Every child has moments of anger, impulsivity, and resistance. These moments are part of growing up. But when the behaviour becomes intense, persistent, and begins to affect family life, school, friendships, or safety, it moves into a different zone—what we call disruptive behaviour disorders (DBDs).

These behaviours are not signs of a “bad child.” They are signs of a child who is struggling with emotional regulation, developmental challenges, or environmental stress. Understanding this can change the entire treatment trajectory.

What disruptive behaviour really means

The term “disruptive” is often misunderstood. It does not mean the child is intentionally causing trouble.
It simply means:

• the behaviour disrupts functioning,

• the child’s emotions are overwhelming their coping capacity,

• and the environment is unable to contain or understand the child’s distress.

The behaviours may include:

• severe tantrums,

• aggression,

• arguing and defiance,

• property destruction,

• refusal to comply with rules,

• irritability,

• lying or stealing in older children,

• explosive outbursts.

These behaviours last weeks to months and appear across settings—not just in isolated moments.

Why do these behaviours happen?

The roots are rarely single, simple, or superficial. Modern research—and decades of clinical experience—show multiple contributing factors:

1. Emotional dysregulation

Children with DBDs struggle to manage big feelings. Their internal brakes are weak, and their emotional accelerator is strong.

2. Underlying neurodevelopmental issues

ADHD, learning difficulties, and autistic traits often lie beneath the surface. When these go unrecognised, frustration explodes outward.

3. Family stress & inconsistent parenting

Parents are not to blame—but family conflict, parental mental health challenges, or inconsistent limit-setting amplify symptoms.

4. Trauma, conflict, or attachment disruptions

Children who experience criticism, chaos, or emotional distance often develop fragile emotional regulation.

5. Environmental overload

Screens, overstimulation, academic pressure, and insufficient sleep can tip vulnerable children into explosive patterns.

Behaviour is always a message. Our task is to decode it—not punish it.

The developmental pathway: why early intervention matters

Research shows that early-onset disruptive behaviour—especially before age 10—can become chronic if ignored.
But the encouraging truth is that most children improve dramatically with timely identification and support.

Early intervention changes:

• the child’s future emotional stability,

• peer relationships,

• school performance,

• risk of depression and anxiety in adolescence,

• and even long-term behavioural outcomes.

Early support is not “overreacting”—it is preventive mental healthcare.

Assessment: building the full picture

A high-quality assessment looks beyond the behaviour. It examines:

• child temperament,

• developmental history,

• attachment patterns,

• family dynamics,

• school functioning,

• underlying ADHD or learning problems,

• sleep, sensory and environmental triggers,

• emotional vulnerabilities,

• and possible trauma or stressors.

Talking to the child alone—and parents alone—is often crucial. Children speak more freely when not observed, and parents share more honestly without fear of judgment.

Interventions that actually work

1. Parent Management Training (PMT)

The most powerful tool we have.
Modern PMT focuses on:

• consistent limits,

• predictable consequences,

• reinforcement of positive behaviours,

• reducing coercive cycles,

• teaching parents emotional-coaching strategies.

Small changes at home often lead to big improvements in the child.

2. Behavioural therapy for the child

This includes:

• anger management,

• problem-solving skills,

• frustration tolerance,

• social skills,

• emotional labelling,

• self-regulation strategies.

Children learn how to pause, choose, and respond—not just react.

3. Family therapy

Families sometimes fall into patterns: shouting, rescuing, blaming, withdrawing.
Family therapy breaks these cycles and builds healthier communication.

4. School collaboration

Teachers observe patterns parents never see. Joint strategies between home and school lead to consistency and stability.

5. Medication (only when needed)

Medication never replaces therapy and parenting strategies. But it can help when:

• aggression is severe,

• ADHD drives dysregulation,

• mood instability is significant,

• or the child is unable to participate in therapy due to emotional overwhelm.

Modern medications are safe when monitored. They are used at minimal effective doses, with careful titration.

A powerful truth: children improve when adults align

When parents receive guidance…
When teachers understand the child…
When clinicians work as a team…

…the entire environment shifts, and the child’s behaviour follows.

Children do not grow in isolation—they grow within relationships.

Disruptive behaviour is not a battle to be won. It is a developmental journey to be guided.

This series aims to bring clarity, compassion, and confidence to families navigating these storms.

Author & Contact

Dr. Srinivas Rajkumar T, MD (AIIMS), DNB, MBA (BITS Pilani)
Consultant Psychiatrist & Neurofeedback Specialist
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall)
✉ srinivasaiims@gmail.com 📞 +91-8595155808