Aggression, Ages 6 to 12

My child hits, kicks, and lashes out at other kids. Should I be concerned?

Yes. Most children outgrow this kind of behavior by the time they enter grade school, because they've developed the language skills to express themselves in words and been socialized to feel that physical aggression is wrong and unrewarding. If your child has failed to learn these lessons, it's time to find out why.

Your child could have a learning, behavioral, or emotional disorder that makes it tough for him to listen, focus, or read, hampering his performance in school. Or he may be suffering from a psychological blow, such as his parents' getting a divorce, that's stirring up more hurt and anger than he can deal with. Most commonly, though, kids become aggressive because they've witnessed aggression in others. Whatever the reason, if you get your child help now, you can prevent more serious problems later on. If your child's aggressive behavior is frequent and severe, or your efforts to curb it have no effect, you'll need to consult your child's physician or a trained mental health professional, such as a child psychologist or psychiatrist.

What are the characteristics of an aggressive child?

All children occasionally shove a sibling who's mocking them or kick the couch when their parents say they can't go to the movies. But a child who has a problem with aggression will typically behave in these ways:

• Frequently loses his temper, getting intensely angry
• Is extremely irritable or impulsive and has trouble staying focused
• Becomes frustrated easily
• Physically attacks and fights other children or adults
• Is frequently disruptive, argumentative, or sullen
• Performs poorly in school or can't participate in classroom or other organized activities
• Has trouble taking part in social situations and making friends
• Argues or fights constantly with family members and won't accept parental authority
• Inevitably challenges authority and refuses to obey rules
• Frequently denies responsibility for his misbehavior and blames others

An aggressive child will act this way in more than one arena, such as school, home, and social events or athletic activities.

What makes a child aggressive?

Physical fear is one straightforward explanation. If your child feels cornered by another child, for example, he might lash out. But some more complicated reasons for especially aggressive behavior include:

• Family difficulties or discord. Children often act out in response to family strife, whether it's battling parents, a sibling who teases relentlessly, a move to a new area, serious illness in the family, or the loss of the breadwinner's job. Such tensions and changes stress children as well as parents, and some kids react by becoming belligerent or destructive, especially if other family members are releasing their feelings in similar ways.
• Learning disorders. About a quarter of aggressive adolescent delinquents have a specific learning disorder, such as dyslexia. (This doesn't work the other way, however: Most children with dyslexia aren't aggressive.) If your child has a problem that makes it difficult for him to read, write, or understand spoken language, he might vent his frustration physically.
• Neurological problems. Sometimes damage or chemical imbalances in the brain lead to aggressive behavior. If you're concerned about this, consult your child's doctor and consider talking to a specialist.
• Behavioral disorders. Nearly half of all children diagnosed with attention deficit/hyperactivity disorder (ADHD) also have oppositional defiant disorder, a condition marked by aggressive conduct. These children need specific treatment to be able to perform well in school, make friends, or accept their parents' authority.
• Emotional trauma. Domestic violence or sexual abuse can create intense anxiety, fear, anger, and depression. A child who has no other outlet may express these feelings with his fists. Furthermore, children who are exposed to violence or abuse at home or in their neighborhoods are more likely to behave aggressively than other children.
• Exposure to violent television shows and movies. Most experts believe that witnessing on-screen violence can temporarily arouse aggression in children. The American Academy of Child and Adolescent Psychiatry recommends that you monitor your child's viewing selections, particularly if he's prone to aggressive behavior.

What can I do?

First and foremost, don't get aggressive yourself. Hitting, yelling, throwing objects, and calling your child names will never get him to curtail his bad behavior -- you'll just give him an example of new things to try and get him even more riled up. Show him that you can control your temper, and you'll help him believe that eventually he'll be able to control his.

If you have trouble with this, try to identify the thoughts that infuriate you. Maybe every time your child disregards what you say, you infer that he's waging a war against you, and that thought triggers your anger. Remind yourself that, realistically, most kids don't follow instructions now and then; they may be asserting their independence (a natural part of growing up) or may simply be distracted by an interesting sight or activity. Decide that the next time you have that thought you'll take a deep breath, count to 10, and tell yourself, "This isn't a war. I'm not going to get angry." If necessary, walk to the other end of the room and wait there until you've cooled off.

