NICE, the healthcare guidance body, is currently developing a clinical guideline on the recognition and management of conduct disorders and antisocial behaviour in children and young people. As part of this process, draft recommendations have been published on the NICE website today (15 August) for public consultation.

Conduct disorders are characterised by repeated and persistent misbehaviour much worse than would normally be expected in a child of that age. This may include stealing, fighting, vandalism and harming people or animals. These disorders are the most common reason for children to be referred to mental health services, with around 5% of all children aged between 5 and 16 years diagnosed with the condition. Conduct disorders also often coexist with other mental health disorders, most commonly attention deficit hyperactivity disorder (ADHD).

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “This draft guidance issued for public consultation includes a number of recommendations to support healthcare professionals to accurately diagnose and treat conduct disorders. The guideline also highlights the importance of involving the child's parents or guardians in the management of the condition - recommending training programmes tailored specifically for them - as aspects of parenting have been repeatedly found to have a long-term association with antisocial behaviour.

“If someone has a conduct disorder during their childhood they are far more likely to develop another mental health disorder when they are an adult - nearly half of children diagnosed go on to develop antisocial personality disorder. Many nation-wide interventions have already been developed for children with conduct disorder and related problems. However, uptake of these programmes has been variable. We hope that the development of NICE guidance in this area will help ensure that children and their families receive the best possible support, wherever they live.”

Draft recommendations issued for consultation include:

• Case identification and initial assessment of children and young people with a possible conduct disorder: For the initial assessment of a child or young person with a suspected conduct disorder, consider using the Strengths and Difficulties Questionnaire1 (completed by both a parent and a teacher) and also assess for the presence of:

- a coexisting mental disorder (for example, depression, post-traumatic stress disorder)

- a neurodevelopmental condition (in particular ADHD and autism)

- a learning disability or difficulty.

• Parent training programmes: Offer a group parent training programme to the parents of children and young people aged between 3 and 11 years with oppositional defiant disorder or conduct disorder.
• Child-focused programmes: Offer group social and cognitive problem solving programmes to children and young people aged between 7 and 14 years with oppositional defiant disorder or conduct disorder.
• Improving access to services: Provide information about the services and interventions that constitute the local care pathway, including the:

- range and nature of the interventions provided

- settings in which services are delivered

- processes by which a child or young person moves through the pathway

- means by which progress and outcomes are assessed

- delivery of care in related health and social care services.

The full draft recommendations will be available on the NICE website (www.nice.org.uk) from 15 August.

Ends

Notes to Editors

References

1. Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry, and Allied Disciplines;38 (Suppl. 5):581-6. Also available www.sdqinfo.com.

About the guidance

2. The draft recommendations will be available on the NICE website from 15 August 2012.

3. This guidance is an update of NICE technology appraisal guidance 102 Conduct disorder in children - parent-training/education programmes (published July 2006) and will replace it.

About NICE

4. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

5. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies -guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

6. NICE produces standards for patient care:

• quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
• Commissioning Outcomes Framework - NICE develops the potential indicators for the COF, the scheme starting in 2013, which will help measure the health outcomes and quality of care commissioned by Clinical Commissioning Groups.

7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.