Delinquency: the role of the paediatrician

Delinquency, that is, criminal behaviour, is one manifestation of anti-social behaviour in adolescence, overlapping considerably with the phenomenon of conduct disorder. Delinquency conceals two distinct categories, each with a unique natural history and aetiology. One group, ‘life-course-persistent’, engages in anti-social behaviour at every life stage, whereas a larger group, ‘adolescence-limited’, is anti-social only during adolescence. Conduct disorder and delinquency have multiple associated risk factors including hyperactivity and impulsivity, low intelligence and attainment, family criminality, poor parental childrearing behaviour, poverty and socially disorganised communities. Paediatricians have a role in both the prevention of delinquency and in the care of affected individuals and their families. Their role in prevention includes: recognition of at-risk children; effective child protection; involvement in parenting programmes; initiatives to reduce poverty and the impact of social disadvantage; and the provision of effective services for hyperactivity and related developmental difficulties. Their role in support and care of affected individuals includes: the provision of both specific and general health services to this group, ensuring that such services are accessible to all affected young people, including those in care and those in prison; and acting as advocates both for individual children and for the whole population.