How COVID-19 increases challenges for youth with ADHD

Compared to their peers, youth with attention-deficit/hyperactivity disorder (ADHD) are more likely to experience significant impairment in school functioning and mental health. Mix in the COVID-19 pandemic and the disruptions are even greater. 

New research has found that youth with ADHD were more likely than their peers to experience COVID-19 symptoms, sleep problems, fear and anxiety related to infection risk, difficulties with remote learning, family conflict, rule-breaking behavior, and lack of school preparation during the first year of the pandemic. Additionally, youth with ADHD are less likely than their peers to be responsive to factors, such as parental monitoring and school engagement, that may mitigate the impact of pandemic school closures. 

The paper, "Impact of COVID-19 on Youth With ADHD: Predictors and Moderators of Response to Pandemic Restrictions on Daily Life," by doctoral students in Lehigh University's school psychology program, George DuPaul, professor of school psychology, and colleagues from Ohio University and The Children's Hospital of Philadelphia, was published in the Journal of Attention Disorders. 

The findings indicate that youth with ADHD may require more specialized support during the transition back to in-school learning and beyond. 

"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 that are helpful for youth without ADHD," explains DuPaul. 

Using data from a large national longitudinal study of youth in the U.S. called the Adolescent Brain and Cognitive Development (ABCD) Study, the researchers were able to select a large sample of youth who met diagnostic criteria for ADHD and then create a sample of youth without ADHD who were matched based on race, sex and age. Parents and youth completed several surveys during the first year of the pandemic and the researchers used survey data from May 2020 and March 2021 for their analyses.  

"The ABCD study is a 10-year, ongoing study that, of course, was greatly impacted by the pandemic. In addition to continuing to collect their regular data throughout the pandemic, the ABCD team added in COVID-19-specific measures to better capture how youth across the country are dealing with this pandemic," says Eliana Rosenthal, a Lehigh school psychology doctoral student and lead author of the study. "Thankfully, we were able to use these data to determine how youth with ADHD in particular were adjusting to the pandemic."

Families of youth with ADHD, educators, and mental health and health care professionals can benefit from the results of this study. 

"Ultimately, the results of our study highlight that the typical interventions that have previously supported youth with ADHD, like personalized schedules and school engagement, are likely not working in the face of this pandemic," says Rosenthal. "Knowing this information can better inform families, educators and clinicians developing interventions and support systems for youth with ADHD moving forward."