We all know kids can be a bit wild at times, but would you ever think that a child could be classified as a psychopath?

The New York Times Magazine recently discussed this issue in an article titled “Can You Call a 9-Year-Old a Psychopath?” The article described a wild, uncontrollable, manipulative boy named Michael, whose parents, as a last resort, took him for series of tests at Florida International University. A possible diagnosis was psychopathy; Michael was found to be two standard deviations outside the normal range for callous-unemotional behavior, a characteristic often found in psychopaths.

Regardless of characteristics or behavior, labeling a young child a psychopath, or even “pre-psychopathic” is highly controversial. Psychopathy has no known effective treatments, and the diagnosis creates long-term social stigma. You can’t rightfully label a child a psychopath until adulthood because he has not had the full chance to emotionally, socially, and morally develop.

From the moment we are born and on through adulthood, people progress through what’s known as the Six Stages of Moral Development, as determined by renowned psychologists Lawrence Kohlberg and Elliot Turiel. During each stage, people continue their development of interpersonal skills, emotional regulation, and problem solving abilities. Some children take longer than others to progress through these stages, and some people stay stuck in a particular stage, due to a trauma, biology, or brain condition. As you can imagine, a 30-year-old man being stuck in Stage I of moral development (the ego-centricity stage of infants and toddlers) would be a cause for concern.

However, for young children to be in these beginning stages is normal, or at least close to where they should be. Some of the traits seen in a psychopath – such as lack of empathy, little or no social respect, and disregard for moral boundaries – are the same traits seen during infancy and very early childhood. This is the starting point. Until an adult or caregiver teaches them otherwise, they don’t know any better than to focus only on their own needs and pound their fists when they want something.

That being said, in the NY Times Magazine article, Michael does indeed show some red flags, including aggression, impulsiveness, and narcissism. However, these red flags should not be diagnosed as symptoms of psychopathy just yet. As a 9-year-old, Michael should be in Stage III, called middle childhood, which spans from 7 – 11 years old. This is the stage where people develop empathy. However, in Stage II, also known as the early childhood stage, children are still very active with short attention spans and are generally self-centered. If Michael’s development is delayed he may still be in Stage II, which would explain his undeveloped sense of empathy.

While I am completely in favor of monitoring and assessing children’s mental health early (as this is the best time to implement preventive services), we have to be very careful about handing out the psychopathy diagnosis, which is not in the APA Diagnostic and Statistical Manual and is used quite loosely. Can a child grow up to be a psychopath? Yes, it can happen. But, until there is a clear cut way to tell that a child is overwhelmingly likely to become a psychopath, the best we can do is monitor their behavior for red flags, and provide the best treatment and support possible.

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–Dr. Kathy Seifert

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