Is the Covid-19 pandemic worsening the mental health of children with ADHD?

  • Confinement at home is a challenge for most children
  • Kids with ADHD had a particularly hard time during the lockdown, struggling e.g. with routine, focus and anger management
  • Once they adapted to online studying, their ADHD symptoms, however, tended to decrease

Confinement during the coronavirus outbreak has made it exceptionally difficult for kids who are struggling with feelings of anxiety and fear related to missing out on their everyday activities, such as being at school, seeing their friends and having access to activities they may not be able to engage in at home.

This may be even harder on kids with attention deficit hyperactivity disorder (ADHD), as the loss of their daily routine and a lack of interpersonal and social interaction could cause mental health problems, or worsen ADHD symptoms, researchers in a recent study said.

To understand how the Covid-19 crisis is affecting the mental health of kids with ADHD, the researchers invited 241 parents of school-aged children (6 to 15 years old) to partake in a survey. The results were published in the Asian Journal of Psychiatry this month and received ethical approval from Shanghai Xinhua Hospital in China.

Attention, sleeping and anger during pandemic

In their paper, the team of 10 researchers wrote that all adults are facing a serious challenge during the pandemic. In addition to this, parents' (of kids with ADHD) anxiety over the situation may work to further worsen their children’s psychological well-being and behavioural problems.

“... Majority of the ADHD children receive care from primary care settings. Children with ADHD could not get timely and professional care from home settings.

"Most of the parents of these children can be assumed not to be the domain experts, but are forced upon the educational responsibility in addition to handling all the children’s emotional and behavioural problems 24/7,” they wrote. 

Parents who took the survey were asked to rate nine behaviour-related questions about their children during the pandemic, including questions on their children’s attention, anger frequency, eating, sleeping, and routine. For example:

  • Attention: Your child’s ability to keep focused _?
  • Quietness: Your child’s ability to work quietly _?
  • Listen to instructions: Your child’s ability to listen to instructions _?
  • Routine: Your child’s ability to keep routine _?

Attention and anger frequency worsened by pandemic

The results showed that almost 54% of parents reported their children’s ability to stay focused worsened during the pandemic, while just over 67% reported an increased anger frequency, and 56.02% reported that the child’s daily routine worsened.

On the flip side, more than half the parents reported that their children’s behaviours in other areas had either improved or maintained the same level in comparison to their normal state.

The researchers found that the parents’ mood state also affected their children’s ADHD symptoms, and referred to previous research which shows that parents of ADHD children experience high levels of daily, child-rearing stress. This, coupled with the fact that schools closed their doors and children had to stay at home might have involved greater challenges and stress for both parents and children, the researchers wrote.

In their paper, they stress the need for developing an approach for specially vulnerable groups during an outbreak.

Online study may be a coping strategy

Online studying has become the norm during the pandemic, particularly in countries under lockdown. For the ADHD children who shifted to this form of learning, the researchers explained that the longer they experienced this routine, the better adapted they became, eventually reducing their ADHD symptoms. This, they said, could become a potential coping strategy for decreasing ADHD symptoms.

However, this is largely applicable to those who can focus longer, they added, also saying that future studies are needed to confirm their results, especially because online education during this time may continue for a while. 

Future studies should investigate certain factors

This is the first study focusing on children with ADHD during the time of the outbreak. Challenges that may have skewed results are firstly that the information was reported by parents, and secondly that the children may have rated their own emotional and behavioural responses differently.

The researchers also explained that the study didn’t examine the link between the children's medication status and their worsened behaviours, and that some parents reported limited access to psychiatric medication for their children during this time – all of which should be considered in future studies. A crucial point they make is that medication for special need groups, such as children with ADHD, should be prioritised during these kinds of crises.  

READ | How lockdown could affect South Africa’s children with special needs

READ | SA’s first children’s book on ADHD is 'impressing teens and adults alike'

READ | Coronavirus in SA: All the confirmed cases

Image: Michael Berman/Getty

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