Attention-Seeking Behavior in Dogs

Quick Facts

🏥 Condition Name
Attention-Seeking Behavior
📋 Also Known As
Attention-Seeking Behavior
📂 Category
Behavioral & Psychological
📍 Subcategory
N/A
🐕 Affects
Social behavior, human-animal relationship, daily routine
🏷️ Type
Behavioral
⚠️ Severity
Mild to Moderate
💊 Treatable
Yes
🔄 Contagious
No
🧬 Hereditary
Predisposition in some breeds
🐕 Common In
All dogs; highly social breeds, under-stimulated dogs

Attention-Seeking Behavior Overview

Attention-seeking behavior in dogs encompasses a range of actions performed specifically to elicit responses from owners or other people, regardless of whether those responses are positive or negative. These behaviors are remarkably common and exist on a spectrum from mild and endearing, such as bringing toys for play, to problematic and disruptive, such as persistent barking, jumping, nudging, or destructive actions designed to force owner engagement. While some degree of seeking human attention is normal and healthy for social animals like dogs, excessive attention-seeking can significantly disrupt household routines, strain the human-animal relationship, and indicate underlying emotional needs that are not being adequately met.

Understanding attention-seeking behavior requires recognizing that dogs are highly social creatures who have evolved over thousands of years in close partnership with humans. Their desire for interaction, engagement, and connection is hardwired and represents a fundamental aspect of the human-canine bond. However, when this natural inclination becomes excessive or manifests in disruptive ways, it typically reflects an imbalance between the dog's needs for social interaction, mental stimulation, and physical activity and what their current lifestyle provides. Dogs may learn that certain behaviors reliably produce owner attention, even if that attention comes in the form of scolding or correction.

The reinforcement patterns that maintain attention-seeking behavior are often subtle and unintentional. Every time an owner responds to a dog's demands, whether by providing the desired attention, attempting to calm the dog, or even expressing frustration, the behavior is reinforced. Dogs do not distinguish between positive and negative attention in the same way humans do; any form of engagement can serve as reinforcement. This understanding is essential because it explains why common owner responses, such as telling the dog to stop or pushing them away, often fail to reduce the behavior and may actually strengthen it.

Successful management of attention-seeking behavior involves a combination of meeting the dog's legitimate needs for interaction and enrichment, teaching alternative behaviors that produce attention appropriately, and eliminating reinforcement for demanding behaviors. This approach requires consistency from all family members, patience during the initial period when behaviors may temporarily intensify, and commitment to providing structured, predictable opportunities for the positive engagement that dogs naturally seek. With appropriate intervention, most attention-seeking problems respond well to treatment, resulting in a more harmonious relationship between dog and family.

Causes of Attention-Seeking Behavior

Attention-seeking behavior develops through a combination of factors including the dog's innate social needs, learned associations between specific behaviors and owner responses, environmental conditions that fail to meet the dog's needs, and sometimes underlying anxiety or emotional issues. Understanding these contributing factors enables targeted intervention that addresses root causes rather than merely suppressing symptoms.

The fundamental cause of attention-seeking behavior lies in the dog's inherent social nature and their dependency on humans for meeting their physical, emotional, and social needs. Dogs have evolved as social species that form strong bonds with their human families and naturally seek interaction, engagement, and connection. This drive for social contact is healthy and appropriate; it becomes problematic only when dogs have not learned appropriate ways to request attention or when their underlying needs for interaction remain chronically unmet. Dogs living in homes where they receive inconsistent or insufficient attention may develop more intense attention-seeking behaviors as they attempt to meet their fundamental social needs.

Learning and reinforcement history play a crucial role in shaping and maintaining attention-seeking behaviors. Dogs are excellent observers and quickly learn which behaviors produce desired outcomes. When a dog performs a behavior and receives attention as a result, whether that attention is positive engagement, reprimands, or even being pushed away, the behavior is reinforced and becomes more likely to occur in the future. This learning often happens inadvertently; owners may not realize that their responses to nuisance behaviors are actually strengthening them. Over time, dogs develop reliable repertoires of attention-seeking behaviors tailored to what works in their specific household.

