Assessing and Managing ADHD in a Pandemic: Guidance Issued for Professionals and Parents in Europe
Navigating the pandemic is particularly distressing for children and young adults with ADHD, placing them at greater risk for behavior problems. To combat this, the European ADHD Guidelines Group (EAGG) recently issued ADHD treatment guidance for clinicians, educators, and families during the era of COVID-19.
April 29, 2020
Children and young adults with neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD) are particularly vulnerable to pandemic-related distress, putting them at increased risk for behavior problems, according to the European ADHD Guidelines Group (EAGG). An international medical group dedicated to making “evidence-based clinical recommendations,” the EAGG recently released the following treatment recommendations to help clinicians, educators, and parents protect adolescents with ADHD during the COVID-19 pandemic.
Mental Health Practitioners: Use Technology to Continue Patient Treatment
To promote mental health, online therapy is an acceptable substitute and should be used in accordance with the current recommendations of the UK Royal College of Psychiatrists1 or the American Psychiatric Association2 to support and monitor adolescents with ADHD.
Educators: Look for Signs of Distress in Students with ADHD
Schools and teachers should make students with ADHD a priority since disorganized thinking related to executive dysfunction may compromise their emotional wellbeing. Lack of participation in online classes and missed or late assignments should be a red flag.
Parents: Use Proven Behavioral Parenting Strategies
For help at home, the EAGG suggest parents use proven behavioral parenting strategies to help manage difficult behavior related to ADHD symptoms, as well as oppositional defiant disorder.3
Clinicians: Ensure Access to ADHD Medication During Quarantine
Pharmacological treatment, if deemed appropriate after clinical assessment, should not be delayed or disrupted. Disruption to medication schedules impacts a patient’s ability to comply with social distancing requirements. Since in-person visits with clinicians are difficult now, regulatory agencies should be accommodating and flexible to ensure medications are distributed in a timely manner.
Parents are advised not to increase doses or add doses to what’s prescribed in an effort to manage new symptoms triggered by pandemic stress. Disruptive behavior should also never be treated with antipsychotic medications or sedatives that aren’t clinically indicated. Weekend drug holidays should be avoided at this time of crisis.
Parents: Good Sleep Hygiene is Critical Now
Disruptions to sleep are linked to poor mental health outcomes. Sleep can be impacted by a variety of factors including stress and disruption of daily routines. The EAGG advises against increasing melatonin beyond the therapeutic range to promote sleep at this time. Good sleep hygiene is the best way to get sufficient rest. Melatonin should not be increased beyond the therapeutic range at this time.
Ibuprofen may be counterindicated in patients with COVID-19. Headaches and other pain should be treated with acetaminophen at this time.
1Royal College of Psychiatrists. PIPSIG guidelines for the use of telepsychiatry.www.rcpsych.ac.uk/docs/default-source/members/sigs/private-and-independent-practice-pipsig/pipsig-telepsychiatry-guidelines-revised-mar16.pdf
Accessed: April 28, 2020
2American Association of Psychiatry. Telepsychiatry.https://www.psychiatry.org/psychiatrists/practice/telepsychiatry Accessed: April 28, 2020
3Daley D, Van Der Oord S, Ferrin M, et all. Practitioner review: current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder.J Child Psychol Psychiatry. 2018; 59: 932-947