AGGRESSIVE BEHAVIOR

Educational and psychological research conducted from the 1960s to the 1990s has established that academic underachievement in the elementary school years is associated with the failure to make adequate educational progress in adolescence and young adulthood. This research also demonstrates that in itself early problems with underachievement may not be the main cause of later-occurring educational problems. Rather, severely disruptive social behavior in early childhood, particularly aggression, has been implicated as a primary cause of both early and later-occurring academic underachievement, the need for special education, and problems with truancy and school dropout. With aggressive and disruptive be haviors showing sharp increases during the last three decades of the twentieth century and prevalence rates of elementary schoolchildren suffering from these behavior disorders estimated at about 20 percent in the 1990s, the negative impact of aggressive/disruptive behavior on children's educational progress has become a serious concern for American society. Accordingly, the purpose here is to review recent findings on the nature and causes of these behavior problems and their relation to children's failure to make educational progress, and to examine promising information regarding preventive measures and treatments.

Aggression and Related Behavior Problems: The Disruptive Behavior Disorders

Narrowly defined, the aggressive child is one who purposely harms others either physically (e.g., fighting) or socially (e.g., spreading malicious rumors). Though this seems a straightforward definition, it does not adequately describe the great majority of aggressive children who are sometimes aggressive but who are more often oppositional (refusing to comply with adult requests), hyperactive, or inattentive. It is now known that this broader range of behavior problems provides a more reliable description of children who experience educational problems throughout their school careers. In fact very few children show severe forms of aggression, oppositionality, hyperactivity, or inattention alone. The great majority show some combination. An important outgrowth of this is that these children are diagnosed by psychologists, psychiatrists, and pediatricians as suffering from one or more of the disruptive behavior disorders, that is, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or, when older, conduct disorder (CD). Thus, these children are best described as suffering from some form of a disruptive behavior disorder (also called externalizing, acting out, or emotionally disturbed disorder) rather than focusing more narrowly on aggression alone.

Impact of Disruptive Behavior on Educational Progress

There are three types of studies used to assess whether or not a particular aspect of children's lives–in this case disruptive behavior–has a negative impact on children's educational progress: (1) concurrent, correlational studies (also called observational studies) that document the co-occurrence of both disruptive behavior and various forms of academic failure; (2) longitudinal, correlational studies that document academic problems at a later time (poor achievement, placement in special education, truancy, etc.) based on disruptive behaviors occurring at an earlier time; and (3) experiments (also called clinical trials) in which disruptive behavior is allowed to develop in a control group but is decreased in a treatment group (usually by replacement with positive behaviors), and it is later observed that the treatment group experiences educational success but the control group does not.

Experiments can be evaluated after a short or long follow-up period after treatment. Given that the study of children's social and academic development requires a long-term perspective, only long-term outcomes (follow-ups of at least three months) are considered here. There are two types of experiments: prevention trials begun in early childhood for children at risk of developing disruptive behavior but before symptoms have appeared and intervention trials begun after children have become symptomatic (i.e., have received a diagnosis of ADHD, ODD, CD, or are classified as severely behaviorally or emotionally disturbed). There are two types of preventions, those focusing exclusively on children and those focusing on children and their parents. There are also two types of interventions, those using medications such as methylphenidate (Ritalin) and those using educational and behavioral means to decrease disruptive behaviors. Because it most clearly establishes that the disruptive behavior targeted for prevention is an actual cause of academic problems and not just a co-occurring problem, by far the most important of these study types is the prevention experiment.

Concurrent and longitudinal correlational studies have clearly established a relation between early occurring disruptive behavior and both early and later-occurring school problems. However, child-focused intervention experiments using both behavioral/educational and medication treatments aimed at replacing disruptive behaviors with cooperative and attentive behaviors have not demonstrated positive educational gains for children. Nor have child-focused prevention experiments had good results. Realizing that the exclusion of parents in these experiments could explain their failure to demonstrate a causal role for disruptive behaviors in children's educational problems, family-based experiments have also been conducted. These studies, both intervention and prevention trials, have been successful, providing evidence that children's disruptive behavior does interfere with children's academic progress. They also provide a useful basis for planning large-scale preventive and interventive efforts.

