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COVID-19 and ADHD study: Understanding the impact on children and their families

The COVID-19 pandemic has and continues to be a difficult time for most people, not least for families with children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Cardiff University medical student Chelsea was part of a team that investigated families' experiences.

With reduced access to face-to-face services, social isolation and the introduction of remote learning, children and adolescents with ADHD and their families have been disproportionately affected by lockdown restrictions.

Adjustments in daily routine and anxieties during the COVID-19 pandemic worsened existing challenging behaviours and increased problems with regulating emotions.

Studies have shown that children and adolescents with ADHD showed increased sadness, boredom, aggression and restlessness.

We held a survey in spring 2021 to assess the perceived impact of the pandemic on families.

Our objectives were to:

  • Understand the importance of research on ADHD for parents and carers.
  • Assess the impact of pandemic restrictions on children and their families.
  • Determine if there were differences in impact in families depending on whether someone in the family had COVID-19.
  • Explore changes in mood and wellbeing of both parent or carer and child.

A woman working from home on a laptop with her child hugging her from behind

So, what did we find?

Just over half of the families participating reported suspected or confirmed COVID-19 illness in the family at the time of the survey.

Whether families had COVID-19 or not, they experienced a substantial effect on daily life due to pandemic restrictions.

What were the biggest issues?

The greatest impact was noted in:

  • Restrictions in activities.
  • Restrictions on travel.
  • Reduced social contact.
  • Difficulties with education.

Restrictions in activities proved to be difficult for many. Parents and carers reported that reduced outdoor time led to worsening ADHD symptoms, which included inattention, hyperactivity and impulsivity.

Parents and carers anonymously reported that:

The lack of social interaction and lack of sporting outlets were most difficult for my child. We very much rely on sports activities to help control the energy levels and once access to these stopped there was a marked downturn of wellbeing for my child.

Another said, “My child with ADHD struggled with the lack of exercise. Their mood and energy levels suffer when they can’t wear themselves out. They started escaping from the house while we were asleep at night as they felt caged in.  They haven’t been able to cope with home-schooling.”

Children’s mental well-being was also affected as a result of reduced social contact with others.

As one parent explained, “To prevent them from seeing another child or to play in a child-to-child relationship for extended periods had a severe lasting impact on their mental well-being. After the lockdowns, they were very fearful of other children.”

Education and healthcare

Anxiety in education was a big concern for many parents and carers. Home-schooling proved to be extremely difficult for many, with hyperactivity and inattention exacerbating the situation.

With the introduction of online learning, parents and carers reported both a lack of routine and, more significantly, a lack of support from schools.

Access to healthcare was also greatly impacted due to the reduced availability of face-to-face services, adding more barriers to accessing healthcare.

On a more positive note, few parents and carers noted shortages of food, medication and essential items.

Parents home-schooling their child.

How were parents and carers affected?

Parents and carers emphasised the need for greater mental health support for them and their children, as well as educational assistance.

Reduced access to services and the adjustment to changes in home life during the pandemic put added pressure on them.

One parent said, “Having to deal with my child being home all the time when they weren’t going to school was mentally exhausting.”

Parents and carers reported an increase in the burden of being a carer, which resulted in an increase in anxiety, depression and stress.

When asked ‘What has affected you and your family the most?’, one respondent said:

Pressures of home schooling while working from home have affected us the most. Challenges of home-schooling a child with poor attention levels impacted the mental health of our family.

“Our anxiety about the children missing out on education and the long-term impacts also affected us.”

Although several participants noted increases in anxiety, other studies suggest that for some, lockdown allowed for flexibility of schedules which relieved anxiety for both the child and the caregiver.

Children gathered on a roundabout.

Next steps

Overall, the study showed that families with children with ADHD were substantially affected by pandemic restrictions.

More research needs to be done assessing the impact after restrictions have been lifted.

The study also highlighted that parents and carers thought that research on ADHD, and in particular, research on long term health outcomes in individuals with ADHD, is extremely important.

With the current relaxation of restrictions and the reopening of schools, the need for support has been highlighted and we can be hopeful that more support is now available.

Despite this, it is important that greater social support alongside psychological interventions for both parents and children is available now and in the future.

Thank you to all those who took part in the survey.


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Chelsea Owusu

Chelsea is a final year medical student at Cardiff University with interests in GP and psychiatry.

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