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Everyone gets angry sometimes, even small children. But some children and teens have so much trouble controlling their anger that they shove, hit, or make fun of other people. This causes them trouble at home and at school. They often have a hard time making friends. And their aggression makes parenting them a challenge.
Aggression is any behavior that hurts other people. It can be physical—hitting or pushing—or verbal, such as name-calling. Aggression also can be social. Children may make fun of other kids or ignore them to make them feel left out. Older children and teens may gossip about peers or spread rumors about them on social media. Bullying is a common type of aggression.
Both boys and girls can be physically or socially aggressive. But boys often express anger in a physical way. Girls tend to be socially aggressive.
The reasons some children are more aggressive than others are complex. Some children may be born with an aggressive personality. They may be more impulsive than other children: They act without thinking about what might happen. They may learn to be aggressive by being around angry adults and peers. Nonaggressive children often don't want to be around them, so aggressive kids can spend time with other aggressive kids, which encourages more aggression.
Aggression also may be a sign of a health problem such as bipolar disorder or ADHD. But having these conditions doesn't mean that a child will be aggressive.
Parenting an aggressive child can be hard and tiring. You may feel overwhelmed, embarrassed, and even angry yourself. But help is available for you and your child. With patience, support, and help, most children can learn to handle conflict without harming others.
All children have to learn how to deal with anger and frustration. Many toddlers go through a phase of temper tantrums, where they yell and scream and swing their arms and legs when they're upset. School-age children may throw things or get into a fight on the playground. As they grow, most children learn from adults—and from other children—how to express anger or handle conflict in a way that doesn't hurt others.
Aggression is a problem if it happens often and gets your child in trouble at home and at school. Aggression may be a sign of a problem called oppositional defiant disorder (ODD). Children with ODD may have tantrums and talk back to their parents or other adults. If this hostile behavior gets worse, it can lead to a more serious problem called conduct disorder. Older children and teens with conduct disorder may break rules, skip school, and steal or destroy property. Conduct disorder is linked to depression, substance abuse, dropping out of school, and crime (which can lead to going to jail or prison).
Extreme aggression is sometimes also called maladaptive aggression.
If a child of any age shows repeated aggression for 6 months or more, it may be a sign of ODD. Older children usually have to show a pattern of severe aggression for a year before they are diagnosed with conduct disorder.
Call your child's doctor right now if:
Call your child's doctor if:
A child or teen's home life and other surroundings can raise the risk of aggression. Children may become aggressive if they:
To see if your child has a problem with aggression, a pediatrician or a mental health professional will ask about your child's behavior at home and at school. Does your child act out of control and have trouble calming down? Does your child throw things? Does he or she get in fights with other children? How often do the outbursts happen? Are they occurring more often?
The doctor or counselor may watch your child at home or at school. Your child's teachers also may be interviewed.
Your child may have a physical exam and tests to see if he or she has a health problem that could cause aggression or make it worse.
Counseling is the main treatment for aggression in youth. Your child may have counseling alone and with you. Through role-playing and other methods, your child can learn how to cope with things that make him or her angry. In some cases, a child may need medicine to treat a mood disorder or another condition that may lead to aggressive behavior.
Counseling can help parents learn how to guide their child to make better choices. Parents sometimes make aggression worse without meaning to. They may get so frustrated by their child's anger or tantrums that they punish him or her by yelling or spanking. They also may forget to praise good behavior. Counseling can help you provide consistent discipline. You show your child the rules and what will happen (the consequences) if he or she breaks them.
Other Works Consulted
Leff S, et al. (2009). Aggression, violence, and delinquency. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 389–396. Philadelphia: Saunders Elsevier.
Walter HJ, DeMaso DR (2011). Disruptive behavior disorders. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 96–100. Philadelphia: Saunders.
October 2, 2013
John Pope, MD - Pediatrics & Louis Pellegrino, MD - Developmental Pediatrics
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