I-American Academy ye-Pediatrics kuqala ikhuphe izitatimende zomgaqo-nkqubo kwi-"Diagnosis and Assessment of the Child With ADHD" kunye ne "Treatment of Child-Aged Child With ADHD" ngo-2000 no-2001. kwaye baphathe izigulane zabo nge- ADHD .
Ekugqibeleni bagqithiselwa indawo ngo-2011 kunye nesitatimende somgaqo-nkqubo, "I-ADHD: Isikhokelo seKliniki yokuSebenza, ukuVavanya kunye nokuPhathwa kweNkcazo-Ukulahleka / ukuxhatshazwa kweengxaki kwi-Children and Adolescents."
Ezi zikhokelo ze-ADHD zibandakanya iziphakamiso zokuvavanya nokuphatha abantwana phakathi kweminyaka engama-4 neye-18, ububanzi obwandisiweyo ngaphezu kokugxininiswa kancinci kwezikhokelo zangaphambili ezingabandakanyi abantwana abaselula okanye abatsha.
Ukuchonga abantwana abane-ADHD
Ngamanye amaxesha abazali bayamangaliswa kukuba abantwana abane-ADHD ngamanye amaxesha banokuzithoba ngakumbi kunokuba bacinga. Emva koko, akukho vavanyo lwegazi oluchanekileyo okanye i-x-ray ongayenza loo nto inokuthi umntwana wakho ungeze okanye u-ADHD .
Kunoko, oogqirha bezingane basebenzise imibuzo yemibuzo ukuba bahlole kwaye baqinisekise ukuba umntwana uhlangabezana neenkqubo ze "I-Diagnostic and Statistical Manual of Disabilities, I-Fourth Edition."
Ngubani omele ahlole?
Naliphi na umntwana "onenkathazo yezifundo okanye zokuziphatha kunye neempawu zokungafanelekanga, ukunyanzeliswa, okanye ukungabi nomdla."
Ukongezelela ekuhlangabezaneni neenqobo ze-ADHD, ukuba zifumane i-ADHD, iimpawu zabo kufuneka zibangele ukuphazamiseka kwaye akufanele kubangelwe enye imeko, njengokukhathazeka, ukuphalazela ukulala, okanye ukukhubazeka kokufunda, njl njl.
Izikhokelo zonyango ze-ADHD
Phakathi kwezigqibo kunye neziphakamiso ezichazwe kule nkcazo yomgaqo-nkqubo kukuba ukugqithiswa kwengxaki yokuxhatshazwa kwempilo kufuneka kubonakale njengesifo esingapheliyo kwaye inkqubo ethile yokhathalela umntwana, kufuneka iphuhliswe kubantwana abanenjongo yokuphucula umsebenzi wokuphucula ubudlelwane kunye ukusebenza esikolweni, ukunciphisa ukuziphatha okuphazamisayo, ukukhuthaza ukhuseleko, ukwandisa ukuzimela nokuphucula ukuzithemba.
Ezinye iziphakamiso ziquka ukuba unyango olushukumisayo kunye / okanye unyango lwendlela yokuziphatha lufanelekileyo kwaye lukhuseleko olukhuselekileyo lwe-ADHD kwaye ukuba abantwana kufuneka babe nokulandelelaniswa rhoqo kunye nokulandelelanayo ukujonga iinjongo kunye nemiphumo emibi. Enye yomeleleyo, kwaye ndicinga ukuba luncedo kakhulu, iingcebiso kwisitatimende somgaqo-nkqubo yintoni enokuyenza nabantwana abangaphenduliyo kunyango oluqhelekileyo. Kaninzi, xa umntwana engaphenduli kwiyeza okanye eqhubeka enenkathazo, unyango luyekile kwaye ushiywe ukuqhubeka esenza kakuhle esikolweni, abe neengxaki zokuziphatha kunye nobudlelwane obubi nabanye. Endaweni yoko, i-AAP icebisa ukuba 'xa ulawulo olukhethiweyo kumntwana ongu-ADHD aluzange luhlangabezane neziphumo ezijoliswe kuzo, oogqirha kufuneka bavavanye ukuxilongwa kwangaphambili, ukusetyenziswa kwazo zonke iindlela zokonyango ezifanelekileyo, ukubambelela kwisicwangciso sonyango, kunye nobukho beemeko ezikhoyo.
