Psychopathic tendencies can sometimes be recognized in childhood or early adolescence. If recognized, a diagnosis of Conduct Disorder, or possibly the related Oppositional Defiant Disorder, may be given. However, while these childhood signs have been found in a significantly higher proportion of psychopaths than in the general population, it must be stressed that not all the subjects of such childhood diagnoses turn out to be psychopaths as adults, or even disordered at all. Therefore, psychopathy is not normally diagnosed in children or adolescents, and some jurisdictions explicitly forbid diagnosing minors with psychopathy and similar personality disorders. This is because such a diagnosis "fails to capture the emotional, cognitive, and interpersonality traits — egocentricity and lack of remorse, empathy, or guilt - that are so important in the diagnosis of psychopathy."
Children showing strong psychopathic precursors often appear immune to punishment; nothing seems to modify their undesirable behavior. Consequently parents usually give up, and the behavior worsens.
The following childhood indicators are to be seen not as to the type of behavior, but as to its relentless and unvarying occurrence. Not all must be present concurrently, but at least a number of them need to be present over a period of years.[65] These indicators are sufficient - but not necessary - indicators of possible psychopathy.[citation needed]
* An extended period of bedwetting past the preschool years, not due to any medical problem.
* Precocious sadism, often expressed as profound animal abuse.
* Pathological firesetting, lacking in obvious homicidal intent. Not to be confused with playing with matches, which is not uncommon for preschoolers. This is the deliberate setting of destructive fires with utter disregard for the property and lives of others.
* Lying, often without discernible objectives, extending beyond a child's normal impulse not to be punished. These lies are so extensive it is often impossible to know lies from truth.
* Theft and truancy.
* Aggression towards peers and relatives. The aggression can include physical and verbal abuse, getting others into trouble, or a campaign of psychological torment.
The three indicators — bedwetting, cruelty to animals and firestarting, known as the Macdonald triad — were first described by J.M. MacDonald as "red flag" indicators of psychopathy and future episodic aggressive behavior. However, subsequent research has found that bedwetting is not a significant factor. The question of whether young children with early indicators of psychopathy respond poorly to intervention, compared to conduct-disordered children without these traits, has only recently been examined in controlled clinical research. The empirical findings from this research have been consistent with broader anecdotal evidence, pointing to poor treatment outcomes
