Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder
Publication Date: February 1, 2020
This patient summary means to discuss key recommendations from the Society for Developmental and Behavioral Pediatrics for complex attention-deficit/hyperactivity disorder.
- We will use the abbreviation ADHD throughout this summary to refer to attention-deficit/hyperactivity disorder.
- ADHD aptly describes the most common behavioral problem among children. These children display several behaviors with varying degrees of intensity.
- Hyperactive: They are unable to sit still, a trait that can be very disruptive in social situations like school.
- Inattentive: They cannot stay on task or sustain focus.
- Impulsive: Acting without self-control or foresight can be dangerous.
- Symptoms of ADHD may persist into adulthood.
- The cause of ADHD is not known.
- Complex ADHD describes additional problems or a greater degree of severity of common symptoms:
- Age under 4 or over 12 at diagnosis
- Poor response to initial treatment
- Racial and ethnic minority backgrounds
- Disruptive behavior
- Substance abuse
- Intellectual/learning disability
- Tics (uncontrolled sudden movements of vocal sounds)
- Autism spectrum
- This patient summary focuses on the management of complex ADHD.
- A possibly life-long condition requires an in-depth evaluation of each patient to assure the correct diagnosis and identify all surrounding circumstances that could be affected.
- For complex ADHD this includes not only a medical history and physical examination but also information from home, school, and community environments past and present, a psychological assessment, and a doctor with specialized training and expertise.
- Education about ADHD and its related conditions followed by behavioral and educational interventions are the foundation for treating of complex ADHD.
- Treatment should begin as soon as the evaluation is complete and include:
- Parent training
- Classroom management
- Peer interventions
- Skills training for older children
- Prevention of anticipated future complications
- Treatment must also include additional problems identified during the evaluation.
- Medications are often needed in addition to behavioral and educational interventions.
- Regular monitoring of each patient’s progress especially during transitions such as preschool to school, elementary to middle school, middle to high school, and high school to postsecondary education or employment.
- ADHD: Attention-deficit/hyperactivity Disorder
Barbaresi WJ, Campbell L, Diekroger EA, Froehlich TE, Liu YH, O'Malley E, Pelham WE Jr, Power TJ, Zinner SH, Chan E. Society for Developmental and Behavioral Pediatrics Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents with Complex Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr. 2020 Feb/Mar;41 Suppl 2S:S35-S57. doi: 10.1097/DBP.0000000000000770. PMID: 31996577.
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.