A 12-year-old went into an abandoned home and raped a 10-year-old girl, according to a Boynton Beach Police report. He was arrested and placed on an ankle monitor but was found to have violated it hundreds of times. Then, he missed class three-quarters of the time against a court order.
Those are signs of conduct disorder, according to clinical psychologist Dr. Stephen McGraw.
The Diagnosis and Statistical Manual of Mental Disorders (DSM) defines conduct disorder as “a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate
societal norms or rules are violated.”
Police arrested the boy in June after the girl came gave a school official a handwritten note that she was sexually assaulted.
“They said if I didn’t let them, they would beat me up,” the girl wrote in the note, the report states.
Conduct Disorder (DSM-5™ Diagnostic Criteria)
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
- Aggression to People and Animals
- Destruction of Property
- Deceitfulness or Theft
- Serious Violations of Rules
An evaluation of the boy was ordered when he was initially taken into custody.
McGraw evaluated the boy and said he was incompetent to stand trial in August, determining the boy was developmentally immature.
Another expert also ruled the boy incompetent and Palm Beach County Judge James Martz agreed in November.
But the boy remained on an ankle monitor. His probation officer said in court that it was during this time he racked up “hundreds of violations.”
“When I see an alert at 2 a-m, I literally have to turn my phone off. I need to sleep," Robert Pagano testified. "I go into work and I see what I’m receiving and I remind him of his age and the dangers of what is happening out there, and he says, 'OK Mr. Pagano I understand.' It works for a short time and then, unfortunately, it goes back to what [the boy] chooses to do.”
The boy was eventually brought into custody again and underwent another evaluation by McGraw.
This time, McGraw diagnosed him with conduct disorder.
“Conduct disorder is something that should be taken very very seriously,” said Raphi Wald, a Boca Raton clinical psychologist. Wald said the diagnosis in people under 18-years-old is a precursor for antisocial personality disorder. “Think of conduct disorder as someone who is going to become a psychopath or a sociopath.”
The DSM will not allow a psychologist to diagnose youth with antisocial personality disorder. Wald said antisocial personality disorder and conduct disorder are disorders that have both biological and learned components.
“The typical childhood of a person who develops antisocial personality disorder or conduct disorder is that they have parents who neglect them, parents who don’t hug them when they are very very little, parents who don’t take care of their basic needs,” said Wald.
For Ron Alvarez, a retired judge who served on the juvenile bench in Palm Beach County for 15 years, a diagnosis of conduct disorder was less surprising.
"Yeah, we all suffer from conduct disorder from time to time when we are kids, especially as teenagers, but essentially he doesn’t follow the rules of society or the home or the school. To me, that is my interpretation," Alvarez said.
According to a recent study, one in ten kids display signs of conduct disorder.
Experts, teachers, and counselors testified what they felt should be done with the boy next in an hours-long court hearing in Palm Beach County. His social studies teacher at his alternative school said the boy is failing and only attends class 25% of the time.
“His treatment needs are behavioral, they’re not psychiatric,” McGraw said.
The boy's family is no stranger to Martz's courtroom. Siblings of the boy taken into custody by officers have also had their cases presided over by Martz.
Court records show the boy's parents have multiple felony drug convictions.
"There is something about the parents' absence here. Because if my child doesn’t go to school, I’m on their back, right?" Alvarez said.
"I think he needs to be in a secure, residential facility," McGraw said. Martz ruled in favor of a state prosecutor’s motion to move the boy from home detention to a state facility.
The boy was placed in the Department of Children and Families juvenile incompetent to proceed program. He’s been placed in a residential facility that will work on behavior modification in order to get him to stand trial one day.
Wald said the boy will be immersed in a “token economy” at the facility.
“When they exhibit positive behaviors they will get more privileges. They may be able to access certain kind of candies from a canteen, something like that," said Wald. "If they exhibit negative behaviors, like getting into a fight, they might lose privileges."
Martz ordered the boy to be held in secure detention once he completes the program until a judge can rule on the next step in the case.