Environmental factors and lifestyle conditions significantly contribute to attention-seeking behavior development. Dogs who do not receive adequate physical exercise may seek attention as an outlet for excess energy. Insufficient mental stimulation leaves dogs bored and seeking engagement through any means available. Lack of structured interaction means dogs must create their own opportunities for connection. Dogs who spend long hours alone may intensify attention-seeking when family members are present, attempting to maximize social contact during available time. Changes in household routines, new family members, or shifts in owner schedules can trigger or exacerbate attention-seeking as dogs adjust to altered patterns of interaction.

Underlying anxiety or emotional issues sometimes manifest as attention-seeking behavior. Dogs with separation anxiety may show intensified attention-seeking as part of their overall distress about owner departures and returns. Generalized anxiety can drive dogs to seek constant reassurance through physical proximity and interaction. Dogs who lack confidence may rely heavily on owner attention for emotional security. In these cases, attention-seeking represents a symptom of broader emotional needs that require comprehensive treatment rather than isolated behavior modification. Distinguishing between learned attention-seeking and anxiety-driven proximity-seeking is important for selecting appropriate interventions.

Symptoms & Warning Signs

Attention-seeking behavior in dogs manifests through a diverse array of actions designed to elicit owner responses. These behaviors can range from subtle and easily overlooked to dramatically disruptive, and they often escalate if initial attempts at gaining attention fail to produce the desired result. Recognizing the full spectrum of attention-seeking behaviors helps owners understand the extent of the pattern and identify all behaviors that require intervention.

Vocalization represents one of the most common attention-seeking strategies. Barking, whining, whimpering, and howling directed toward family members typically occur when the dog wants engagement and intensify if ignored. The vocalizations may begin at low intensity and escalate in volume and persistence if they do not produce the desired response. Some dogs develop characteristic attention-seeking vocalizations distinct from their barking in other contexts. Dogs may vocalize when owners are talking on the phone, working, or otherwise engaged in activities that exclude them. The intermittent nature of owner responses to vocalization, sometimes responding and sometimes not, can create particularly persistent vocal attention-seeking.

Physical contact behaviors frequently serve attention-seeking purposes. Jumping on family members or guests demands immediate acknowledgment. Pawing, nudging, or poking with the nose interrupts owner activities and forces engagement. Some dogs place their heads or paws on owners' laps, keyboards, or books to interpose themselves between the owner and their current focus. Climbing into laps uninvited, leaning heavily against owners, or persistent following throughout the house may represent attention-seeking, though these behaviors may also indicate anxiety that requires different intervention approaches. Physical attention-seeking behaviors often occur during times when owners are engaged in other activities and not attending to the dog.

Disruptive and destructive behaviors can function as sophisticated attention-seeking strategies. Dogs may knock objects off tables, steal items known to provoke chase responses, or engage in counter-surfing when owners are present because these behaviors reliably produce dramatic reactions. Some dogs learn that destructive behavior during owner absences results in intense attention upon the owner's return, though this pattern may also indicate separation distress. Inappropriate elimination in front of owners, particularly when the dog is otherwise housetrained, sometimes serves attention-seeking functions. These high-impact behaviors often develop when subtler attention-seeking attempts have been unsuccessful.

Bringing objects to owners, while often charming, can become excessive and demanding. Dogs may persistently present toys, shoes, or other items and refuse to settle until play or interaction occurs. The behavior may include dropping items, picking them up again, and repeated presentation. Some dogs progress from bringing items to more intrusive behaviors if the initial invitation is not accepted. While object-bringing reflects healthy social behavior in moderation, its persistence and the dog's response to being declined reveal whether it has become problematic attention-seeking.

Timing patterns provide important clues for identifying attention-seeking behavior. These behaviors typically increase when owners are present but not engaged with the dog, such as during phone calls, meals, television viewing, or work activities. They may peak during certain times of day when the household routine historically involved dog attention. Behaviors often intensify immediately after being ignored and may temporarily escalate during initial treatment before improving, a phenomenon known as an extinction burst. Noting when attention-seeking occurs helps identify triggers and contexts that require management.

Diagnosis

Diagnosing attention-seeking behavior as a primary behavioral pattern rather than a symptom of underlying conditions requires careful evaluation of the dog's behavioral history, the contexts in which behaviors occur, and the potential contribution of medical or emotional factors. This assessment helps distinguish between learned attention-seeking, which responds to behavioral modification, and behaviors driven by anxiety or medical issues that require additional intervention.

