Key priorities for implementation

The following recommendations have been identified as priorities for implementation.

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 Questionnaire (completed by a parent, carer or teacher).

  • Assess for the presence of the following significant complicating factors:

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

    • a neurodevelopmental condition (in particular ADHD and autism)

    • a learning disability or difficulty

    • substance misuse in young people.

Comprehensive assessment

  • The standard components of a comprehensive assessment of conduct disorders should include asking about and assessing the following:

    • core conduct disorders symptoms including:

      • patterns of negativistic, hostile, or defiant behaviour in children aged under 11 years

      • aggression to people and animals, destruction of property, deceitfulness or theft and serious violations of rules in children aged over 11 years

    • current functioning at home, at school or college and with peers

    • parenting quality

    • history of any past or current mental or physical health problems.

Parent training programmes

  • Offer a group parent training programme to the parents of children and young people aged between 3 and 11 years who:

    • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or

    • have oppositional defiant disorder or conduct disorder or

    • are in contact with the criminal justice system because of antisocial behaviour.

Foster carer/guardian training programmes

  • Offer a group foster carer/guardian training programme to foster carers and guardians of children and young people aged between 3 and 11 years who:

    • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or

    • have oppositional defiant disorder or conduct disorder or

    • are in contact with the criminal justice system because of antisocial behaviour.

Child-focused programmes

  • Offer group social and cognitive problem-solving programmes to children and young people aged between 9 and 14 years who:

    • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or

    • have oppositional defiant disorder or conduct disorder or

    • are in contact with the criminal justice system because of antisocial behaviour.

Multimodal interventions

  • Offer multimodal interventions, for example, multisystemic therapy, to children and young people aged between 11 and 17 years for the treatment of conduct disorder.

Pharmacological interventions

  • Offer methylphenidate or atomoxetine, within their licensed indications, for the management of ADHD in children and young people with oppositional defiant disorder or conduct disorder, in line with Attention deficit hyperactivity disorder (NICE clinical guideline 72).

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[2].



[2] Adapted from Common mental health disorders (NICE clinical guideline 123).

  • National Institute for Health and Care Excellence (NICE)