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Experts say that just because a child misbehaves or can’t concentrate during remote learning under COVID-19 restrictions, that doesn’t necessarily mean they have ADHD. Marko Geber/Getty Images
  • Experts say that there’s been an increase in evaluations and diagnosis of ADHD in children as they adjust to remote learning.
  • They caution parents that misbehavior or a lack of concentration in children during distance learning isn’t always ADHD.
  • To help with at-home learning, experts recommend that parents make sure their children get adequate sleep, eat a good breakfast, and get dressed for school.

The COVID-19 pandemic has created a seismic shift in the way children are learning.

According to the U.S. Census Department, nearly 93 percent of households with school-age children report they’re involved in some form of distance learning.

Experts say that the remote learning environment has had an impact on children who deal with attention deficit hyperactivity disorder (ADHD).

Studies and anecdotal evidence show that more parents are having their children evaluated for the condition and that more are being diagnosed.

It also seems that the remote learning situation is exacerbating the symptoms of children with ADHD.

Athenahealth, a private company that provides services to healthcare organizations, conducted a study last spring just as the pandemic lockdowns were launching.

It found an increase in the percentage of its patients ages 13 to 17 newly diagnosed with ADHD, particularly among teenage boys. That represented a 67 percent increase over the same time period the year before.

Officials at the national nonprofit Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) say that they saw an immediate spike in the number of parents reaching out for help.

“Once COVID hit, we saw a huge increase in our website traffic. New users jumped 78 percent,” said April Gower-Getz, chief operating officer at CHADD.

“Through our helpline, there were requests for medical help to find a doctor who specializes in ADHD. Those requests jumped 60 percent since March,” she told Healthline.

Experts also say that the children who have already been diagnosed with ADHD are struggling more.

“What I’ve seen, anecdotally, is a worsening of the symptoms because of the chronic stress of the pandemic and the disruption of in-person schooling,” said Dr. Adiaha I. A. Spinks-Franklin, MPH, a developmental-behavioral pediatrician at the Meyer Center for Developmental Pediatrics at Texas Children’s Hospital.

Spinks-Franklin is also an associate professor of pediatrics at Baylor College of Medicine in Houston and a member of the executive committee for the American Academy of Pediatrics on developmental and behavioral pediatrics.

“We’re seeing an escalation because of the pandemic,” she told Healthline. “I call it an adverse country experience… ACE… That’s the big C in Ace… because the entire country has been affected, and it’s caused everyone’s stress level to go up.”

If your child seems easily distracted, unfocused, and can’t seem to finish their projects in virtual school, the experts say you shouldn’t assume it’s ADHD.

“I think we have to be a bit more cautious in how we label this and what we say it is,” said Dr. Max Wiznitzer, the co-chair of CHADD’s Professional Advisory Board. Wiznitzer is also a pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland and a professor of pediatrics and neurology at Case Western Reserve University.

“What I would want the parent to do is recognize something is going on and then discuss it with the pediatrician to try and figure out exactly what is happening,” Wiznitzer told Healthline. “You will have kids with undiagnosed ADHD that becomes much more manifest, but there could be other reasons.”

Spinks-Franklin explained, “If you have never noticed your child being distracted, off task, a little more hyper and that never happened until you went to remote learning, that probably is not ADHD. If your child was a little bit distracted before and is a whole lot more distracted now, that also doesn’t mean they may have ADHD.”

She continued, “If you have a preschooler who was climbing [up] the walls, jumping off the book shelf and was compulsive, that might be a kid who had ADHD whose symptoms have just worsened during the pandemic.”

In an article she wrote for the American Academy of Pediatrics, Spinks-Franklin cautioned that other mental health disorders can mimic ADHD.

“I’m just asking people not to rush to conclusions,” she said. “There are classic symptoms of anxiety disorder, feeling restless, being more active, having difficulty concentrating, that look like ADHD.”

“In depression, you’ve got a kid who struggles with memory, concentration, and is more disorganized. Those are also symptoms of ADHD,” she explained.

The experts advise parents to start with their pediatrician.

They can refer you to specialists if needed. In these pandemic times, it might be easier to schedule a telehealth visit, especially in small or rural communities.

CHADD has put together a COVID-19 tool kit. The guide can help you figure out how to get your child an assessment and who in your community specializes in ADHD.

“You need comprehensive management of the disorder, not just medications, but behavior therapy, behavior interventions, and school support,” said Spinks-Franklin. “Then, medications to address the biology of the disorder. Sometimes the child may need an increased dose of their medication and in other cases, a child may need more school intervention.

“Families need a lot of support, and it’s hard. Because of the pandemic, resources are really stretched. And the families have to deal with co-pays and medications, it can be cost prohibitive,” she added.

She suggests another resource is the Open Path Psychotherapy Collective, a national nonprofit that partners with psychologists and psychotherapists to provide low cost mental health services.

“I say do the ABCs of management of kids with ADHD: structure, routine, and consistency,” Wiznitzer said. “Same routine every morning for remote learning.”

He recommends making sure your child has a good night’s sleep, a good breakfast, and is dressed for school with no pajamas. Get rid of distractions around them, including access to computer games.

“Keep an eye on them once in a while to see what’s going on,” he added.

Wiznitzer suggests working with your child’s teacher to make accommodations. If there’s a long lecture and your child has a short attention span, let the teacher know, and see if they can break down assignments and tests.

Don’t do all the homework at once, and take breaks in between. If your child has been prescribed medication, make sure that they take it.

“Gratitude journaling is really good. Talking about or writing down the things you’re thankful for,” said Spinks-Franklin. “That’s been found to be a really positive activity for the brain to reduce symptoms of stress.”

She also suggests the following:

  • Weather permitting, get outdoors and take a walk.
  • Indoors, turn on some music and dance, do yoga, or play boardgames.
  • Limit screen time. It can make it harder for children to concentrate.
  • Let kids get their stress out by talking. Don’t shut them down.

“Realize that children don’t have the coping strategies and capacity that adults do,” Spinks-Franklin explained. “They’ve adapted to an absolutely crazy societal situation, which is what the pandemic has been. It’s remarkable that they’ve done as well as they have.”