Initial evaluation should include veterinary examination to rule out medical conditions that might cause behaviors resembling attention-seeking. Pain or discomfort can cause dogs to seek increased proximity to owners or display restless behaviors that appear attention-seeking. Cognitive dysfunction in older dogs may manifest as increased neediness, vocalization, and following behavior. Neurological conditions can alter behavior in various ways. Sensory decline may cause dogs to seek more physical contact for reassurance. Medical evaluation ensures that physical health issues are identified and addressed as part of comprehensive treatment.

Behavioral history gathering focuses on understanding the pattern of attention-seeking behaviors and their development over time. Questions address when behaviors first appeared, whether they have increased in frequency or intensity, what specific behaviors the dog displays, when during the day behaviors occur, what family members do in response, and whether any interventions have been attempted. Understanding the dog's daily routine, including exercise, mental stimulation, alone time, and structured interaction with family members, reveals whether unmet needs may be driving the behavior. Information about the dog's early history, socialization experiences, and any known traumatic events provides context for understanding current behavior.

Distinguishing between attention-seeking behavior and anxiety-driven proximity-seeking is essential for selecting appropriate treatment. Both may involve following owners, seeking physical contact, and distress when ignored, but the underlying motivations differ substantially. Attention-seeking dogs typically appear confident and escalate demanding behaviors when not engaged, while anxious dogs appear worried and show stress signals when separated from owners even briefly. Attention-seeking behavior is specifically directed toward obtaining interaction, while anxiety-driven behavior reflects the dog's emotional distress and need for security. Dogs with separation anxiety show distress specifically around owner departures and absences, while attention-seeking dogs may be equally demanding whether owners are coming, going, or staying. Some dogs have elements of both patterns, requiring treatment that addresses both learned behavior and underlying anxiety.

Functional assessment examines what consequences maintain the attention-seeking behavior. Identifying what the dog achieves through their behavior, whether it is physical interaction, play, food, or simply owner acknowledgment, guides treatment planning. Understanding the exact sequence of behavior and consequences reveals the reinforcement patterns that maintain the problem. Video recording of the dog's behavior when owners are home, particularly during times when attention-seeking is common, provides objective information that may reveal patterns not apparent from memory alone. This assessment forms the foundation for developing behavior modification strategies that eliminate reinforcement for demanding behaviors while teaching appropriate alternatives.

Treatment Options

Effective treatment of attention-seeking behavior combines meeting the dog's legitimate needs for interaction and enrichment, eliminating reinforcement for demanding behaviors, and teaching appropriate alternative ways to request attention. Success requires consistency from all family members, patience during the initial period when behaviors may temporarily intensify, and commitment to long-term maintenance of improved patterns.

Meeting the dog's needs proactively forms the essential foundation of treatment. Many attention-seeking dogs are communicating legitimate needs for more interaction, exercise, and mental stimulation than their current lifestyle provides. Increasing daily exercise through walks, play sessions, and activities appropriate for the individual dog helps reduce the energy that fuels demanding behavior. Providing mental enrichment through puzzle feeders, training sessions, sniffing opportunities, and varied experiences addresses cognitive needs. Scheduling regular, predictable periods of focused attention throughout the day ensures the dog receives adequate social interaction. When needs are met proactively, dogs have less motivation to demand attention and more capacity to tolerate periods of non-engagement.

Eliminating reinforcement for attention-seeking behaviors requires withdrawing all responses to demanding behavior while simultaneously reinforcing calm, appropriate behavior. When the dog engages in attention-seeking behavior, all family members must refrain from any response, including eye contact, verbal responses even if negative, touching even to push the dog away, and changes in body position that acknowledge the behavior. This planned ignoring must be absolute and consistent, as intermittent reinforcement, where behaviors sometimes produce responses, creates especially persistent behavior patterns. The dog must learn that demanding behaviors no longer produce any result.

Owners should anticipate an extinction burst, a temporary increase in the intensity and frequency of attention-seeking behaviors when reinforcement is first withdrawn. This escalation occurs because the dog is trying harder to produce the responses that previously worked. The extinction burst is a normal part of the behavior change process and actually indicates that treatment is progressing correctly. Persistence through this challenging period is essential; giving in during an extinction burst teaches the dog that escalated behavior works, making future behavior modification more difficult. The extinction burst typically lasts days to a few weeks before behaviors begin to decrease.

