What to do if you have an Aggressive Child?

The initial step to deal with aggressive behavior is to assist parents in obtaining evidence based parent and child skills. These skills need to be age and developmental specific. Cognitive, behavioral and affective patterns of the child need to be integrated into the types of services and intervention provided. These services can be provided by any professional with expertise in the skills necessary for your child.
The engagement of families and children improves success and compliance. This can be done through supportive services and information available in the office and through online resources, including social media.
The importance of identifying and choosing target behaviors with parents is vital for short and long term success. If a primary issue or antecedent can be identified then this should be addressed first. In doing so the goal is to avoid the use of medication if the cause of the aggression can be identified and eliminated.
Antipsychotic medication is effective in treating aggressive behavior. The use of medication can protect and revitalize families who are in severe and often dangerous discord. Studies and information about comparative use of antipsychotic medications in pediatric populations is limited. Information suggests there are more adverse metabolic outcomes for clozapine and olanzapine than for quetiapine and risperidone. No matter what medication is chosen close follow-up and dose titration is needed and caution used when tracking behavioral responses which are highly variable and may be independent of ongoing issues. Target symptoms and monitoring parameters need to be chosen and closely followed.
When antipsychotic medication and psychosocial interventions are inadequate the use of a mood stabilizer should be considered. Although the use of the “fewest medications possible” is the golden rule, children with complex conditions may require multiple medications to deal with specific symptoms. At all times every chosen medication must be selected with the individual patient in mind. Lower risk medications with potential sustained benefits and known patterns of positive compliance should be chosen first, if possible.
During every step in this treatment process parents and family members need to be engaged and involved in observation and decision making. A therapeutic alliance with the family will foster success.