Hare states that the traits of psychopathy emerge at an early age. Evidence suggests that most parents of psychopaths are aware of their child’s issues before they start school. Childhood psychopathy is characterized by habitual lying, lack of empathy, defiance of authority, and antisocial behavior, including stealing, vandalism, arson, aggressive behavior, truancy, cruelty to animals, and sexual behavior.

Hare recounts letters he has received from the desperate parents of young psychopaths. One mother reported that her five-year-old daughter had attempted to flush their kitten down the toilet on more than one occasion and was cruel to her baby brother. By the time her daughter was 13, she was often truant, sexually active, and repeatedly stole money from her parents.

Hare asserts that the Diagnostic and Statistical Manual of Mental Disorders does not include a condition that adequately encompasses the traits of psychopathic children and adolescents. Instead, the DSM lists a range of “Disruptive Behavior Disorders” (158): attention-deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder. While these conditions include some of the characteristics consistent with psychopathy, none of them provides the full picture. For example, although conduct disorder entails violating societal norms and the well-being of others, it does not involve the requisite grandiosity or a lack of empathy and remorse.