Teaching alternative behaviors provides the dog with appropriate ways to request attention that can be reinforced. Training a settle or place command gives dogs an acceptable way to remain near owners without demanding interaction. Teaching dogs to bring a specific toy as an invitation to play provides an appropriate attention-requesting behavior that owners can choose to honor or decline. Reinforcing calm resting behavior with periodic attention teaches dogs that relaxation produces positive outcomes. Capturing and rewarding any spontaneous moments of calm, independent behavior gradually increases their frequency. The goal is to replace demanding behaviors with polite alternatives that work for both dog and family.

Structured attention protocols help establish predictable patterns that meet the dog's social needs while preventing demanding behavior. Specific times during the day are designated for focused interaction, training, play, or companionship. Outside these scheduled times, the dog is expected to entertain themselves or rest calmly. This structure provides the predictability that helps dogs relax and the guaranteed interaction that reduces motivation to demand attention at other times. Over time, dogs learn to anticipate and rely on scheduled attention periods rather than constantly seeking engagement.

Recovery & Prognosis

Recovery from problematic attention-seeking behavior typically follows a predictable trajectory, though the timeline varies based on how long the behavior has been established, the consistency of treatment implementation, and the dog's individual temperament. Understanding what to expect helps owners maintain motivation through challenging periods and recognize meaningful progress.

The initial treatment phase, typically lasting one to three weeks, is often the most challenging. During this period, the extinction burst causes attention-seeking behaviors to temporarily increase in intensity and frequency. Dogs may try new variations of demanding behavior when their usual tactics no longer work. Owners frequently feel discouraged during this phase, wondering if treatment is making things worse. Consistency through this period is essential; giving in teaches the dog that escalated behavior works, while persistence leads to eventual improvement. The extinction burst duration depends on the behavior's reinforcement history, with longer-established patterns typically producing longer bursts.

Following the extinction burst, behaviors begin to decrease as dogs learn that demanding tactics no longer produce results. This improvement may be gradual and uneven, with some days better than others. Occasional reappearance of attention-seeking behaviors is normal and does not indicate treatment failure. Dogs may test whether previously reinforced behaviors might work again, particularly during times of stress or change. Continued consistency during these testing periods prevents re-establishment of problematic patterns. Owners often notice that the dog seems more relaxed overall as they adjust to predictable routines and learn appropriate ways to interact.

Significant improvement typically becomes evident within four to eight weeks of consistent treatment implementation. Dogs spend more time resting calmly, show increased interest in independent activities, and display attention-seeking behaviors less frequently. When attention-seeking does occur, behaviors are often less intense and dogs give up more quickly when not reinforced. Alternative behaviors that have been taught and reinforced become more reliable. The overall tone of interactions between dog and family improves as demanding patterns diminish.

Long-term maintenance requires ongoing attention to the principles that produced improvement. Continuing to meet the dog's needs for exercise, enrichment, and social interaction prevents the motivation for demanding behavior from rebuilding. Maintaining consistency in not reinforcing demanding behaviors prevents re-establishment of problematic patterns. Continuing to reinforce calm, appropriate behavior keeps these patterns strong. Periodically reassessing whether the dog's needs are being met, particularly during life changes that affect routines, helps prevent regression. With appropriate maintenance, improvement is typically stable and lasting.

Prevention

Prevention of problematic attention-seeking behavior begins with understanding dogs' normal social needs and implementing practices from puppyhood that meet those needs while establishing appropriate patterns of interaction. Preventing problems is far easier than addressing established attention-seeking patterns, making early intervention in puppy development particularly valuable.

Establishing appropriate interaction patterns from the beginning teaches puppies how to request and receive attention in acceptable ways. Rather than responding to every puppy demand, owners should initiate interaction on their own schedule, teaching the puppy that attention comes predictably but not on demand. Capturing and reinforcing moments when the puppy is calm and quiet teaches that relaxed behavior produces positive outcomes. Teaching puppies to settle on a mat or bed during family activities creates alternatives to constant attention-seeking. Early training should include periods of separation and independent activity so puppies develop the ability to self-occupy and self-soothe.

