Returning to School with ADHD During COVID-19
By Dr. Mary Rooney, Ph.D.Students who are returning to in-person school this fall are faced with the challenge of shifting into back-to-school mode while simultaneously navigating new COVID-19 school requirements. The back-to-school adjustment is always difficult for kids with ADHD under normal circumstances.
Unfortunately, adhering to new COVID-19 requirements at school will place additional demands on students’ attention, impulse control, executive functioning and organizational skills, and emotion regulation – the very domains that are most affected by ADHD. Students with ADHD will need extra support now, as they adapt to the “new normal” at school, and throughout the upcoming COVID-19 school year.
How the return to school may affect kids with ADHD:
- Behavior: You may see an uptick in oppositional behavior from your child or teen with ADHD. This may stem from frustration over dealing with demands that are greater than what their ADHD brains can handle. It may also be a natural reaction to receiving so many corrections and negative feedback throughout the school day if they are repeatedly (and often accidentally) not following the new COVID-19 rules. Oppositional behavior can also be a sign that your child is anxious or overly stressed but lacks the ability to express their feelings.
- Mood and Anxiety: Many kids with ADHD also struggle with depression and anxiety at some point during their child or teen years. Stressful situations increase the likelihood that a child or teen will develop clinical levels of anxiety or depression, and across the board, we are seeing higher rates among kids with ADHD since the start of COVID-19.
Some key signs of depression in kids and teens include low mood or increased irritability, a lack of interest in things they usually enjoy, social withdrawal, and/or changes in sleep and eating habits. Signs of anxiety can include physical complaints (like headaches or stomachaches), school avoidance or refusal, a worsening of attention problems, a fear of being away from family members (separation anxiety), difficulty sleeping, and for some kids, an increase in disruptive or oppositional behavior. - Learning: Focusing and learning throughout the school day requires far greater mental effort for students with ADHD under typical (non-COVID-19) circumstances. In practical terms, this means that the mental strain of following and coping with COVID-19 school rules will negatively affect academic learning more severely for students with ADHD.
When discussing this phenomenon with parents and teachers, I often ask them to visualize a student’s mental capacity as a fuel tank that starts off full every morning and is gradually drained throughout the day. Under normal (non-COVID-19) circumstances, a child with ADHD may need to use 80-100% of their fuel to simply stay on task and absorb the basic academic details that are being taught in the classroom. This leaves very little “mental fuel” available for everything else, like navigating challenging social situations, controlling impulses, managing difficult emotions – or in today’s world, learning and following new COVID-19 rules.
In contrast, under typical circumstances, a child without ADHD may only need to devote 50% of their mental fuel to learning and staying on task. As a result, they have far more fuel available for whatever comes their way, including learning and following new COVID-19 rules and schedules throughout the day. So, expect that your child or teen will have a more difficult time meeting academic demands at the start of this school year.
How to help your child manage the back-to-school transition:
- Set realistic expectations. Kids and teens with ADHD are going to have a more difficult time remembering to follow through on COVID-19 public health requirements – including social distancing, mask wearing (and simply keeping track of their mask), and hand washing. Do not expect perfection, and don’t hesitate to calmly provide reminders, pack extra masks and hand sanitizer in their backpacks, and praise them when they do follow through.
- Advocate for your child. Partner with your child’s school to ensure that your child or teen is receiving the behavioral and academic support that they need. If your child already has an IEP or a 504 Plan in place, then consider having the plan expanded to account for COVID-19-related changes in the classroom environment, the school schedule, the quantity of academic material, or the method of instruction. If your child does not currently have a special education plan, consider starting the process now.
- Follow routines. Create a sense of security for your child and minimize organizational difficulties at home by following consistent routines at key points in the day. This includes a morning routine, an after-school or homework routine, and an evening routine.
- Prioritize physical health. Your child or teen will be able to manage their ADHD symptoms and cope with stress much more effectively if they are getting enough sleep and physical activity and are eating well. When you put your child’s physical health needs first, improvement in their mental health and academic skills will follow.
- Provide additional learning support. In order for your child or teen to keep up with academic demands and avoid falling behind their peers, they will likely need additional outside learning support. As always, the Huntington Learning Center in your area is a fantastic resource for getting your child or teen with ADHD the extra support that they need.
- Adjust your child’s ADHD treatment plan as needed. As children and teens grow and demands on their attention increase, they will need adjustments to their ADHD medication and behavior management plans. Work closely with your child or teen’s doctor and therapist to optimize their ADHD treatment throughout the school year, and promptly address symptoms of anxiety or depression if they emerge.
Returning to school with ADHD during COVID-19 will be a challenge. As a parent, you are your child’s greatest source of support and advocacy. Work closely with your child’s teachers, doctors, and therapists to make sure they are getting the support they need during these unique times.
ABOUT DR. MARY ROONEY
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
ABOUT HUNTINGTON
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