Treatment

Parent training programmes

• group parent training programme should be offered to the parents of children and young people aged between 3 and 11 years who:
  • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or
  • have oppositional defiant disorder or conduct disorder or
  • are in contact with the criminal justice system because of antisocial behaviour

Foster carer/guardian training programmes

• group foster carer/guardian training programme should be offered to foster carers and guardians of children and young people aged between 3 and 11 years who:
  • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or
  • have oppositional defiant disorder or conduct disorder or
  • are in contact with the criminal justice system because of antisocial behaviour

Child-focused programmes

• group social and cognitive problem-solving programmes should be offered to children and young people aged between 9 and 14 years who:
  • have been identified as being at high risk of developing oppositional defiant disorder or conduct disorder or
  • have oppositional defiant disorder or conduct disorder or
  • are in contact with the criminal justice system because of antisocial behaviour.

Multimodal interventions

• multimodal interventions, for example, multisystemic therapy, should be offered to children and young people aged between 11 and 17 years for the treatment of conduct disorder

Pharmacological interventions

• methylphenidate or atomoxetine, within their licensed indications, for the management of ADHD in children and young people with oppositional defiant disorder or conduct disorder, in line with Attention deficit hyperactivity disorder
  
  
• consider risperidone for the short-term management of severely aggressive behaviour in young people with a conduct disorder who have problems with explosive anger and severe emotional dysregulation and who have not responded to psychosocial interventions
  
  
• provide young people and their parents or carers with age-appropriate information and discuss the likely benefits and possible side effects of risperidone including:
  • metabolic (including weight gain and diabetes)
  • extrapyramidal (including akathisia, dyskinesia and dystonia)
  • cardiovascular (including prolonging the QT interval)
  • hormonal (including increasing plasma prolactin)

Notes:

• At the time of publication (March 2013) some preparations of risperidone did not have a UK marketing authorisation for this indication in young people and no preparations were authorised for use in children aged under 5 years. The prescriber should consult the summary of product characteristics for the individual risperidone and follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's Good practice in prescribing and managing medicines and devices for further information.

Reference:

• (1) NICE (March 2013). Antisocial behaviour and conduct disorders in children and young people: recognition, intervention and managemen