Parents, it turns out, can make or break a psychopath. Often, they will punish children behaving violently or callously, ignorant to the fact that their child’s brain may be hardwired not to understand the punishment. This breeds resentment, making the relationship colder and inspiring a child to act out in more extreme ways, according to Randy Salekin, a psychology professor at the University of Alabama in Tuscaloosa.

Most of the therapies that have produced the best results for callous-unemotional children focus on training parents, says Hawes, though he is quick to point out that many of the sample sizes for these studies have been small. These therapies also seem to be more effective when administered earlier in a child’s development. So psychopathy researchers are now pushing for interventions with children at increasingly early ages—sometimes as young as 2.

The problem, though, is that it’s hard to identify at-risk children at such a young age. Some children start showing signs of psychopathy as early as 15 months. But usually kids don’t get recommended for treatment until they start to behave or socialize in ways that trouble parents or teachers. That, of course, requires someone to notice—and callous-unemotional traits are often found in children who were severely neglected or abused by their parents. “Callousness and unemotional traits could be adaptive for some people,” Salekin says. In other words, the very thing that causes the behaviors could also obscure them from the professionals that could help; some children will grow up with the disorder unaddressed until they are finally recommended to a psychologist after contact with the law, often in their preteen or teen years.