ADHD (attention deficit hyperactivity disorder) affects a child's ability to focus, sit still, and practice self-control. About 1 in 20 children have ADHD, but this condition rarely flies solo.
Two out of three kids with ADHD have one or more other problems with learning, behavior, or mood. Doctors call this cluster of conditions complex ADHD.
The most common issues that go along with ADHD are:
- Defiant or hostile behavior, called oppositional defiant disorder (ODD)
- Anxiety disorder
- Autism spectrum disorders
- Problems with thinking, self-care, and social skills, called intellectual disability
- Tics, or Tourette syndrome
- Substance use disorder
Because complex ADHD comes with a range of symptoms that sometimes overlap, it can be hard to diagnose and treat. The stimulant medicines that manage ADHD symptoms may not help with other conditions. Any problems that aren't treated in childhood could stay with kids as they grow up.
Children with complex ADHD do better when they see a team of doctors and mental health providers who have experience managing this disorder, and they get on the right combination of treatments. You can help by looking for symptoms and talking to your child's doctor about them.
What Are the Symptoms?
Many kids have trouble focusing or sitting still sometimes. The difference between typical childhood behaviors and ADHD is that ADHD symptoms are severe enough to affect your child's daily life.
Children with ADHD often:
- Talk too much
- Have trouble sitting still and paying attention
- Have problems getting along with other children and adults
- Forget or lose things
- Take risks or act on their urges
- Make careless mistakes
Each condition that goes along with ADHD has its own set of symptoms. Kids with autism spectrum disorders repeat the same behaviors and have different ways of communicating and interacting with people. Children with ODD argue, refuse to follow rules, and have temper tantrums. And those with tics make repeated movements or sounds they can't control.
Many of these symptoms overlap with ADHD, making it hard to tell them apart. For example, making mistakes at school could be a sign of ADHD or a learning disorder. Temper tantrums are a symptom of ADD and ODD.
How Is It Diagnosed?
Doctors don't have one single test to diagnose complex ADHD. If your child has symptoms, see a child psychologist, child psychiatrist, or developmental pediatrician who has training and experience in diagnosing and treating complex ADHD.
The specialist will ask about your child's symptoms and health history. They can screen for the symptoms of ADHD and conditions that go along with it, such as behavior and learning disorders.
Psychologists use a few different tests and mental health assessments to diagnose complex ADHD. They may ask for input from you, your child's other caregivers, and teachers. The people who know your child best will have the most insight on how ADHD affects their day-to-day life.
What Are the Treatment Options?
Your child's pediatrician or psychologist can often manage ADHD symptoms. But caring for the diverse needs of kids with complex ADHD requires a team of specialists. Each expert will help with a different part of your child's care.
Your team of specialists might include a:
- Developmental specialist
- Child psychologist
- Nurse practitioner
Treatment usually starts by focusing on the condition that causes the most problems, whether that's ADHD or something else. Depending on the conditions involved, your child's treatment plan might include some combination of medication, psychosocial support, school strategies, and parent training.
Medication. Not every child with complex ADHD needs medication, but it can be part of the treatment.
Stimulant medicines like methylphenidate (Concerta, Focalin, Ritalin, and others) and amphetamine (Adderall) may be useful for managing ADHD symptoms such as inattention, hyperactivity, and impulsiveness. These same medicines also treat ODD symptoms. Antidepressants can be part of the treatment for anxiety and depression, along with therapy.
Conditions like autism, anxiety, depression, and tics each have their own set of treatments. These can include a combination of medication and behavior/education strategies.
Psychosocial support. Psychosocial support is a group of treatments that help kids with complex ADHD get along better in their daily life. It includes behavior management, education, and social skills training. The choice of treatments should be based on your child's age, conditions, and stage of development.
Examples of psychosocial support are:
- Education to help your family and child understand complex ADHD and its treatments.
- One-on-one sessions with a therapist to teach your child about their moods and behaviors and how to manage them.
- Training to improve their organizational skills.
- Support groups where your child can meet other kids with complex ADHD and learn what treatments helped them.
- Social skills training programs to help your child learn to live more independently, interact with others better, and manage any stresses that come their way.
School strategies. Your child's teachers can reinforce positive behaviors in the classroom by posting rules, rewarding your child for following those rules, and setting consequences for breaking them.
Kids with learning disorders may qualify for special services. Your school can help you set up an Individualized Education Program (IEP) or 504 plan based on the supports your child needs.
Parent training. Parents play an important role in managing complex ADHD. There are some things you can do at home to set your child up for success.
Getting trained in behavior management will better equip you to help your child. This program teaches you the skills and strategies you need to manage problem behaviors at home, in school, and in social settings.
Consistency is important for kids with complex ADHD. That's why these programs will teach you how to set rules and routines. You'll learn to offer positive reinforcements and rewards when your child follows those rules – for example, when they do their chores or get along with their siblings – and how to set firm but fair consequences when they break those rules.
