‘Don’t turn a blind eye, help is available’, psychiatrist advises parents…

Violence among children of school-going age is often preceded by certain warning signs in their behaviour. Where adults are able to recognise and address these early indications in time, more serious incidents and tendencies towards violent behaviour in future can often be avoided.

“Recent news reports following a few extreme incidents, such as stabbings and murder, have highlighted the issue of violent behaviour among children and adolescents, however the majority of violence taking place in schools is in the form of bullying and psychological violence,” says Dr Marshinee Naidoo, a specialist psychiatrist practising at Akeso Alberton psychiatric hospital.

According to Dr Naidoo, children as young as pre-schoolers can demonstrate violent behaviour. Parents and other adults who witness the behaviour may become concerned but often hope that the young child will “outgrow it”.

“The complex and troubling issue of violence in childhood needs to be carefully understood by parents, teachers and other adults. Violent behaviour in a child, at any age, always needs to be taken seriously. It should not be dismissed as simply a phase the child is going through,” she says.

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Early warning signs

While warning signs may present differently from one child to another, and not all of these signs may necessarily occur together, it is worth consulting a mental health professional if you notice your child exhibiting these types of behaviours or emotions.

Dr Naidoo says that the following behaviours may be early warning signs that a child could go on to develop violent tendencies.

  • Excessive feelings of isolation and feeling alone
  • Excessive feelings of rejection
  • Feelings of being persecuted
  • Low school interest and poor academic performance
  • Expression of violence in writings and drawings
  • Becoming easily frustrated
  • Social withdrawal
  • History of discipline problems
  • Intolerance for differences, and prejudicial attitudes
  • Extreme irritability
  • Uncontrolled, intense anger
  • Frequent loss of temper or ‘blow-ups’
  • Extreme impulsiveness

Dr Naidoo points out that it is not uncommon for children to demonstrate some of these behaviours or emotions in isolation as part of normal childhood development, but where these behaviours start to become entrenched it is cause for concern.

“The problem is that if such behaviour is not recognised and addressed by parents, teachers and the school, with no interventions provided to children, then it can escalate into violence that could be much more harmful.

Risk factors

Dr Naidoo says there are various factors that may increase the risk of a child developing violent tendencies. “These are always highly complex, however, and the presence of such factors does not necessarily mean that a child is destined to become violent.”

There are various factors that may increase the risk of a child developing violent tendencies.

“If a child is exposed to violence, they are more likely to become violent themselves. Children who experience or witness violence in their community, physical punishment or domestic violence, and those who have been victims of physical or sexual abuse are more at risk of becoming violent themselves,” she explains.

“Even violence in the media, such as movies, TV shows or computer games, could potentially increase the risk of a child exhibiting violent behaviour. There may also be genetic factors that could predispose a child to violence, and certain types of brain damage from head injuries may also play a role in the development of violent behaviours.”

Children who are being bullied, or have become involved with gangs, drugs or alcohol, as well as those facing a combination of stressful family socio-economic factors such as poverty, severe deprivation, marital breakup, single parenting, unemployment, or loss of support from extended family, may also be at greater risk.

Signs that danger may be imminent

Imminent warning signs that a child may have a serious violent episode require immediate intervention.

“Serious physical fighting with peers or family members, severe destruction of property, or the child displaying severe rage for seemingly minor reasons, are signs that assistance is urgently required. Equally, threats of lethal violence, or a detailed plan to harm or kill others, particularly if the child has a history of aggression or has attempted to carry out threats in the past, should never be ignored,” Dr Naidoo warns.

Imminent warning signs that a child may have a serious violent episode require immediate intervention.

“If it is discovered that a child has self-inflicted injuries, if they threaten suicide, or indicate a preoccupation with suicide or violence, professional help is also needed as soon as possible.”

According to Dr Naidoo, both parents and educators have the responsibility to take action where these signs are noted. “Adults involved in the child’s life have a responsibility to seek assistance from child and family service providers, community mental health professionals, or other appropriate organisations.”

“Immediate intervention from parents or caregivers, school authorities, possibly with the involvement of law enforcement officers, is needed when a child has a detailed plan to commit violence or is carrying a weapon. Parents should be informed immediately when students exhibit any threatening behaviour at school or in their communities,” she adds.

Manifestations of violent behaviour

Violent behaviour in children and adolescents can include a wide range of behaviours, including:

  • Physical aggression or fighting
  • Explosive temper tantrums
  • Bullying
  • Setting fires
  • Threats or attempts to hurt others
  • Use of weapons
  • Cruelty toward animals
  • Intentional destruction of property and vandalism

Reducing the risk

“Violent behaviour can be prevented, or the probability of it manifesting can be reduced, if risk factors are minimised or, preferably, eliminated. Efforts should be directed at dramatically decreasing the exposure of children and adolescents to violence in the home, community, and through the media, as clearly, violence leads to violence,” Dr Naidoo says.

“Whenever a parent or another adult is concerned, they should immediately arrange for a comprehensive evaluation by a qualified mental health professional”

“Whenever a parent or another adult is concerned, they should immediately arrange for a comprehensive evaluation by a qualified mental health professional, usually a psychiatrist or psychologist, as early identification and treatment can often help.

“The outcome of the assessment would indicate the most suitable treatment programme, most likely individual psychotherapy by a clinical psychologist, however in younger children play therapy may be indicated. Where needed, the psychologist will refer the child to a psychiatrist,” she notes.

The goals of treatment typically focus on helping the child learn how to control anger; express anger and frustrations in appropriate ways; take responsibility for their actions; and accept consequences for their actions.

“Treatment is most often done on an outpatient basis. Where in-hospital treatment is indicated, various programmes are offered at psychiatric facilities, such as at selected Akeso psychiatric hospitals, however this would be discussed with the family on a case-by-case basis.

“Where children and families receive the required professional support in time, it can make an enormous difference to the child’s life in the years to come. It is therefore imperative that adults understand how to identify the warning signs and take action to assist the child in overcoming violent impulses,” Dr Naidoo concluded.

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