Meeting the dog's needs proactively and consistently prevents the development of demanding behavior born of unmet needs. Providing adequate daily exercise appropriate for the dog's breed, age, and health status addresses physical needs. Offering mental enrichment through puzzle feeders, training, and varied experiences keeps dogs mentally satisfied. Scheduling regular, predictable periods of focused attention throughout the day ensures social needs are met. Dogs whose needs are consistently fulfilled have less motivation to develop demanding behaviors and more capacity to relax during times when owners are not available.

Teaching independence skills helps dogs develop the ability to entertain themselves and tolerate periods without owner attention. Gradual practice with separation, starting with very brief absences and slowly increasing duration, builds tolerance for alone time. Providing appropriate chew toys, puzzle feeders, and other independent activities gives dogs acceptable ways to occupy themselves. Reinforcing calm, independent behavior teaches dogs that relaxation is valued. Avoiding constant interaction that creates dependency on owner engagement for entertainment helps dogs develop self-sufficiency.

Consistency among family members prevents the development of patterns where the dog learns that demanding behavior works with some people but not others. All household members should agree on interaction protocols and implement them uniformly. Children need guidance about not reinforcing demanding behaviors and understanding appropriate ways to interact with the dog. Guests should be instructed about household rules for dog interaction. This consistency ensures that dogs receive clear, unified messages about what behavior produces attention and what does not.

Early intervention at the first signs of attention-seeking behavior prevents patterns from becoming established. When owners notice the beginnings of demanding behavior, implementing treatment strategies immediately is far more effective than waiting until behaviors become ingrained habits. Consultation with a trainer or behaviorist early in problem development provides guidance before patterns become difficult to change. Recognizing that some attention-seeking is normal while identifying when patterns are becoming problematic helps owners intervene at the optimal time.

Living With & Managing Attention-Seeking Behavior

Living with a dog who has had attention-seeking behavior requires ongoing attention to the practices that produced improvement and vigilance against the gradual re-establishment of problematic patterns. Long-term management integrates the principles of treatment into daily life in sustainable ways that maintain positive behavior while meeting the dog's social and emotional needs.

Daily routines should include structured interaction periods that provide the dog with predictable, guaranteed attention. These scheduled times for training, play, walks, or quiet companionship meet the dog's social needs in appropriate ways. Between scheduled interaction periods, dogs are expected to occupy themselves calmly with appropriate activities such as chewing, resting, or independent play. This structure provides the predictability that helps dogs relax and the regular interaction that prevents the buildup of unmet social needs. Routines should be sustainable for the family's lifestyle so they can be maintained consistently over time.

Environmental enrichment helps dogs stay occupied during times when owners are not available for interaction. Puzzle feeders and food-dispensing toys provide mental stimulation and extend meal times. Rotating toys maintains novelty and interest. Safe chew items give dogs appropriate oral activity. Window viewing, when it does not produce problematic barking, offers entertainment. A variety of enrichment options ensures that dogs have alternatives to attention-seeking when owners are busy. The goal is to create an environment where independent activity is readily available and naturally reinforcing.

Maintaining consistency in not reinforcing demanding behaviors prevents re-establishment of problematic patterns. Over time, owners may gradually begin responding to low-level attention-seeking without realizing it, allowing behaviors to rebuild. Periodic self-assessment helps identify any drift in consistency. All family members should remain aligned in their responses to attention-seeking attempts. When regression occurs, returning to stricter implementation of treatment protocols typically restores improvement relatively quickly if patterns have not become strongly re-established.

Recognizing and responding to legitimate needs prevents the dog from developing new attention-seeking strategies to communicate genuine concerns. Dogs may vocalize or seek attention when they need to go outside, when they are hungry or thirsty, when they are feeling unwell, or when something in their environment is wrong. Learning to distinguish between demanding behavior and legitimate communication helps owners respond appropriately. Meeting legitimate needs promptly while maintaining boundaries around demanding behavior balances the dog's welfare with behavior management goals.

Adapting to life changes maintains management effectiveness during transitions. Changes in household routines, new family members, moves, schedule changes, and other transitions can disrupt established patterns and trigger regression. Proactive planning for predictable changes helps maintain consistency. Increasing attention to enrichment and structured interaction during stressful periods prevents the buildup of unmet needs. Recognizing that some temporary regression during transitions is normal helps owners respond calmly rather than reactively. Returning to treatment protocols when needed addresses any emerging problems before they become established.