Successful Prevention and Intervention

In a 1998 paper, Steven McFadyen-Ketchum and Kenneth Dodge reviewed eight long-term, family-based experimental studies (four preventions and four interventions), which successfully decreased children's disruptive behavior and produced improved educational outcomes. In all of these studies disruptive behavior was reduced, and cooperative attentive behavior was increased for periods ranging from one to fourteen years. Educational gains included higher grades, higher achievement scores, higher IQ scores, improved use of expressive language, decreased participation in special education, and decreased truancy and dropout rates. It is important to emphasize that these gains occurred only when parents as well as children were participants in the prevention and intervention programs. This means that in addition to replacing disruptive behavior with more cooperative/attentive behavior in children, it was also necessary to replace negative (e.g., nagging) and ineffective (e.g., failing to set clear limits) behaviors in parents with behaviors that were firm and friendly as well as with a parental will-ingness to consistently attend to children's cooperative efforts instead of taking them for granted.

Contribution to Theory

It has long been known that children's cognitive and intellectual deficits interfere with early academic achievement and long-term educational success. The studies discussed here clearly identify an additional source of dysfunction that also seriously interferes with educational progress: aggression and other forms of disruptive social behavior. These studies also clearly demonstrate that preventive/interventive efforts can be successfully applied to these behavior problems with positive educational results. In addition, they achieve a third, though less obvious, goal, that is the clarification of theory regarding the causes of children's disruptive behavior disorders.

As mentioned above, prevention and intervention experiments whose goal was to decrease disruptive behavior in children, but without also addressing the contribution of parents, consistently failed to show positive gains in treatment when compared with control groups of children. In contrast, those experiments that included parents consistently succeeded. Children in these successful treatment groups showed both behavioral and educational gains compared to control-group children. The clear implication is that in addition to whatever genetic or other environmental factors may be at work (e.g., lead poisoning), the parents' support of their children's positive behavioral efforts is necessary if children are to experience educational success. Because some of these experiments were preventions conducted before disruptive behavior problems had developed, these findings demonstrate that positive parental behavior toward young children plays a causal role in children's behavioral and educational success.

These findings may appear to be in sharp contrast to the often-reported finding that genetics play a primary causal role in the kinds of behavioral and educational problems being discussed here, especially for children diagnosed with ADHD. What these findings demonstrate, and what has also been argued by geneticists who study childhood behavior problems, is that genes are not destiny. Children can be helped to perform well in school if it is recognized that their parents play a causal role in producing cooperative, attentive behavior, and are included in the educational process.

See also: Affect and Emotional Development; Classroom Management; Stress and Depression.

bibliography

Achenbach, Thomas, and Howell, Catherine T. 1993. "Are America's Children's Problems Getting Worse? A Thirteen-Year Comparison." Journal of the American Academy of Child and Adolescent Psychiatry 32:1145–1154.

American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), 4th edition, text revision. Washington, DC: American Psychiatric Association.

Carlson, Caryn L.; Tamm, Leanne; and Gaub, Miranda. 1997. "Gender Differences in Children with ADHD, ODD, and Co-Occurring ADHD/ODD Identified in a School Population." American Academy of Child and Adolescent Psychiatry 36:1706–1714.

Coie, John D., and Dodge, Kenneth A. 1998. "Aggression and Antisocial Behavior." In Handbook of Child Psychology, Vol. 3: Social, Emotional and Personality Development, ed. Nancy Eisenberg and William Damon. New York: Wiley.

Hinshaw, Stephen P. 1992. "Academic Underachievement, Attention Deficits, and Aggression: Comorbidity and Implications for Intervention." Journal of Consulting and Clinical Psychology 60:893–903.

Hinshaw, Stephen P. 1992. "Externalizing Behavior Problems and Academic Underachievement in Childhood and Adolescence: Causal Relationships and Underlying Mechanisms." Psychological Bulletin 111:127–155.

McFadyen-Ketchum, Steven A., and Dodge, Kenneth A. 1998. "Problems in Social Relationships." In Treatment of Childhood Disorders, 2nd edition, ed. Eric J. Mash and Russell A. Barkley. New York: Guilford.

Plomin, Robert; DeFries, John C.; McClearn, Gerald E.; and Rutter, Michael. 1997. Behavioral Genetics, 3rd edition. New York: Freeman.

Schachar, Russell, and Tannock, Rosemary. 1993. "Childhood Hyperactivity and Psychostimulants: A Review of Extended Studies." Journal of Child and Adolescent Psychopharmacology 3:81–97.

Yoshikawa, Hirokazu. 1994. "Prevention As Cumulative Protection: Effects of Early Family Support and Education on Chronic Delinquency and Its Risks." Psychological Bulletin 115:28–54.

