Sometimes a child labeled ‘difficult’ is just expressing a healthy need for independence. But in other cases, the label is actually too mild. Adults can be violent, irresponsible, indifferent to the harm they do others and typically that behavior begins in childhood.

Not all such children are potential criminals, but they share some of the characteristics – refusal to fully accept reality, poor impulse control, lack of empathy, disrespect for the rights of others and a range of destructive behavior against people, animals and property.

Usually the signs are all too clear to parents – refusal to accept limits or take instruction, shouting, temper tantrums and sometimes hitting siblings or even parents. Sometimes the condition is influenced by genetic and hormonal factors – as in Asperger’s Syndrome, ADHD or even autism. It can be magnified by stressful factors in the environment.

Some temperaments are natural, such as extreme sensitivity to stimuli, some moods can be brought on by new elements such as a new child in the home. Sometimes, as with adults, it’s simply a choice to misbehave.

Sorting out all these complex factors is one of the parent’s toughest jobs. Testing may help. It can be useful to get a good diagnosis, but take what you hear with a grain of salt. Consult more than one specialist when possible. There is a lot of junk science in child development.

But whatever the causes, the parent will need to exercise even more than normal patience to deal with the child’s behavior. Frustration and anger are normal, but only add to an already difficult situation.

Dealing with the child and its behavior can range from simple time outs to distraction to some drug therapy (in extreme cases). When a child misbehaves and refuses to listen, removing a wanted toy or restraining a desired activity can be helpful. It should be accompanied by clear and firm expressions of the reasons for the actions. That helps the child associate its unwanted behavior with the consequences.

Physical punishment rarely helps, but a tap on the hand is hardly abuse. Parents should avoid feeling guilty, as if they caused the behavior. There are abusive parents, but these are not the ones who are seeking to understand and mold their child’s actions toward more healthy expressions.

Be prepared to alter the environment. It may be necessary in some cases to not have pets in the house and siblings should be protected from any bad behavior. Often, with patience and the employment of standard techniques, the child’s behavior can be altered, sometimes dramatically.

Dealing with difficult children is, by definition, difficult. But with patience and training both parents and children can achieve satisfying results.