Study Reveals ADHD Symptoms Worsening During COVID Pandemic

Little girl reading on her bed
Anger, Issues with Routine and Attention Are Among Symptoms Reported.

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Key Takeaways

  • Kids with ADHD thrive on structure and routine. The COVID-19 pandemic has made it extremely difficult for families to provide adequate support to these kids.
  • A small study in China found that parents reported worsening ADHD symptoms in kids during the coronavirus lockdown.
  • There are lots of small things parents can do to help alleviate the difficulties associated with distance learning and stay-at-home orders for kids with ADHD.

It’s estimated that approximately 9% of children in the US have been diagnosed with Attention Deficit Hyperactivity Disorder or ADHD. Under typical conditions, this common childhood disorder, characterized by inattention and lack of focus, can be managed relatively easily with a consistent schedule and clear guidelines for daily tasks. 

But ever since mid-March, we can all agree that a consistent schedule and clear guidelines have been sorely missing in all of our lives, thanks to the coronavirus pandemic. And in the months since, as we’ve all been ordered to shelter in place to varying degrees, a recent study shows that kids with ADHD are having a particularly difficult time adjusting to this new normal.

Here, we’ll take a look at the findings and examine why the shutdown has exacerbated ADHD symptoms in some kids, and what can be done about it.  

ADHD During the Pandemic: The Problem

This year, when schools and activities shuttered overnight, kids of all ages found themselves suddenly dealing with the loss of social and physical activities, the introduction of online learning, and a total upending of their daily life.

While this would be a difficult transition for any child, those with preexisting conditions like ADHD, autism, and anxiety disorders have struggled immensely to adapt to the lack of schedules and routines they so desperately need.

Unsurprisingly, a study conducted in China during the height of the pandemic found that certain ADHD-related behaviors had worsened during the lockdown.  

What exactly is causing these behaviors to worsen now that kids are at home? "Children with ADHD typically thrive with routine and predictable structure, which allows them to understand and be aware of their daily expectations in a consistent manner," says Shivani Chopra, MD, a triple board-certified psychiatrist and founder of the Premier Mind Institute in Southern California.

In the absence of these structural elements since the start of the pandemic, kids with ADHD are facing immense challenges in all aspects of life: it’s easier to become distracted on a Zoom call than it is in a live setting, the home is much louder and more chaotic than a classroom during learning time, and the number of things vying for a child’s attention at home is much greater (think: pets, video games, comic books, etc.). 

Indeed, two of the areas where kids with ADHD have struggled the most, according to the study, are attention and routine. Parents involved in the study reported much worse behavior in these two areas, likely a direct result of the drastically different setting brought on by the pandemic. 

What Do Kids with ADHD Need? 

In general, kids with ADHD need exactly what a school setting provides: structure, routine, and consistency. "Given that many parents are trying to work from home and have little experience with online learning, many are unable to provide a consistent, structured environment to mimic what their child may have been receiving while at school," says Chopra.

The following are some of the things kids with ADHD need on a daily basis in order to function at their best:

Physical Activity

Children with ADHD thrive in active environments, says Leela Magavi, M.D., psychiatrist and regional medical director at Community Psychiatry in Newport Beach, California. “Various study results reiterate the importance of daily exercise in reducing ADHD symptoms and improving cognitive function in children," says Magavi.

The necessary safety measures being taken during the pandemic have unfortunately prevented children from the amount of daily exercise they need.

Individualized Learning

Many children have Individualized Education Plans, or IEPs, which often include one-on-one support and help with particular subjects, says Magavi. This can be difficult to replicate at home, especially when parents are responsible for their own work deadlines.

A Distraction-Free Environment

In a school setting, kids with ADHD often have the opportunity to learn in small groups, separate from a large classroom full of students. Whether this takes place at the back of the room, in a hallway, or somewhere else completely, it’s hugely beneficial for students with ADHD, who may struggle to pay attention or fully engage when part of a large group (or while sitting on a Zoom call).

A Consistent Schedule

With little exception, kids know what to expect when they sit down at their desks first thing in the morning. The school environment is structured to look very similar each day, or at the very least, each week. Without this, kids with ADHD struggle to manage their time and tend to become unfocused quickly.

Help With Transitions

Transitions are hard for most people, and adjusting to this pandemic is certainly no exception. With so many large changes going on, kids with ADHD may demonstrate a particularly difficult time with the smaller transitions in life, like moving from one subject to another or even getting started in the morning.

These transitional times are ripe for kids with ADHD to lash out in anger. Indeed, at least 30% of parents in the Chinese study indicated a much higher frequency of angry outbursts in their kids during the pandemic. 

How Parents Can Help

We can all agree that these unprecedented times have not been easy on anyone. And working parents attempting to support special needs children likely have the most difficult job of all. But that doesn’t mean hope is lost. There are plenty of ways parents can alleviate some of the difficulties faced by kids with ADHD. We’ll take a look at a few below. 

Provide a Basic Routine

There’s no need to pressure yourself to make every day exactly the same. Simply nail down a basic routine that includes school time, fun time, and physical exercise time as well.

A great way to ensure it sticks? Enlist your kids’ help! “I often recommend that a general schedule be written on a board in a common space of the home with clear, short, simple directions so that a child can anticipate the events of the day. Of course, as you design this schedule together, allow for some flexibility in timing,” suggests Chopra. 

Get Moving

Exercise is important for everyone, but it’s critical for kids with ADHD. “Exercise is a great way for children to burn off energy and temper some hyperactive behaviors,” says Chopra. “In addition, exercise increases dopamine and norepinephrine neurotransmitters, which are the chemicals that stimulant medications target.”

Even with social distancing requirements in place, kids can take walks or runs with you, or play in the yard if you have one. If you’re in an apartment setting, try kids yoga or exercise videos for an indoor sweat session. 

Connect With Your Child’s Teacher

If your child has ADHD and was on an IEP in school, there’s a good chance his or her teacher will be more than willing to provide additional help when needed. “If you’re not aware of the type of accommodations your child gets while in school, contact the school or the teacher to get a good understanding of what academic, environmental, and behavioral strategies the school was using to help your child succeed,” says Chopra.

Talk With Your Child

“During this tumultuous time, we must have open, honest conversations about COVID-19 to dissipate stress caused by any misinformation,” says Magavi. “Voicing emotions, limiting screen time, and maintaining familiar routines as much as possible could help alleviate ADHD, depressive and anxiety symptoms,” she says.

A Word From Verywell

In this difficult situation, it's important to have patience with yourself in addition to your child. There is no perfect parent, and you're doing the best you can with the situation at hand. Taking time for yourself, even if it's just a few minutes, will give you the boost you need to help your child succeed in this challenging environment.

Learn More

Support for Kids with ADHD During the Coronavirus Crisis (Childmind.org)


5 Focus Tricks for Students With ADHD Learning at Home (Additude Mag)

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Article Sources
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  1. CDC. Data and statistics about ADHD. Updated October 15, 2019.

  2. Zhang J, Shuai L, Yu H, et al. Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak [published online ahead of print, 2020 Apr 9]Asian J Psychiatr. 2020;51:102077. doi:10.1016/j.ajp.2020.102077