Aggression in Youth
What is aggression?
Everyone gets angry sometimes, even small children. But some children and teens have so much trouble controlling their anger that they shove, hit, or make fun of other people. This causes them trouble at home and at school. They often have a hard time making friends. And their aggression makes parenting them a challenge.
Aggression is any behavior that hurts other people. It can be physical—hitting or pushing—or verbal, such as name-calling. Aggression also can be social. Children may make fun of other kids or ignore them to make them feel left out. Older children and teens may gossip about peers or spread rumors about them on social media. Bullying is a common type of aggression.
Both boys and girls can be physically or socially aggressive. But boys often express anger in a physical way. Girls tend to be socially aggressive.
The reasons some children are more aggressive than others are complex. Some children may be born with an aggressive personality. They may be more impulsive than other children: They act without thinking about what might happen. They may learn to be aggressive by being around angry adults and peers. Nonaggressive children often don't want to be around them, so aggressive kids can spend time with other aggressive kids, which encourages more aggression.
Parenting an aggressive child can be hard and tiring. You may feel overwhelmed, embarrassed, and even angry yourself. But help is available for you and your child. With patience, support, and help, most children can learn to handle conflict without harming others.
When is aggression a serious problem?
All children have to learn how to deal with anger and frustration. Many toddlers go through a phase of temper tantrums, where they yell and scream and swing their arms and legs when they're upset. School-age children may throw things or get into a fight on the playground. As they grow, most children learn from adults—and from other children—how to express anger or handle conflict in a way that doesn't hurt others.
Aggression is a problem if it happens often and gets your child in trouble at home and at school. Aggression may be a sign of a problem called oppositional defiant disorder (ODD). Children with ODD may have tantrums and talk back to their parents or other adults. If this hostile behavior gets worse, it can lead to a more serious problem called conduct disorder. Older children and teens with conduct disorder may break rules, skip school, and steal or destroy property. Conduct disorder is linked to depression, substance use disorder, dropping out of school, and crime (which can lead to going to jail or prison).
Extreme aggression is sometimes also called maladaptive aggression.
If a child of any age shows repeated aggression for 6 months or more, it may be a sign of ODD. Older children usually have to show a pattern of severe aggression for a year before they are diagnosed with conduct disorder.
When to call a doctor
Call your child's doctor right now if:
- Your child hurts or threatens to hurt others or himself or herself.
- Your child attacks you, or you fear for your safety.
Call your child's doctor if:
- Your child has been caught stealing several times.
- Your child is repeatedly sent home from school for behavior problems.
What can increase the risk of aggression in youth?
A child or teen's home life and other surroundings can raise the risk of aggression. Children may become aggressive if they:
- See violence in their neighborhood.
- Feel pressure to join a gang.
- Live in a home with weapons.
- Use alcohol or drugs.
- Are being bullied.
- Live in a home with parents who are aggressive, have marital problems, or have a problem with drugs or alcohol.
- Spend a lot of time without adult supervision.
- Have parents who discipline with harsh language and spanking.
- Watch violent movies or TV programs or play violent video games.
How is an aggression problem diagnosed?
To see if your child has a problem with aggression, a pediatrician or a mental health professional will ask about your child's behavior at home and at school. Does your child act out of control and have trouble calming down? Does your child throw things? Does he or she get in fights with other children? How often do the outbursts happen? Are they occurring more often?
The doctor or counselor may watch your child at home or at school. Your child's teachers also may be interviewed.
Your child may have a physical exam and tests to see if he or she has a health problem that could cause aggression or make it worse.
What is the treatment for aggression problems?
Counseling is the main treatment for aggression in youth. Your child may have counseling alone and with you. Through role-playing and other methods, your child can learn how to cope with things that make him or her angry. In some cases, a child may need medicine to treat a mood disorder or another condition that may lead to aggressive behavior.
Counseling can help parents learn how to guide their child to make better choices. Parents sometimes make aggression worse without meaning to. They may get so frustrated by their child's anger or tantrums that they punish him or her by yelling or spanking. They also may forget to praise good behavior. Counseling can help you provide consistent discipline. You show your child the rules and what will happen (the consequences) if he or she breaks them.
How can you prevent aggression in your child?
Set rules and consequences
- Make house rules for your family. Let your child know the consequences (such as loss of certain privileges) for not following the rules.
- If you say you will take away a privilege, do it. It can be hard to follow through when your child says he or she is sorry. But your child needs to know you mean what you say.
- Create a chart with rules and chores for younger children. Your child can earn stars or other stickers for completed chores or good behavior. These stars can be turned in for privileges, such as more play time or a game night with the family.
- Ask your child how he or she would feel if someone pushed him or her on the playground.
- Read stories to young children about a child coping with a problem in a positive way.
- When reading with your child or watching a TV show, ask what was good about a character's behavior, and what was not good. What could the character have done differently to make a better choice?
Model good behavior
- Teach toddlers not to hit or bite others. Gently pull your child away and say "no" firmly.
- Use your own behavior to show your child how to act. Try not to yell when correcting your child's behavior.
- Catch your child being good. Praise your child when he or she handles conflict in a positive way or shows empathy for others.
- Involve your child in a sport. Or help your child find a hobby or social activity to share with other kids.
- Encourage your child's friendships with nonaggressive peers. Even one friend who is a positive role model can help a child feel accepted and make good choices.
Other Works Consulted
- Leff S, et al. (2009). Aggression, violence, and delinquency. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 389–396. Philadelphia: Saunders Elsevier.
- Walter HJ, DeMaso DR (2011). Disruptive behavior disorders. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 96–100. Philadelphia: Saunders.
Current as of: May 28, 2019
Author: Healthwise Staff
John Pope MD - Pediatrics
Kathleen Romito MD - Family Medicine
Louis Pellegrino MD - Developmental Pediatrics