What to Expect
Treating complex ADHD is a long journey. Many kids won't ever grow out of complex ADHD. They'll continue to have mental health, social, and learning challenges as adults, but they can learn how to live with those challenges.
Kids with complex ADHD need careful follow-up throughout their lifetime. Monitoring their progress and adjusting treatment as they grow and move through the different developmental stages will improve their chance of succeeding in school and beyond.
ADHD (Ugonjwa wa Upungufu wa Uangalifu na Utendaji wa Juu) huathiri uwezo wa mtoto wa kukaza fikira, kukaa kimya, na kujidhibiti. Karibu mtoto mmoja kati ya watoto 20 ana ADHD, lakini hali hii haipatikani mara nyingi. Watoto wawili kati ya watatu wenye ADHD wana tatizo moja au zaidi la kujifunza, tabia, au hisia. Madaktari huita kikundi hiki cha hali ADHD tata. Matatizo ya kawaida ya ADHD ni: - tabia ya uhasama au ya uhasama, inayoitwa ugonjwa wa uhasama wa upinzani (ODD) - ugonjwa wa wasiwasi - ugonjwa wa autism - matatizo ya kufikiri, kujitunza, na ujuzi wa kijamii - ugonjwa wa akili - ugonjwa wa Tourette - ugonjwa wa matumizi ya dawa - kwa sababu ADHD ngumu inakuja na dalili nyingi ambazo wakati mwingine huingiliana. Dawa za kuchochea ambazo hushughulikia dalili za ADHD zinaweza kutosaidia na hali zingine. Matatizo yoyote ambayo hayatafutwa katika utoto yanaweza kubaki na watoto wanapokua. Watoto wenye ADHD ngumu hufanya vizuri zaidi wakati wanaona timu ya madaktari na watoa huduma za afya ya akili ambao wana uzoefu wa kusimamia ugonjwa huu, na wanapata mchanganyiko sahihi wa matibabu. Unaweza kusaidia kwa kuangalia dalili na kuzungumza na daktari wa mtoto wako kuhusu dalili hizo. Dalili Zina Ufafanuzi Gani? Watoto wengi huwa na matatizo ya kukaza fikira au kukaa kimya nyakati nyingine. Tofauti kati ya tabia ya kawaida ya utotoni na ADHD ni kwamba dalili za ADHD ni kali vya kutosha kuathiri maisha ya kila siku ya mtoto wako. Watoto wenye ADHD mara nyingi huzungumza sana, wana shida kukaa kimya na kuzingatia, wana shida kupata pamoja na watoto wengine na watu wazima, wanasahau au kupoteza vitu, huchukua hatari au kutenda kwa matakwa yao, hufanya makosa ya kutojali, na kila hali inayoambatana na ADHD ina dalili zake. Watoto wenye autism spectrum disorder wana tabia tofauti za kuwasiliana na kuingiliana na wengine. Watoto wenye ODD hujadiliana, hukataa kufuata sheria, na huwa na hasira kali. Tics ni aina ya hisia ambayo hutokea mara kwa mara na hutokea kwa sauti ambazo haziwezi kudhibitiwa. Mengi ya dalili hizi hufanana na ADHD, na hivyo ni vigumu kuzitofautisha. Kwa mfano, kufanya makosa shuleni kunaweza kuwa ishara ya ADHD au tatizo la kujifunza. Matatizo ya hasira ni dalili ya ADD na ODD. Ugonjwa huo hugunduliwaje? Madaktari hawana mtihani mmoja tu wa kugundua ADHD tata. Ikiwa mtoto wako ana dalili, tazama mwanasaikolojia wa watoto, mtaalamu wa akili wa watoto, au daktari wa watoto mwenye uzoefu katika kugundua na kutibu ADHD ngumu. Mtaalamu atauliza kuhusu dalili za mtoto wako na historia ya afya. Kwa hivyo, unaweza kugundua dalili za ADHD na hali zinazohusiana na ADHD, kama vile tabia na matatizo ya kujifunza. Wataalamu wa saikolojia hutumia vipimo kadhaa tofauti na tathmini za afya ya akili kugundua ADHD tata. Huenda wakakuomba ueleze maoni yako, ya wale wanaomtunza mtoto wako, na ya walimu. Watu wanaomjua mtoto wako bora watakuwa na ufahamu zaidi juu ya jinsi ADHD inavyoathiri maisha yao ya kila siku. Kuna Njia Gani za Kutibu? Kwa mfano, daktari wa watoto au mtaalamu wa kisaikolojia anaweza kusaidia mtoto wako kupata dalili za ADHD. Ili kukidhi mahitaji ya watoto wenye ADHD, timu