COVID-19 is Amplifying Everyday Challenges for Kids with ADHD

Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed behavioral disorder in children. And as ADHD already affects a child's ability to plan, pay attention and regulate emotions, a global crisis can exacerbate the everyday challenges these individuals face.

"Youth with ADHD are even more susceptible than average to these mental health conditions, and then the symptoms of ADHD make pandemic life more challenging, thereby increasing the stress and the risk for mental health problems—a vicious cycle," says Michael Reardon, MD, a pediatric neurologist at Child Neurology Consultants of Austin.

ADHD and Mental Health

Statistics vary when it comes to ADHD in children in the United States. But according to the 2016 National Survey of Children's Health, about 9.4% of U.S. children aged 2 to 17 have ever been diagnosed with ADHD.

Children with ADHD tend to be easily distracted and can have trouble remembering details and finishing tasks. They can also become overwhelmed and frustrated easily, which can lead to behavioral issues. For many children, these problems can lead to rejection and low self-esteem.

As rates of anxiety and depression have soared during the pandemic, children with ADHD have been placed at even greater risk of mental health issues due to an upheaval of the structure and activities that helped manage their condition.

According to the Centers for Disease Control and Prevention, about 77% of children who are diagnosed with ADHD are receiving medication or behavioral treatment. Of course, treatment can be extremely helpful. However, Reardon notes that while adults with ADHD may have a handle on medications and coping mechanisms, this typically isn't the case yet for children and their families.

"Children and their parents may just be in the beginning stages of figuring out what ADHD is and what they can do about it," Reardon says. "And then this pandemic comes along and throws life into a rollercoaster of constant changes, making it challenging to get an effective treatment plan in place."

Navigating At-Home Learning

Reardon points out that to succeed in school or work, we rely on our abilities to plan, set goals, stay on task, tune out distractions, pace ourselves and monitor our own progress. These functions provided by the frontal lobe are even more important in unpredictable or unstructured, self-directed scenarios like working or attending school from home.

Because these functions are less well-developed in children and adolescents with ADHD, it's even more crucial for these individuals to have structure and predictability. The uncertainty, abrupt changes, and shift to at-home learning borne of the pandemic have become a perfect storm for school-age children with ADHD.

"One way to think of it is, they need parents, teachers, and the learning environment itself to 'be' their frontal lobes, to provide that ongoing monitoring and feedback to make sure things are staying on track," Reardon says. "This has all become much more challenging while everyone involved is stressed by the pandemic, and school systems are scrambling to make adjustments to the waves of Covid outbreaks that keep coming."

A recent study focused on the experience of children with ADHD as they navigate the pandemic reiterates this. Researchers found that while children with ADHD did not have higher Covid-19 infection rates, they were more likely to experience education and mental health difficulties compared to their peers during this time.

"Youth with ADHD were, and are, particularly vulnerable to interruptions to in-school learning as a function of the pandemic, particularly with respect to engagement with learning, increased anxiety, and greater conflict with family members; and they are less responsive to factors, like parent monitoring, that are helpful for youth without ADHD," says study author George DuPaul, PhD, associate dean for research at Lehigh University's school psychology program.

The study's findings suggest that children with ADHD and their families may need additional assistance and support from schools.

"Our findings have implications for the kind and intensity of support services that youth with ADHD will need during the transition to in-school learning and beyond, as well as the preparation future generations will need to successfully navigate possible interruptions to in-school learning that may result from crises or pandemics," DuPaul says.

For parents, Reardon recommends working with your child's school to ensure a plan is in place for your child's success. But at the same time, it's important to keep in mind that school systems are under immense stress during the pandemic, as well.

"I recommend assertively stating your child’s issues and needs but making every effort to be an ally and work together with the school, rather than being in conflict with them," Reardon says.

As the stress and uncertainties of the pandemic look like they'll continue for the foreseeable future, it's important for parents take an active role in supporting their child if they're struggling through the pandemic because of ADHD.

Reardon strongly suggests introducing them to therapy if it's accessible. Talking through the worries and obstacles of living with ADHD can help, especially when received with empathy. And above all, troubleshooting with an experienced doctor can help determine what treatment will be most effective.