Steven A. McFadyen-Ketchum

Aggressive behavior

Definition

Aggressive behavior is reactionary and impulsive behavior that often results in breaking household rules or the law; aggressive behavior is violent and unpredictable.

Description

Aggression can a problem for children with both normal development and those with psychosocial disturbances. Aggression constitutes intended harm to another individual, even if the attempt to harm fails (such as a bullet fired from a gun that misses its human target). There is no single theory about the causes of aggressive behavior in humans. Some believe aggression is innate or instinctive. Social theorists suggest the breakdown in commonly shared values, changes in traditional family patterns of child-rearing, and social isolation lead to increasing aggression in children, adolescents, and adults. Aggression in children correlates with family unemployment, strife, criminality, and psychiatric disorders.

Differences exist between levels of aggression in boys and girls in the same families. Boys are almost always more aggressive than girls. Larger children are more aggressive than smaller ones. Active and intrusive children are also more aggressive than passive or reserved ones.

Aggressive behavior may be intentional or unintentional. Many hyperactive, clumsy children are accidentally aggressive, but their intentions are compassionate. Careful medical evaluation and diagnostic assessments distinguish between intentional behaviors and the unintentional behaviors of emotionally disturbed children.

Children in all age groups learn that aggressive behavior is a powerful way to communicate their wishes or deal with their likes and dislikes.

Infancy

Infants are aggressive when they are hungry, uncomfortable, fearful, angry, or in pain . Parents can tell what babies need by the loudness and pitch of crying and the flailing of arms and legs. Crying is an infant's defense, the way to communicate feelings and needs.

Toddlers

Children between two and four years of age show aggressive outbursts such as temper tantrums and hurting others or damaging toys and furniture because they are frustrated. Usually the aggression in this age group is expressed toward parents as a way to get their compliance with the child's wishes. Verbal aggression increases as vocabulary increases.

Preschool

Children between four and five years of age can be aggressive toward their siblings and peers. Because of greater social interaction, children need to learn the differences between real and imaginary insults, as well as the difference between standing up for their rights and attacking in anger.

School-age and adolescence

Aggressive boys between three to six years of age are likely to carry their behavior style into adolescence . In extreme cases, they may show aggression by purse snatching, muggings, or robbery, or in less overt ways by persistent truancy, lying , and vandalism. Girls younger than six years of age who have aggressive styles toward their peers do not tend to continue being aggressive when they are older, and their earlier aggression does not correlate with adult competitiveness.

Common problems

Frustration is a response to conditions that keep children from achieving goals important to self-esteem . Frustration and aggression are closely associated. If children learn that being aggressive when frustrated is tolerated or gives them special treatment, the behavior is reinforced and may be repeated. Aggression may be a way for children to face obstacles or solve problems. It is important not to attribute malice to children who are responding to anxiety , feelings of incompetence, or a sense of low self-esteem.

Through the media, including film, the U.S. culture reinforces violence and aggressive behavior in children. Police brutality, crime-based television programs, and governmental reliance on military aggression to solve political and economic differences all create a climate in which violence is presented to children as a legitimate solution to problems.

Violent behavior in children and adolescents

CULTURAL VIOLENCE Violence includes a wide range of behaviors: explosive temper tantrums, physical aggression, fighting, and threats or attempts to hurt others (including homicidal thoughts). Violent behaviors also include the use of weapons, cruelty toward animals, setting fires, and other intentional forms of destruction of property.

PREDISPOSITION TO VIOLENCE Some children are supersensitive, easily offended, and quick to anger. Many children are tense and unusually active, even as infants. They are often more difficult to soothe and settle as babies. Beginning in the preschool years, they are violent toward other children, adults, and even animals. They often lash out suddenly, sometimes for no obvious reason. When they hurt someone in their anger, they tend not to be sorry and may tend not to take responsibility for their actions. Instead, they blame others for their own actions. Parent should give this behavior serious attention and take measures to correct it.

Children may go through a brief period of aggressive behavior if they are worried, tired, or stressed. If the behavior continues for more than a few weeks, parents should talk to the pediatrician. If it becomes a daily pattern for more than three to six months, it could be a serious problem.