Breeds at Risk for Attention-Seeking Behavior

While attention-seeking behavior can develop in any dog, certain breeds and breed types may show predispositions based on their historical development and typical temperament characteristics. Understanding breed-related tendencies helps owners of predisposed breeds implement preventive measures from the beginning and recognize early signs of problematic patterns.

Breeds developed for close partnership work with humans often show strong orientation toward human interaction that can manifest as attention-seeking behavior. Companion breeds, including Cavalier King Charles Spaniels, Bichon Frises, Maltese, and similar breeds developed specifically for human companionship, are often highly focused on their owners and may be prone to demanding attention. Herding breeds such as Border Collies, Australian Shepherds, and Shelties are bred for close cooperation with handlers and may seek engagement intensely. Sporting breeds developed to work alongside hunters, including Labrador Retrievers, Golden Retrievers, and Spaniels, typically have strong desires for interaction. These breed tendencies are not inherently problematic but may require proactive management to prevent attention-seeking patterns from developing.

High-energy breeds who do not receive adequate outlets for their physical and mental needs are particularly prone to attention-seeking as a way of soliciting activity. Working breeds, terriers, and sporting dogs with high exercise requirements may develop demanding behaviors when under-stimulated. The attention-seeking in these cases often reflects legitimate unmet needs that require increased enrichment and activity rather than behavior modification alone. Owners of high-energy breeds should ensure exercise and enrichment needs are fully met before assuming that remaining attention-seeking represents purely learned behavior.

Individual variation within breeds is substantial, and many dogs of predisposed breeds never develop attention-seeking problems while dogs of unexpected breeds may struggle with demanding behavior. Early experiences, socialization, training history, and the individual dog's temperament interact with breed tendencies to determine actual behavior. Prevention practices should be implemented regardless of breed, with particular attention to breeds with known predispositions. Selecting dogs whose energy level and social needs match the family's lifestyle and capacity helps ensure that the dog's needs can be consistently met, reducing the motivation for attention-seeking behavior.

Related Conditions

Attention-seeking behavior shares features with and may co-occur with several other behavioral conditions. Understanding these relationships helps ensure accurate diagnosis and comprehensive treatment that addresses all contributing factors rather than focusing narrowly on attention-seeking behaviors while missing underlying issues.

Separation anxiety represents an important differential diagnosis when evaluating dogs with attention-seeking behavior. Both conditions involve intense focus on owners and behaviors designed to maintain proximity or engagement. However, separation anxiety specifically involves distress when separated from attachment figures, with symptoms including destructive behavior, elimination, vocalization, and escape attempts during owner absence. Dogs with separation anxiety show distress during departures and exuberant, prolonged greeting behavior upon returns. Attention-seeking behavior may occur in dogs with separation anxiety but reflects different underlying motivations. Some dogs have both conditions, requiring treatment approaches that address both learned demanding behavior and underlying anxiety. Distinguishing between these conditions affects treatment selection and prognosis.

Generalized anxiety may manifest as clingy, attention-seeking behavior as anxious dogs seek reassurance through owner proximity and contact. These dogs often show other signs of anxiety including hypervigilance, restlessness, startle responses, and physical stress indicators. Their attention-seeking reflects emotional neediness rather than learned demanding behavior, and they typically appear worried rather than confident and persistent. Treatment for anxiety-driven attachment behaviors requires addressing the underlying anxiety in addition to any behavioral modification. Medication may be appropriate for dogs whose attention-seeking stems from significant anxiety.

Boredom and under-stimulation contribute to and may be difficult to distinguish from true attention-seeking behavior. Dogs who do not receive adequate physical exercise and mental enrichment may seek owner interaction as a source of stimulation. In these cases, increasing enrichment and activity often substantially reduces attention-seeking without specific behavior modification. Assessing whether the dog's exercise, mental stimulation, and social interaction needs are being met helps determine whether attention-seeking reflects learned behavior patterns or unmet needs. Most cases involve some combination of both factors, and treatment should address needs as well as learned behavior patterns.

Compulsive behaviors occasionally develop from attention-seeking origins. When attention-seeking behaviors are strongly reinforced, they may become repetitive and seem to occur independent of their original function. Distinguishing between persistent attention-seeking and true compulsive behavior affects treatment approach. Consultation with a veterinary behaviorist helps clarify complex cases where multiple behavioral issues may be present.