New research is finding that children and teenagers with ADHD (attention deficit hyperactivity disorder) may have been experiencing a harder time than others stemming from challenges due to the COVID-19 pandemic.
Child Neurology Consultants’ board-certified pediatric neurologist Dr. Michael Reardon recently contributed to an article on the subject for Verywell Mind.
Examples of pandemic-related stresses on children over the past two years include attending school online, isolation from friends, limited opportunities for extracurricular activities, and wearing masks lending to already often subconscious emotions about appearance.
All of these can contribute to a diminished sense of mental health in kids who already have a hard time adapting, focusing, and communicating with others.
“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,” explains Dr. Reardon. “This increases the stress and the risk for mental health problems which is a vicious cycle.”
Here are some of Dr. Reardon’s additional thoughts, and recommendations, on how to ease the anxieties and challenges of the pandemic for those with ADHD:
How has the pandemic exacerbated the challenges of living with ADHD?
The pandemic has exacerbated the challenges of living. Period. But there are unique challenges for those living with ADHD. The most critical factor is the loss of predictability and structure in life.
We all rely on our so-called executive functions- planning, goal setting, staying on-task, tuning out distractions, pacing ourselves and monitoring our own progress- to succeed and meet the demands of school or work. We especially rely on these functions when we get into an unstructured, self-directed situation, like working from home, or when the external environment is not as consistent or predictable as usual.
These executive functions, provided by the frontal lobes, are less well developed in children and adolescents with ADHD. For that reason, it is immensely helpful for them to have structure and predictability in their learning environment and schedules, with frequent prompting, and external cues helping to keep them organized and reminding them where they are relative to their goals.
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. This has all become much more challenging while everyone involved is stressed by the pandemic, and school systems have been scrambling to make adjustments to the waves of COVID outbreaks that have kept coming.
Are there aspects of the pandemic that have had a greater impact on youth with ADHD (versus adults)?
While we cannot make generalizations that apply to all youth or all adults, at least adults with ADHD have had more time to develop strategies to compensate for their difficulty focusing and staying on-task, to strengthen their executive functions, and hopefully have some tools for coping with the changes brought by the pandemic. They may also have had more time to get their medications “dialed in” for the most optimal benefit.
On the other hand, children and their parents may just be in the beginning stages of figuring out what ADHD is and what they can do about it, and then this pandemic comes along and throws life into a roller-coaster of constant changes, making it challenging to get an effective treatment plan in place.
What has been your experience in treating children with ADHD during this time?
There has been quite a wide range of experiences, and it seems there have been a few distinct phases of the pandemic so far, so it is challenging to narrow it down. However, the thing that stands out the most to me now, this school year, is something that has also been echoed by my brother Ryan who is a high school science teacher, and that is, after the near-total shut-down of spring 2020, and then the “weird” 2021 school year-sometimes back on campus (for some but not others), sometimes virtual, and still so different from normal, it has just been very difficult for students to get back into a groove at school.
Study habits have declined; the mental conditioning- the ability to keep up with the previously normal pace, has declined. I can liken it to how it can be difficult to get back into work-mode after a vacation, or how, (when you were a kid, of course) there is winter weather predicted, and you stayed up too late anticipating that snow day tomorrow, and then you wake up to find out it didn’t happen; no white stuff; roads are fine; you’re going to school. It’s a bit hard to get motivated.
Not to make light of this. The COVID pandemic has been like the snow day from hell (not to mention last February). There have been serious mental health consequences resulting from many facets of this- the fear of catching it; for some, the trauma of having loved ones who have become sick or have died from it; the total disruption of life; the isolation; the loss of social life, sports, the arts, and so many other activities that make life worth living for youth.
We all know that the rates of anxiety and depression have been soaring during the pandemic.
What can be done to help children who are having a hard time?
If you haven’t already, find a doctor that has experience with this stuff. Meet and follow up as often as you can or is recommended. Medicines can help a lot. Empathy helps. Having someone listen to you and hear about your struggles and then make an effort to help you helps. Troubleshooting with a professional with experience helps.
Psychotherapy can help. Therapists with openings have been hard to come by, for obvious reasons. If you can find someone that is affordable and you like, I highly recommend it.
Contact your school and work with the school officials as well as you can. A child with ADHD should have a 504 plan- a special education plan that allows for classroom accommodations and flexibility without modifying the curriculum or content of the student’s lessons and assignments. Realize that teachers and school systems have been under a lot of stress due to the pandemic; special education departments have been running way behind on assessments and planning meetings. 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.
Child Neurology Consultants of Austin has experience treating a wide range of neurological conditions in children and teenagers from 0 to 21 years old.
To make an appointment with one of our board-certified pediatric neurologists, please contact us here.
