Study finds how COVID-19 disrupted lives of families with kids who have ADHD

While the COVID-19 pandemic was disruptive for all families, new research finds that families raising children who have attention-deficit hyperactivity disorder (ADHD) were especially vulnerable.

Barbara Fenesi, assistant professor with the Faculty of Education at Western, was senior author for the study alongside co-authors Alexis Winfield and Carly Sugar, both graduates of the faculty's Masters in Counseling Psychology program.

Published recently in the open-access journal PLOS ONE, the research focuses on families in Ontario and gives voice and nuance to their experiences by applying a qualitative lens, a new approach in studying this issue.

To understand the mental health impact on families, researchers applied systems theory to their findings. This is the first study on the impact of COVID-19 on families dealing with ADHD which has seen the use of systems theory.

The theory is a study of systems which are dependent on one another, such as families, education and health care.

The researchers held virtual interviews with 15 families that have at least one child with an ADHD diagnosis. Parents and children were interviewed separately.

"It became instantly apparent in conducting these interviews that these families were immensely grateful to have their experiences acknowledged," said Fenesi.

"For many parents and children, the interviews were the first time they discussed how they felt about the pandemic," she said.

Three recurring themes emerged in the interviews: increased child anxiety, feelings of social disconnectedness and deteriorating parental mental health.

Tied to the reports of child anxiety was a fear of themselves or loved ones contracting COVID-19. Attachment issues were also reported, with one mother telling researchers, "(my child's) not able anymore to sleep by himself in his own room."

Difficulty navigating online learning from home and a lack of structure and routine played a role in increasing child anxiety as well.

Social isolation guidelines stemming from government responses to the pandemic contributed to a sense of social disconnectedness among participants.

A lack of social support led to deteriorating parental mental health, as children lost the ability to have sleepovers and socialize with friends.

"All of the people who gave us a break and gave our kids a break, are not there," said one parent in an excerpt from their interview with Fenesi's team.

Parental duties became difficult to manage, especially for those who began working from home while caring for their children. Struggling to fulfill these duties created a sense of guilt, adding to a growing list of pandemic-related stressors.

Parent-led schooling and a lack of information regarding school guidelines led to increased frustration and stress for parents as well.

Lastly, as seen in their children, an increase in parental anxiety was reported, largely stemming from fearing the unknown aspects of COVID-19 and general anxiety surrounding their parenting skills under pandemic conditions.

"Our work showed that the pandemic caused massive fractures to component elements of the family system by disrupting connections to family, friends, peers, educational support, places of employment, therapy groups, and extracurricular outlets," said Fenesi.

"While these fractures were experienced by families around the world, systems theory points to an inherent vulnerability among families raising children with ADHD, making the impact of additional stressors significantly worse in these households."

This inherent vulnerability is exposed in other higher-stress situations often experienced by these families that mirror many of the circumstances created by the pandemic. A few examples include greater employment instability, more financial difficulties, lack of therapeutic and educational support, negative parent-child interactions, and greater parental discord.

"The supports that these families need extend beyond the added constraints of what the COVID-19 pandemic created," Fenesi added.

A lack of educational support was one of the most common challenges faced by the families interviewed, which is especially problematic given that "children with ADHD require targeted support during their learning to thrive," Fenesi said.

Be it the pandemic or any other scenario that leaves a similar impact, schoolboards, colleges, and universities could prepare for the worst by leveraging their network of teachers and faculty to offer coordinated support for those struggling the most, according to Fenesi. A similar measure includes having tutors matched with children on a needs basis.

The importance of extracurricular outlets and structured routine is made evident by the challenges faced by families who lost them and Fenesi sees a solution in having schools or community centers provide more online or socially distanced activities.

To cope with the impacts of social isolation, creating an environment where children can discuss their feelings or simply socialize is paramount and is something that "could be facilitated by scheduling time in the school day for students to chat with one another through virtual breakout rooms or in-person group activities," Fenesi said.