Ignoring early warning signs of defiance can lead to deviant behaviors in adolescence

Rule breaking is not uncommon for preschool children, but being able to identify those children most at risk of long-term defiant behavior is key in helping them avoid a myriad of negative consequences.

Miguel Villodas

FIU psychologist Miguel Villodas evaluated 788 children identified as high-risk of maltreatment including those from low-income families, single parent homes or with very young parents, and those living in neighborhoods with a high prevalence of violence. He found approximately half of the participants were exposed to maltreatment – 56 percent of those before the age of 4.

Children at-risk of maltreatment or who experience abuse are more likely to develop conduct-related disorders including attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder. Villodas found some of the children in the study exhibited aggressive and defiant behaviors as early as age 4. More importantly, he discovered that if left untreated, those behaviors persisted into adolescence.

“Kids with extreme problem behaviors can be identified early in childhood and tend to remain stable in the category into which they were originally classified,” Villodas said.

The study tracked the externalizing problems of children and adolescents at-risk of physical abuse, sexual abuse or neglect. Externalizing problems can range from minor disruptive or nuisance behaviors such as calling out in class, to more severe and even criminal behaviors including physical assault. Villodas conducted assessments of the participants at ages 4, 8 and 12. According to the behaviors observed, the children were classified into one of three categories:

• well adjusted
• hyperactive/oppositional
• aggressive/rule-breaking

However, by age 12, a fourth category emerged – defiant/deceitful – characterized by more severe behaviors. By age 14, interviews including the participants’ caregivers were conducted to provide formal diagnoses. Approximately 9 percent of the 14-year-olds were diagnosed with ADHD, 13 percent with ODD and 10 percent with conduct disorder.

Results also showed children who were allegedly physically abused recently, were at a higher risk for exhibiting aggressive/rule-breaking behavior in preschool and preadolescence. Moreover, children who allegedly experienced neglect or sexual abuse were less likely to be well adjusted as they move into adolescence.

Because there is substantial overlap in the behaviors exhibited by children with ADHD, ODD and conduct disorder, it is important to implement multifaceted interventions and forms of treatment. Targeting and curbing a broad spectrum of externalizing problems allows for more effective early interventions.

“Our primary goal with this research is to help the kids,” Villodas said. “We want to target certain parenting behaviors to help parents manage stressful situations. Maltreatment doesn’t necessarily lead to bad behavior, sometimes the bad behavior leads to maltreatment.”

As a researcher for FIU’s Center for Children and Families, Villodas evaluates clinic and school-based psychosocial intervention models that target impairments associated with ADHD and externalizing behavior problems among children and adolescents.

Villodas conducted the study in collaboration with researchers from San Diego State University, Juvenile Protective Association, University of North Carolina at Chapel Hill, University of Massachusetts-Lowell, University of Washington and University of Maryland supported by funding from the U.S. Department of Health and Human Services and the National Institutes of Health. The article is pending print publication in the journal Development and Psychopathology and the findings are currently available online.