By: Adiaha Spinks-Franklin, MD, MPH, FAAP
Changes in regular routines and activities to help prevent the spread of COVID-19 can be stressful for any child. Children with attention-deficit/hyperactivity disorder (ADHD) may face extra challenges dealing with these changes, especially once school starts again this fall.
The American Academy of Pediatrics (AAP) suggests ways to help support students with ADHD and their families during this stressful time.
Stress of COVID-19 & ADHD symptoms
Lots of kids have times when their behavior seems difficult to manage. But children with
ADHD have frequent and severe symptoms of hyperactivity, impulsivity, and inattention. They also struggle with "executive function skills"--organizing which tasks to start first, managing their time, finishing a task, and keeping track of tools for the task.
Students with ADHD often need order to their day to be able to function their best. Different schedules and routines, whether at home or with school, can increase a child's ADHD symptoms. These behaviors are often signs the child is under stress. Repeated stress can affect how a child:
Develops and learns. The student might resist doing tasks, act without thinking, and argue.
Focuses on tasks, learns new things, and remembers what was learned. The student might seem more easily distracted and off-task.
Behaves. The student may seem restless or struggle to calm down.
While parents can expect more behavioral issues during times of stress, it is important to remember that your child is not purposefully being disorganized, easily distracted, or unable to wait their turn. It is also important to remember that there are strategies and resources available to help parents with the unique challenges of parenting children with ADHD during COVID 19.
Focusing on your child's strengths, working together to establish a routine, setting clear and age-appropriate expectations and rules, seeking support from teachers, pediatricians, or counselors who know your child, and connecting with online behavior management resources for children with ADHD can help both parents and children make the most of this unique time.
ADHD: Online & in-person school during the pandemic
When schools were closed in the spring, some students with ADHD may have had trouble adjusting to online learning without a teacher present to support them.
Online learning often requires students to be self-guided, manage their time and motivation, and complete tasks, assignments, or projects in the required time. However, other students may find fewer distractions at home, making it easier to focus on tasks. Learning from home also gives students a way to develop independence.
Overall, the AAP advises that students learn best in-person and encourage
schools to reopen if they can do so safely in their communities. But whether your child returns to school online or in person this fall, here are some ways to help your child with ADHD manage challenges during the pandemic:
If your child has an
Individualized Education Program (IEP), supports that are in their written plan should continue. This includes speech therapy or specialized reading instruction. An IEP is designed to support a student's learning needs and must include instructional interventions, supports, accommodations, and modifications.
With new teaching methods, some students may need new or different accommodations. Would reading or dictation software help with virtual learning, for example? What about extended time assignments that need parental supervision, which may not be available during school hours?
If your child's schooling stays remote and there is no set time to log in, you can let your student choose the time that is best for them. It may help if the student makes a
visual schedule and checklist based on each day's tasks. This can help the student stay interested and willing to work. Encourage your child to explore what works for them, such as a timer or apps that help students stay on task.
When structuring the day, try alternating school work your child finds less appealing with the motivation of more enjoyable activities. And remember that children and adolescents with ADHD benefit from free play breaks that can help them use their brains in different ways and build skills.
With virtual learning, remind your child to take movement breaks between tasks. Indoor breaks could include dancing and simple exercises. Consider safe outdoor activities, such a bike riding or jumping rope. This can also provide exercise that may help with ADHD symptoms.
Use positive attention, focusing on your child's strengths and efforts. Kids with attention and impulse control challenges often benefit from specific, immediate and bold feedback. For example, saying, “Great job getting started on your assignment right on time!" rather than “good job" muttered from the kitchen may have very different effects.
Many students have difficulty learning new information in stressful times. Students with ADHD may benefit from going over the material that their teachers already taught. This can help them remember what they learned. In many cases, having more hands-on supervision and guidance from parents may help. If you're working from home, let them know when you are available try to give them undivided attention during those times.
Parents can also ask teachers what videos or web sites they recommend to help students break new information into smaller parts. Teachers may also offer virtual office hours on the computer or other ways for students to get more one-on-one help.
- School systems and teachers have also been taxed trying to adjust to changed learning environments. If you feel your child is not supported well enough in this new setting, reach out to your school's learning specialist, principal, or superintendent to advocate for your child's rights. Your pediatrician can support you in this as needed.
Talk with your pediatrician
Your pediatrician is available to help if you have questions or concerns about your child's ADHD symptoms during this time of added change and stress. Your pediatrician may also refer you to a mental health professional who can develop ways to help your child cope with stress.
Call your pediatrician right away if your child or teen:
has symptoms that are getting in the way of how well they can function.
is taking medications for ADHD symptoms, depression, or anxiety, and symptoms get significantly worse.
Helping students with ADHD navigate through school during the time of COVID-19 can be challenging and rewarding. Pediatricians, teachers, and mental health professionals are here to help you, your child, and your family stay well and thrive.
About Dr. Spinks-Franklin
Adiaha Spinks-Franklin, MD, MPH, FAAP, is a developmental-behavioral pediatrician in the Meyer Center for Developmental Pediatrics at Texas Children's Hospital and an Associate Professor of Pediatrics for Baylor College of Medicine. Dr. Spinks-Franklin is an Executive Committee member of the American Academy of Pediatrics Section on Developmental & Behavioral Pediatrics. She also serves on the AAP's Section on Minority Health, Equity, and Inclusion and Council on Foster Care, Adoption and Kinship Care.