Fifteen-minute consultation: The angry child

Abstract

Children who present with difficult behaviours due to underlying anger are commonly presented to paediatricians for help and advice. This paper gives a basic structure of how to approach the subject, by exploring whether the problems occur at home, school or both, and analysing the behaviour by focusing on antecedents, behaviour and consequences. It is important to find the underlying causes in order to know what to recommend, as this can vary from medication, anger management strategies, school-based interventions, parenting programmes or family therapy.

Stopping inappropriate medication of children with intellectual disability, autism or both: the STOMP–STAMP initiative

“…The key is to identify the underlying problem and to resolve it (Swanepoel 2019). To do so, it is helpful to (a) consider the child's ability to function and to communicate, (b) assess the function of the behaviour and then (c) decide how to manage it most effectively.…”

“…‘Intellectual disability’ is the preferred diagnostic term replacing ‘learning disability’ and ‘mental retardation’. A provisional diagnosis of a disorder of intellectual development (previously referred to as global developmental delay) is used to describe children with delayed development where the level of their impairment is not yet clear or accurately measurable but where they are likely to have an intellectual disability (World Health Organization 1993, 2022). ‘Learning difficulty’ is an educational term with variable interpretation and will not be used here (Department for Education 2015).…”

“…It is known that ADHD is underdiagnosed in both children and adults with intellectual disability (Clark 2018; Xenitidis 2020). This is probably at least partly the result of the historic ICD-10 and DSM-IV not allowing concurrent diagnoses of autism and ADHD, which has been corrected in the updated guidance (ICD-11 and DSM-5) as more research has become available to show that intellectual disability, autism and ADHD are very often comorbid (World Health Organization 1993, 2022; American Psychiatric Association 1994, 2013; Clark 2018; Bougeard 2021).…”