Medical Reasons for Defiance

There are many medical problems that can cause a child to be cranky, irritable, aggressive, and unpredictable, and to seek out dangerous situations or high-stimulation environments. Take a close look at some possible medical reasons for defiance and ask yourself if you think any of them might be affecting your child. If so, you may wish to call these issues to your pediatrician's attention. Some of the problems can be more easily alleviated than others.

Problems You Might Alleviate

Sleep disorders are known to cause crankiness in kids of all ages. If your child does not sleep deeply, it could be affecting her ability to function and to behave herself. If your child sleeps less than others her age, or if she wakes up frequently, talk to a therapist and a pediatrician. Also, be aware that a change in sleep patterns — beginning to sleep more or less than usual — is a symptom of depression and drug use. Finally, kids' sleep patterns change at puberty as they begin to have trouble getting up in the morning and feel inclined to stay up later.

If your child has Type 1 or Type 2 diabetes, low blood sugar can be causing crankiness, spaced-out looks, and grumpy outbursts. Type 1 diabetes has nothing to do with diet, exercise, and obesity; it's an autoimmune disease that develops for reasons still not completely understood. Type 2, on the other hand, is a metabolic disease that particularly affects obese and sedentary children. Type 1 diabetes is more common in children, but Type 2 is more common overall.


The Everything ® Parent's Guide to Children with Juvenile Diabetes provides comprehensive, detailed information on managing symptoms of diabetes in kids. It also explains in greater detail the difference between each type of diabetes and some of the symptoms your child may present with, like excessive urination or bed-wetting.

Allergies and sensitivities can cause irritability and unpredictability in kids. No one knows for sure exactly why — though there are some strong theories — but allergies are much more common today than they were a generation ago. So, your child may be allergic to wheat, for example, even if no one else in your family is. Allergies and sensitivities that have not yet been detected are especially problematic, because they can cause weird behavior in kids without the kids or the parents knowing why. Think about your child's behavior and take note if it always happens just after a meal or just after going into the garage where toxic cleaning supplies and highly perfumed detergents are kept.

Abnormal hormone levels can cause aggressive behavior in kids. This is something that a pediatric specialist will need to test thoroughly before a diagnosis can be made. Before you fill any prescriptions, talk at length with the specialist, research the prescription and side effects, and then ask any other questions you may have.

Problems You Can't Alleviate

Unfortunately, there are some medical reasons for defiance that you can do little or nothing to fix. But, if you suspect one of these problems, take hope — you can help your child and even alleviate some of the symptoms through time and practice.

When the brain and nervous system don't function correctly, behavior is affected. Abnormal development of the brain and nervous system can result from genetic factors or reasons only a neurosurgeon can detect. However, head injuries and fetal exposure to drugs, alcohol, and tobacco — events that you or another caregiver might be aware of — can also impair brain development and cause aggressive or dangerous behavior. (Fetal exposure to drugs, alcohol, and tobacco is akin to a fetal brain injury.) Some people whose brain or nervous system development has been impaired have difficulty controlling their impulses. They may also require more sensory stimulation for their brains to function normally, leading them to seek out dangerous, exciting, or highly stimulating activities in order to feel good. Some of those activities could include run-ins with authority, fights, drug use, unprotected sex, and so on — all behaviors that can be called defiant.

Children are generally healthier than adults and can recover quickly from a cold, for example. That doesn't mean, however, that a child can “bounce back” when her brain hasn't developed normally. As a general rule, the key to helping a damaged nervous system function better is to move quickly so that there are no further impairments. You may not be able to change the past, but you can still change the future. If you suspect your child has impaired brain functioning, act now and consult a pediatric specialist.

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