ODD is characterised by behaviours such as: a child or young person often loses their temper, argues with adults, defies adult requests, and deliberately annoys others, shifts blame to others, touchy, easily annoyed, angry, resentful, spiteful or vindictive. These behaviours can be common in childhood, these behaviours would become a concern if they are being displayed outside of typical developmental norms.
Conduct Disorder and Challenging behaviour in this context can include: self-injurious behaviour culturally abnormal behaviours of such intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities.
Initial intervention from other Tier 1/2 services (Universal and Targeted services) prior to specialist CAMHS involvement
Children up to the age of 19yrs can be referred to Local Children Centres for parenting support. The evidence base suggests specialist parenting is the most effective intervention.
For some children a Paediatric assessment may be indicated.
In complex cases, including those where the challenging behaviour is linked to cognitive impairment, consultation with CAMHS can be sought to determine whether the client meets the referral to CAMHS due to the presence of a co-morbid mental health difficulty or because the behaviour is believed to be the way in which the client demonstrates mental distress. Behaviours believed to be primarily the result of a learning disability or a social communication difficulty will not warrant a referral in themselves.
Service provided by Specialist Child and Adolescent Mental Health Service – Tier 3
In complex cases, Case Formulation and discussion of risk as part of a multiagency team.