Attention Magazine February 2022

What have researchers learned about the key challenges for youth with ADHD during the pandemic? In this update on recent research, the first study focused on the top problems for adolescents and young adults with ADHD. The concerns that came up the most were social isolation, problems with remote learning engagement, difficulties with motivation, and boredom. There is a need to increase opportunities for social interactions, improve motivation for school, and monitor for signs of depression.

The second study compared how students with and without ADHD managed remote learning during COVID-19. Compared to those without ADHD, children with ADHD experienced more difficulties with attention span, independence, and commitment in their learning. Children with ADHD as well as children without ADHD experienced emotional and behavioral changes, such as increased anxiety, restlessness, and aggression.

These studies indicate that youth with ADHD experienced pronounced effects from the COVID-19 pandemic experience, underlining a need for timely interventions to mitigate these impacts and improve well-being.

Pandemic-related problems and benefits
This study examined the challenges faced by adolescents and young adults with ADHD in the United States during the pandemic. One hundred and thirty-four adolescents and young adults with ADHD between the ages of 13-22 participated in this study, conducted between April and June 2020.

The parents and teens or young adults listed the three top problems they were experiencing and rated the severity of these problems immediately before the pandemic and currently during the pandemic. They also listed the three top benefits of lifestyle changes during the pandemic, and rated the impact of the benefit on ADHD.

Parents most commonly reported the three top problems of their offspring as motivation challenges, social isolation, and issues with remote learning. Adolescents and young adults reported their main problems to be social isolation, boredom, and challenges with remote learning engagement. These difficulties were rated as more severe during COVID-19 compared to prior to the pandemic.

In terms of benefits of the pandemic, parents reported more time spent with family, more time to complete schoolwork, and lower anxiety. Adolescents and young adults reported that they had more unstructured time for relaxation, more family time, and more time for schoolwork. These benefits were noted to have negligible impacts on ADHD severity.

In the first few months of the pandemic, parents and adolescents or young adults with ADHD did not endorse high levels of serious substance use, school dropout, legal problems, or major depression, although the problems noted above that they did indicate are risk factors that need attention. Given these results, clinical recommendations include monitoring for symptoms of depression among adolescents and young adults, treatment to increase academic motivation and engagement, and increasing opportunities for peer engagement in the pandemic context, such as through virtual peer interactions.

Sibley MH, Ortiz M, Gaias LM, Reyes R, Joshi M, Alexander D, & Graziano P. (2021). Top problems of adolescents and young adults with ADHD during the COVID-19 pandemic. Journal of Psychiatric Research, 136, 190-197. https://doi.org/10.1016/j.jpsychires.2021.02.009

Distance learning challenges

This study examined the academic and emotional challenges of students with ADHD in Italy during the first wave of COVID-19. Two hundred and seventy-six mothers of students aged 6 to 15 (92 mothers of children with ADHD, and 184 mothers of children without ADHD) completed questionnaires examining organization of remote learning, child behaviors and attitudes related to remote learning, and parental difficulties and perspectives on remote learning.

For students both with and without ADHD, remote learning was reported by their mothers as requiring greater child effort, involving instability in routine, and being disorganized. As well, most children with and without ADHD demonstrated behavioral and emotional symptoms, such as anxiety, restlessness, and aggressiveness. Compared to students without ADHD but with learning disorders, those with ADHD were more likely to receive changes in academic expectations in their remote learning, such as being exempted from lessons or completing fewer tasks. Students with ADHD also showed more difficulties with attention span than students without ADHD, as well as less independence and lower commitment to remote learning.

In addition, mothers of students with ADHD reported that remote learning was insufficient and they experienced more challenges in managing their roles as remote learning teachers for their offspring, parents, and employees. These mothers were also less likely to have outside support from relatives and family friends compared to mothers of students without ADHD.

Overall, these findings indicate that mothers and children in general have experienced adverse effects due to the COVID-19 pandemic, with particular challenges for mothers and children with ADHD. Research on the consequences of remote learning during the pandemic is important to developing interventions to better support the needs of children and parents during this critical time.

Tessarollo V, Scarpellini F, Costantino I, Cartabia M, Canevini MP, & Bonati M. (2021). Distance learning in children with and without ADHD: A case-control study during the COVID-19 pandemic. Journal of Attention Disorders. Advance online publication. https://doi.org/10.1177/10870547211027640

Yuanyuan Jiang, PhD, is an assistant professor in the school of counseling, psychotherapy, and spirituality at Saint Paul University and an adjunct professor in educational psychology at the University of Alberta. She directs the Attention, Behaviour, and Cognitions (ABC) Lab, which focuses on studying how attention, behavior, and cognitions interact to improve assessments and interventions for children with inattentiveness or hyperactivity/impulsivity.

Pooneh Montazeralsedgh, MA, is in her first year of the counseling and spirituality doctoral program at Saint Paul University. She completed her bachelor of arts degree at the University of Ottawa and her master of arts degree at Saint Paul University. She is interested in understanding how to support families and children with inattentiveness or hyperactivity/impulsivity.