Kubantwana abane-ADHD abaqhubeka beengxaki ngeempawu eziphambili, kubandakanywa ukungalindelekanga, ukungaxhatshazi, kunye nokungafuneki, ukuba loo mayeza ayengeyona inxalenye yesicwangciso sokuqala sonyango, kufuneka imichiza ekhuthazayo ifanele ingqwalaselwe kwaye unyango olufanelekileyo lufanele luqiniswe. Abantwana abasele beyeza kumachiza avuselelayo kwaye benza imiphumo emibi , banokutshintshwa babe yimichiza eyahlukileyo.
Uninzi lweengxelo kunye nezigqibo zalo mgaqo-nkqubo kufuneka zikhuthaze abazali, kubandakanywa nokuba:
- Ukuphonononga nokuhlaziywa kweengxelo eziliqela kubonise ukuba imichiza evuselelayo isebenza kwimpawu eziphambili ze-ADHD kwaye kwiimeko ezininzi 'kuphucula ukukwazi komntwana ukulandela imithetho kunye nokunciphisa ukunyamezeka kwengqondo, oku kuholele ekuphuculeni ubudlelwane obuhle kunye noontanga nabazali.
- Imiphumo emibi yemithi ekhuthazayo ihlala 'imnene kwaye imfutshane,' kunye nabazali abakhathazeke ngemiphumo yokuphuza imithi ekukhuleni komntwana, ukuba akukho 'ukuphazamiseka okuphawulekayo kokuphakama okufikelelekileyo' kwimpilo yabantu abadala.
AMAHLA
Isitatimende somgaqo-nkqubo we-AAP siquka kwakhona ukuhlaziywa okufutshane kwamachiza asetyenziswe kunyango lweNkcazo yokuKhathazeka kweNkunkuma, kuquka ukuvuselela kunye nokungakhuseli.
Izikhuthazo zibandakanya iifom ezahlukeneyo ze-methylphenidate:
- Ukwenza okufutshane, njengoRitalin kunye ne-Focalin, kunye neeyure ezingama-3-5
- Isibambiso esiphakathi, njengoRitalin SR, iMetadate ER, kunye ne-Methylin ER, kunye neeyure ezingama-3-8
- Ukuthatha ixesha elide, njenge-Concerta, i-Daytrana, i-CD ye-Metadate, i-Focalin XR, kunye nobude beeyure eziyi-8 ukuya kwe-12 kwaye ingasetyenziswa kanye kuphela ngosuku
Olunye uhlobo olukhuthazayo lubandakanya iindlela ezahlukeneyo ze-amphetamine:
- I-act-short-acting, njenge-Dexedrin ne-Dextrostat, kunye nobude bee-4-6 iiyure eziphakathi, njenge-Adderall kunye ne-Dexedrine Spansule, kunye neeyure ezingama-6-8
- Ukuthatha ixesha elide, njenge-Adderall XR kunye neVivvanse
Uninzi olungakhuthazi lukhoyo ngoku, kuquka iStrattera, Intuniv , neKapvay. Ngokubanzi, isikhokelo se-AAP sichaza ukuba ubungqina bobubungqina "bunamandla ngakumbi kwimithi enomdla kwaye zanele kodwa zingaphantsi." Oku kukhokelela abaninzi abantwana kunye nabazali ukuba bazame ukuvuselela unyango wokuqala.
Ukukhetha iMida ye-ADHD
Ngazo zonke iintlobo ezahlukeneyo zemithi ye- ADHD , kwaye ezininzi ezitsha, ukhetha ukuba ngubani oza kuwusebenzisa kumntwana wakho? Ngubani osebenza kakuhle? Ngokuqhelekileyo, akukho 'nonyango' yonyango kwaye i-AAP ithi 'nganye impawu eziphuculisayo ziphucula iimpawu ezisemgangathweni.'