Factors that increase risk of violent behavior

Parents and teachers should be careful not to play down aggressive behaviors in children. In fact, certain factors put some children at risk for developing violent behaviors as adults. These factors include the following:

• being the victim of physical and sexual abuse
• exposure to violence in the home and community
• exposure to violence in media (TV, movies)
• use of drugs and alcohol
• presence of firearms in home
• combination of stressful family socioeconomic factors (poverty, severe deprivation, marital breakup, single parenting, unemployment, loss of support from extended family)
• brain injury

Parents can teach children nonviolence by controlling their own tempers. If parents express anger in quiet, assertive ways, children may follow their parent's example. Children need to understand when they have done something wrong so they can learn to take responsibility for their actions and learn ways to make amends. Responsible parenting does not to tolerate violence or use it in any way.

Violence prevention strategies

Efforts should be directed at dramatically decreasing the exposure of children and adolescents to violence in the home, community, and through the media. Clearly, violence leads to violence. Parents can use the following strategies to reduce or prevent violent behavior:

• prevent child abuse in the home
• provide sex education and parenting programs for adolescents
• provide early intervention programs for violent youngsters
• monitor children's TV programs, videos, and movies

The most important step that parents can take with aggressive children is to set firm, consistent limits and be sure that everyone caring for the children acts in accord with the parents' rules and expectations.

Parents should know the importance of helping children find ways to deal with anger without resorting to violence. Children can learn to say no to their peers, and they can learn how to settle differences with words instead of physical aggression. When children control their violent impulses, they should be praised.

Parental concerns

All children have feelings of anger and aggression. Children need to learn positive ways to express these feelings and to negotiate for what they want while maintaining respect for others. Parents can help their children develop judgment, self discipline, and the other tools children need to express feelings in more acceptable ways and to live with others in a safe way.

Understanding the aggressive child

When children lose their sense of connection to others, they may feel tense, frightened, or isolated. These are the times when they may unintentionally lash out at other children, even children to whom they are close. Parents should be careful not to let children think aggression is acceptable.

When children are overcome with feelings of isolation or despair, they may run for the nearest safe person and begin to cry. They immediately release the terrible feelings, trusting that they are safe from danger and criticism. Effective parents listen and allow the child to vent without becoming alarmed.

Disciplining aggressive behavior

Parents can control the aggressive child in various ways. They should intervene quickly but calmly to interrupt the aggression and prevent the their child from hurting another child. Younger children may need a time-out to calm down and before rejoining a group. Simple rules about appropriate behavior are easier for a child to understand than lengthy explanations. Parents can affirm feelings while stressing that all feelings cannot be acted upon.

Parents can reach older children with eye contact, a stern voice, and physical contact. Older children can be told that they need to learn a better way to handle conflicts. Parents can suggest that, for instance, the child ask an adult to intervene before lashing out at a classmate. Any disciplinary measures should be explained as a simple consequence to the child's aggression.

When parents arrive after conflict occurs, it may be useful to listen to the child's explanation. Having a parent listen can encourage the child to develop trust in the parent.

Parents should not expect the aggressive child to be reasonable when he or she is upset. The child may need time to calm down. Sometimes the child may feel trapped and may need adult support. Parents should encourage the aggressive child to come to them when they are upset, hopefully before violence occurs.

KEY TERMS

Anxiety —Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions, such as fast pulse, sweating, trembling, fatigue, and weakness, may accompany anxiety.

Consequences —Events that occur immediately after the target behavior.

Misbehavior —Behavior outside the norms of acceptance within the group.

Time-out —A discipline strategy that entails briefly isolating a disruptive child in order to interrupt and avoid reinforcement of negative behavior.

Resources

BOOKS

Davis, Jean Q. Anger, Aggression, and Adolescents. New York: Pantheon Books, 2004.

Delfos, Martine F. Anxiety, ADHD, Depression, and Aggression in Childhood: Guidelines for Diagnostics and Treatment. Herndon, VA: Jessica Kingsley Publishers, 2003.

Valkenburg, Pattie M. Children's Responses to the Screen: A Media Psychological Approach. Mahwah, NJ: Lawrence Erlbaum Associates, 2004.

ORGANIZATIONS

Parents Leadership Institute. PO Box 1279, Palo Alto, CA 94302. Web site: <www.parentleaders.org>.

WEB SITES

"Understanding Violent Behavior in Children and Adolescents." American Academy of Child and Adolescent Psychiatry, March 2001. Available online at <www.aacap.org/publications/factsfam/behavior.htm> (accessed December 12, 2004).

Aliene S. Linwood, RN, DPA, FACHE