You need to teach your child to recognize and understand his emotions and guide him toward acceptable ways of letting anger, fear, and disappointment show. These tips can help:

• Respond immediately. Don't wait until your child punches his brother for the third time to say, "Okay, that's enough!" Your child should know instantly when he's done something wrong. You might want to try "time-ins" (instead of time-outs): Stop what you're doing, and ask your child to sit down with you and remain silent. Hold or touch him in a loving way if he'll let you. After a few minutes of peace, briefly discuss what happened; then simply resume your activities. (If he sometimes refuses to go to his room, this technique will let you avoid that battle.)
• Cool down; then discuss what happened. The best time is after your child has settled down but before he forgets the episode -- ideally, a couple of hours. Calmly and gently review the circumstances that led to his aggressive behavior. Ask him to explain what triggered it. Emphasize that it's perfectly normal to have angry feelings but it's not okay to show them by hitting, kicking, or biting. Suggest better ways of responding, for example, by verbalizing his emotion ("I feel really angry because you took my basketball") or by walking away from the situation or person so he has some time to cool down and think about what to do.
• Discipline consistently. As much as possible, respond to each episode the same way. Over time, your consistent response ("Okay, you hit your brother again. That means another time-out") will set up a pattern that your child will recognize. Eventually, he'll internalize this pattern and anticipate consequences before he acts, which is the first step in regulating his own behavior.
• Promote self-control. Instead of giving your child attention only for being bad, try to catch him being good -- for example, when he asks for a turn at the computer game instead of snatching the joystick from his brother. Emphasize that self-control and conflict resolution are skills he'll need to be successful and well liked in high school and beyond. If he's having a particularly hard time with this, you might want to reward him with a special treat every time he manages to control his temper. It can be as simple as getting some extra time with you, maybe by taking a walk to the park for some batting practice.
• Make him responsible. If your child damages someone's property, he should pay to have it fixed, either out of his allowance or with money earned by doing extra chores around the house. Don't frame this as a punishment handed down from parent to child; rather, stress that it's the natural consequence of a belligerent act and that anyone (child or adult) who harms another person's possessions would have to do the same.
• Teach the moral reasons for not acting aggressively. Tell your child that acting out physically isn't right because it hurts other people. To develop empathy and ethics, he needs you to lay out some principles, including that he must think about how his actions affect other people.

When should I seek help?

Make an appointment with your child's doctor if the techniques above don't make a difference, or if your child's aggressive behavior is making it difficult for him to participate in school, family, or other activities.

Your pediatrician may refer you to a child psychologist or psychiatrist, who can assess your child for a learning disability as well as emotional or behavioral problems that sometimes set off aggressive behavior.

Depending on what problems are uncovered, treatment may include behavioral therapy, a specialized instructional approach in school, family counseling, or even prescription drugs. Some of the medications used to decrease disruptive behavior, as well as impulsiveness and distractibility, are -- counterintuitively -- stimulants. Other classes of drugs, such as antidepressants, hypertension medications, and anticonvulsants, may also be used.

But responses to these drugs vary; your pediatrician or child's therapist can help you decide if this option is right for your child. For example, even though some doctors prescribe antidepressants to children, the FDA warns that such drugs may increase suicidal tendencies in young people.

Don't forget to get some help for yourself, too, whether it's individual counseling, a support group, or just frequent heart-to-hearts with your friends. Dealing with aggression in your child is unsettling and demands great patience. Look after yourself, and you can be a steady source of support and guidance for your child.

References

American Academy of Child and Adolescent Psychiatry. Facts for Families: Conduct Disorders. http://aacap.org/cs/root/facts_for_families/conduc...

American Academy of Child and Adolescent Psychiatry. Facts for Families: Understanding Violent Behavior in Children. http://aacap.org/cs/root/facts_for_families/unders...

American Academy of Child and Adolescent Psychiatry. Facts for Families: Fighting and Biting. http://www.aacap.org/cs/root/facts_for_families/fi...

American Academy of Child and Adolescent Psychiatry. Children and Watching TV. http://www.aacap.org/cs/root/facts_for_families/ch...

National Alliance on Mental Illness. Attention-Deficit/Hyperactivity Disorder. http://www.nami.org/Template.cfm?Section=By_Illnes.../ContentManagement/ContentDisplay.cfm&ContentID=9554

National Resource Center on AD/HD. AD/HD and Co-Existing Disorders. http://www.help4adhd.org/en/treatment/coexisting/WWK5

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