Omnye umbuzo yintoni umlinganiselo wokusetyenziswa. Ngokungafani neminye imithi, izikhuthazo 'azixhomekeke kumzimba,' ngoko uneminyaka engama-6 ubudala kunye nomnyaka oneminyaka engama-12 unokuba ngumlinganiselo omnye, okanye umntwana omncinci angadinga umlinganiselo ophezulu. Ngenxa yokuba ayikho imilinganiselo ephantsi esekelwe ubunzima bomntwana, izikhuthazi zivame ukuqaliswa kwisilinganisi esisezantsi kwaye ngokunyuka zanda ukuba zifumane umthamo ongcono lomntwana, 'nguye okhokelela kwimiphumo emihle ngemiphumo emibi. Ezi ziphumo zingabandakanya ukunciphisa intlanzi, intloko, ukuxhamla, ukukhathazeka ukulala, ukuhlaselwa kunye nokuhlaliswa kwezenhlalakahle, kwaye ngokuqhelekileyo kunokulawulwa ngokulungiswa komyinge okanye xa unyango lunikezelwa. Ezinye iziphumo ezichaphazelekayo zingenzeka kubantwana abanomlinganiselo ophezulu kakhulu okanye abo banokukhathazeka ngokugqithiseleyo kubakhuthaza kwaye kunokubangela ukuba 'baxakeke kakhulu kwiyeza okanye babonakale benganyaniseki okanye banqande kakhulu.' Abanye abazali abachasene nokusebenzisa ukuvuselela ngenxa yokuba abafuni ukuba umntwana wabo abe 'zombie,' kodwa kubalulekile ukukhumbula ukuba ezi ziyimpembelelo engathandekiyo kwaye ziqhele ukuphathwa ngokunciphisa umlinganiselo weyeza okanye ukutshintsha a mayeza.
Kwaye ngenxa yokuba 'ubuncinane abantwana abangama-80% baya kuphendula kwenye yezikhuthazo,' ukuba imithi emi-1 okanye emi-2 ayisebenzi okanye ingaba nemiphumo engathandekiyo, kwaye enye yesithathu ingazama. Ukuba umntwana uyaqhubeka engaphenduli kakuhle unyango, kufuneka kwakhona ukuhlaziywa kwakhona kufuneke ukuba kuqinisekiswe ukuxilongwa kwe-ADHD okanye ukujonga iimeko ezikhoyo, ezifana nokuchasana nokuphazamiseka kwengxaki, ukuphazamiseka kokuziphatha, ukuxhalabisa, ukudandatheka kunye nokukhubazeka kokufunda.
Ezinye i-ADHD Treatment
Ukongeza kwizinto ezikhuthazayo, iingxelo zepolisi zincoma ukusebenzisa unyango lwendlela yokuziphatha , olunokubandakanya uqeqesho lwabazali kunye neeseshoni ezingama-8-12 zeveki nganye kunye nomqeqeshi oqeqeshiwe ukuba atshintshe ukuziphatha ekhaya nakwiklasini kubantwana abane-ADHD. Ezinye iindlela zokungenelela kwengqondo, kubandakanywa unyango lwezokudlala, unyango oluqaphelayo okanye unyango oluthile lokuziphatha, aluzange luboniswe ukusebenza kunye nokunyangwa kwe-ADHD.
Ezinye iinkcukacha ezithakazelisayo malunga ne- ADHD ezikhankanywe kulo mgaqo-nkqubo ziquka ukuba:
- I-60-80% yabantwana abane-ADHD bayaqhubeka benempawu ekufikeni
- I-4-12% yabantwana abaneminyaka esikolweni bayacingelwa ukuba bane-ADHD
- Ukuvuselela okuqhelekileyo akudingeki ukuba 'i-serologic, hematologic okanye i-electrocardiogram'. Nangona ukuqwalaselwa kweemvavanyo zentsholongwane kwakufuneka ukuba abantwana bathathe i-Cylert (engasetyenziswanga kwakhona), ukusetyenziswa kwezinye izikhuthazo akudingi naziphi iimvavanyo zegazi rhoqo.
- Izikhuthazo zingabangela iziphumo ezingalindelekanga kwii-motor tics, ezenzeke ngokukhawuleza kwi-15-30% yabantwana abathabatha izikhuthazo, kodwa ubukho be-tics ngaphambili okanye ngexesha lolawulo lwezonyango lwe-ADHD akukona ukuchasene ngokupheleleyo ekusebenziseni imithi evuselelayo.
I-AAP "I-AAP" Isikhokelo soKhuseleko lweNkcazo yokuHlola, ukuPhononongwa nokuPhathwa kweNkcazo-Ukulahleka / ukuHlulelwa kweMvakalelo e-Children and Adolescents "kunceda gqitha ukuba oogqirha banakekele abantwana ngolu daba olucelomngeni kwaye luvame ukuphikisana. Inokukunceda ekufundiseni abazali malunga naluphi ukhetho lwezokwelapha olukhoyo, kwaye xa befuna uncedo olongezelelweyo.
> Imithombo:
> I-ADHD: Isikhokelo seKliniki yokuSebenza, ukuVavanya kunye nokuPhathwa kweNkcazo-Ukulahleka / ukuxhatshazwa kwengxaki kwi-Children and Adolescents. Izifo zengqondo kaNovemba 2011, 128 (5) 1007-1022.