ADHD Weekly, July 22, 2021

It may be the middle of summer, but the school year will be here soon, judging by the number of back-to-school commercials popping up on TV and radio programs.

During the last school year, the COVID-19 pandemic presented quite a different learning experience for most students in the United States. At-home learning, hybrid classrooms, staggered school schedules, and family-provided homeschooling took the lead over traditional in-person classes. This year, the majority of school districts plan to return to more traditional educational settings.

The move to reopen in-person education is supported by both the US Centers for Disease Control and Prevention and the American Academy of Pediatrics (AAP) as the best option for students in kindergarten through high school. Parents and school administrators are supportive of the return to classrooms where safe and appropriate.

One aspect of pandemic life that is expected to remain is the continued use of masks for students and school personnel. The COVID-19 vaccines currently available have not yet received authorization for children aged twelve and younger.

Masks for students encouraged

This week the AAP shared its guidance for schools returning to in-person classes. They state that communities should prioritize children returning to classrooms to learn from their teachers and to be with their friends and classmates once more. Requiring—or strongly encouraging—the use of face coverings and masks is an important way of making this happen.

“The pandemic has taken a heartbreaking toll on children, and it’s not just their education that has suffered but their mental, emotional and physical health,” says Sonja O’Leary, MD, FAAP, chair of the AAP Council on School Health. “Combining layers of protection that include vaccinations, masking, and clean hands hygiene will make in-person learning safe and possible for everyone.”

Without an approved vaccine for children, all children—and especially those with additional health risks—are still vulnerable to contracting the COVID-19 virus and the newly arising variants. Children can become sick from COVID-19. The majority who do will recover, but there are many who could continue to experience long-term health conditions related to the illness. In areas of the country with low vaccination rates, the number of diagnosed cases is increasing. Hospitals are again becoming stressed from large numbers of COVID-19 patients.

“There are many children and others who cannot be vaccinated,” said Sara Bode, MD, FAAP, chairperson-elect of the AAP Council on School Health Executive Committee. “This is why it’s important to use every tool in our toolkit to safeguard children from COVID-19. Universal masking is one of those tools, and has been proven effective in protecting people against other respiratory diseases, as well. It’s also the most effective strategy to create consistent messages and expectations among students without the added burden of needing to monitor everyone’s vaccination status.”

Current guidelines state fully vaccinated people do not need to wear face coverings or masks, unless otherwise required by law. At this time, teens and adults are eligible to receive one of the available vaccines. The AAP guidance includes adults who are vaccinated while they are in educational settings. The difference in guidelines might seem confusing but are based on the specific needs of the general community and the educational community comprised mostly of unvaccinated students.

“I think that the American Academy of Pediatrics (is) a thoughtful group,” says Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases. “They analyze the situation, and if they feel that that’s the way to go, I think that is a reasonable thing to do.”

Returning to school for students with ADHD

Students with ADHD have had varying experiences when it comes to wearing a face covering or mask. Just like a fidget toy, the mask offers them something to fiddle with while thinking or an opportunity for distraction.

If your child will be new to wearing a mask at school or hasn’t needed one during the summer months, begin preparing him before school starts again. The first task is to find masks that are right for your child. Younger children often like masks that highlight superheroes or popular movies, or they might choose one that has their favorite animal’s nose and whiskers. Older children often like flashy patterns and bold colors.

Masks should fit snugly over the child’s nose and mouth but not be uncomfortable or rub tightly on their cheeks or behind their ears.

Sometimes a child with ADHD also experiences sensory issues. Keep your child’s sensory needs in mind when picking out a mask: Does he like soft and smooth textures? What does the fabric smell like? Would straps that go around his head be more conformable than ear loops?

Once your child has picked out several masks for the school week, have him practice wearing the mask during the day. Children learn by observation, so wearing your own mask during this practice time can help your child follow your example. If your child is prone to fidgeting with the mask, brainstorm other ways to fidget when he wants to play with the mask. If your child struggles with forgetfulness, make sure to pack an extra mask in his bookbag. A breakaway lanyard attached to one of the ear loops can also help prevent masks being dropped on the ground or left on the bus.

Guidance changes as evidence, circumstances change

It might feel like the need for masks is unending, but there is evidence that we are gaining ground on the COVID-19 virus. Just as the vaccines have made it possible for vaccinated teens and adults to return to normal activities, they have made it possible to reopen school campuses with basic health precautions.

As the needs of local communities change, and as medical science is able to provide more vaccine options, guidance on mask wearing will change. This is to be expected and even looked forward to. Communities that experience an increase in diagnoses may need to briefly return to mask wearing. Others that have fewer people becoming sick may be able to drop mask wearing or require masks in fewer circumstances.

For students who have ADHD, returning to school and being able to better receive educational services and supports is extremely important. Continuing to wear masks, or adapting to them for the first time, enables them to receive the education that will help them succeed in life.

COVID-19 and educational resources:

• ADHD & COVID-19 Resources Toolkit
• Educational Rights and Resources for Students with ADHD
• When They Return to School
• Special Education & the Pandemic: Three Things to Know
• Balancing Virtual and Classroom Learning
• School Is Different Now. Does Your Child’s Plan Still Work?

Join the discussion: How have you helped your child adjust to wearing a mask in public?