficult behaviour by children should be regarded as some sort of ‘disorder’'


    I come across lots of 'difficult behaviour' by all sorts of people - why is it a medical problem when kids display the behaviour, but not so if adults do it ?

    Adults dislike being 'challenged' - some of this, is purely down to that, I suspect.

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  • it is currently the mode, probably from the USA, to classify, stereotype, 'pathologize', 'psychiatrize', and 'treat' any kind of behaviour which deviates from their idea of the 'norm'. this can only lead to labelling, discrimination and stigmatisation. The new DSM-V due to be published this spring has been said to embrace many more types of affect and behaviours. Is this to keep psychiatrists and mental health workers in business and for the benefits of the insurance companies rather than those they are trying to capture as 'patients'?

    thankfully the European equivalent ICD-10 is far more cautions and the NICE would be well advised to stick to their criteria. This and treatment should be standardised and approved by panels of experts across the EU instead of questionable local organisations such as NICE making up their own rules.

    Surely better teacher and parent education would be more beneficial in helping and supporting their children and help reduce later associated problems in adult life.

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