ya wataalamu inahitajika. Kila mtaalamu atasaidia katika sehemu tofauti ya utunzaji wa mtoto wako. Kwa mfano, msaidizi wa matibabu ya watoto, mtaalamu wa maendeleo, mtaalamu wa kisaikolojia wa watoto, na msaidizi wa matibabu ya watoto, kwa kawaida huanza kwa kuzingatia hali inayosababisha matatizo zaidi, iwe ni ADHD au kitu kingine. Kulingana na hali zinazohusika, mpango wa matibabu wa mtoto wako unaweza kujumuisha mchanganyiko wa dawa, msaada wa kisaikolojia, mikakati ya shule, na mafunzo ya wazazi. Dawa za kulevya. Si kila mtoto mwenye ADHD ya tata anahitaji dawa, lakini inaweza kuwa sehemu ya matibabu. Dawa za kuchochea kama vile methylphenidate (Concerta, Focal, Ritalin, na wengine) na amphetamine (Adderall) zinaweza kuwa muhimu kwa kusimamia dalili za ADHD kama vile kutojali, hyperactivity, na impulsivity. Dawa hizo hizo pia hutumia kutibu dalili za ODD. Dawa za kukandamiza huzuni zaweza kuwa sehemu ya matibabu ya wasiwasi na mshuko wa moyo, pamoja na tiba. Hali kama vile ugonjwa wa akili, wasiwasi, mshuko wa moyo, na tics kila moja ina matibabu yake mwenyewe. Hizi zinaweza kutia ndani mchanganyiko wa dawa na mbinu za tabia/elimu. Msaada wa kisaikolojia. Msaada wa kisaikolojia ni aina ya matibabu ambayo husaidia watoto wenye ADHD ngumu kupata pamoja vizuri katika maisha yao ya kila siku. Inatia ndani usimamizi wa tabia, elimu, na mafunzo ya ustadi wa kijamii. Uamuzi wa matibabu unapaswa kutegemea umri wa mtoto wako, hali zake, na hatua yake ya ukuzi. Msaada wa kisaikolojia ni pamoja na: - Elimu ya kusaidia familia yako na mtoto kuelewa ADHD tata na matibabu yake. Mkutano wa moja kwa moja na mtaalamu wa matibabu ili kumfundisha mtoto wako kuhusu hali zao na tabia na jinsi ya kuzisimamia. - Mafunzo ya kuboresha ustadi wao wa shirika. Kujiunga na kikundi cha msaada cha watoto wenye ADHD ya kawaida na kujifunza jinsi ya kufanya hivyo. Programu za mafunzo ya ustadi wa kijamii ili kumsaidia mtoto wako kujifunza kuishi kwa kujitegemea zaidi, kuingiliana na wengine vizuri, na kusimamia mkazo wowote unaokuja njia yao. Mkakati wa shule. Walimu wanaweza kuimarisha tabia nzuri katika darasa kwa kuweka sheria, kumpa mtoto wako tuzo kwa kufuata sheria hizo, na kuweka matokeo kwa kuvunja sheria hizo. Watoto wenye matatizo ya kujifunza wanaweza kustahili huduma za pekee. Shule yako inaweza kukusaidia kuanzisha Programu ya Elimu ya Mtu binafsi (IEP) au mpango wa 504 kulingana na msaada unaohitajika na mtoto wako. Mazoezi ya Wazazi. Wazazi wana jukumu muhimu katika kusimamia ADHD tata. Kuna mambo unayoweza kufanya nyumbani ili kumsaidia mtoto wako afanikiwe. Kujifunza jinsi ya kusimamia tabia ya mtoto wako kutakusaidia kumsaidia. Programu hii inakufundisha ujuzi na mikakati unayohitaji kusimamia tabia za tatizo nyumbani, shuleni, na katika mazingira ya kijamii. Utaratibu wa kawaida ni muhimu kwa watoto wenye ADHD. Kwa hiyo programu hizi zitakufundisha jinsi ya kuweka sheria na utaratibu. Utajifunza kutoa utegemezo mzuri na thawabu wakati mtoto wako anafuata sheria hizo - kwa mfano, wakati wanafanya kazi zao za nyumbani au kupata pamoja na ndugu zao - na jinsi ya kuweka matokeo thabiti lakini ya haki wakati wao kuvunja sheria hizo. Ugonjwa wa ADHD ni mgumu sana. Watoto wengi hawawezi kukua kutoka kwa ADHD tata. Wanaendelea kuwa na matatizo ya akili, kijamii na kujifunza kama watu wazima, lakini wanaweza kujifunza jinsi ya kuishi na changamoto hizo. Watoto wenye ADHD ngumu wanahitaji kufuatiliwa kwa uangalifu maisha yao yote. Kufuatilia maendeleo yao na kurekebisha matibabu wakati wanakua na kupitia hatua tofauti za maendeleo kutaongeza nafasi yao ya kufanikiwa shuleni na zaidi.