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Recommendations for Parents of Young Children and Young Children with ADHD in Navigating the COVID-19 Situation

Friday, May 1, 2020 - 8:45am

School Psychology doctoral students, Courtney Cleminshaw and Alicia Chunta, Dr. Lee Kern, Director of the Center for Promoting Research to Practice and Professor of Special Education and Dr. George DuPaul, Associate Dean for Research and Professor of School Psychology created these recommendations for parents with young children and young children with ADHD to help navigate home life during the COVID-19 pandemic. While these strategies are important to use now, they can be used beyond this uncertain and trying time.  

Courtney Cleminshaw is a fourth year doctoral student in the school psychology program at Lehigh University, pursuing a sub-specialization in pediatric school psychology. Courtney’s research interests include interventions for ADHD and co-occurring disruptive behavior disorders, self- and emotion-regulation, and promoting social functioning and peer relationships in children with disruptive behavior. Courtney is also interested in the intersection of externalizing behaviors and pediatric health risk and the integration of psychology services into pediatric primary care.

Alicia Chunta is a second year doctoral student in the school psychology program. Her research and practical interests include the development and dissemination of evidence-based interventions for children with ADHD and other behavioral challenges, child/parent/teacher self-efficacy and the role it plays in treatment outcomes, parent education groups, and school-wide positive behavioral support. Further, Alicia is interested in the development and outcomes of summer treatment programs for children with ADHD and related behavioral concerns.

Dr. Lee Kern's research interests are in the area of interventions for students with social, emotional, and behavioral disorders. Recently, she has researched multi-component intervention packages for high school students with behavioral and mental health issues, adaptations to interventions for elementary age students with mild to moderate emotional and behavioral problems, and parent implemented interventions for pre-school children with ADHD.

Dr. George DuPaul's primary research interest is the treatment of individuals with (ADHD) attention-deficit/hyperactivity disorder and related behavior disorders.  Specifically, he conducts research on school-based academic and behavioral interventions for youth in K-12 settings; early intervention for young children at-risk for ADHD; and the assessment and treatment of college students with significant ADHD symptoms. Dr. DuPaul also has interests in health promotion and pediatric psychology; having directed student-led studies related to nutrition education, asthma, and psychopharmacology.

Strategies

Schedule

Encourage engagement

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Providing preschoolers with an interesting schedule helps to encourage engagement and limit anxiety

Routines help to provide structure and minimize undesirable behaviors or frustration - this is especially important for children with ADHD and predictability helps your child know what to expect throughout the day.

With changes due to Covid-19, it will be helpful to maintain structure and routine over a longer period of time throughout the day: maintain wake time, meal times, and scheduled screen time should be kept as consistent as possible. Be sure to Include scheduled breaks and times for fun/reinforcing activities throughout the day, particularly after children are asked to complete chores or practice school-related tasks. Make sure activities and expectations are specific and well-defined ( Examples: after waking up, you will dress up, come downstairs for breakfast, and then brush your teeth; during mealtime, you will sit at the table, keep toys and electronics away from the table, and eat everything on your plate).

Create a visual reminder of the daily schedule for preschoolers who cannot read and do your best to keep activities short as preschoolers have short attention spans and having ADHD can compound this. Activities that are challenging should be no longer than 10-15 minutes. Easier activities can last a bit longer.

Ensure expected activities included in daily routine are within your child’s skill set (e.g. some preschoolers may not be able to get dressed independently in the morning). Be ready to assist with the more difficult activities and gradually allow your child more independence as their skills improve.

Try to break down large tasks into smaller tasks (consider creating checklists of individual components for multi-step activities). For example, if you want your child to look at books or do other academic activities, break the reading or other activity into pages or tasks that your child can complete at different times throughout the day (e.g., before lunch, after lunch, after dinner or cleaning room checklist: make your bed, put your toys away, put your clothes in the hamper).

Using a timer to help young children complete activities in an expected amount of time and anticipate transitions from one activity (e.g., playing with Legos) to another (e.g., cleaning up for meal time) can help with tricky transition times. 

Behavior

Reinforce positive behaviors

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Managing your child’s behavior in a positive fashion when your child is bored, tense, or anxious as a top priority

Include your child in household chores and activities that you need to complete (have your child help you dust, clean out a closet, or wash vegetables for dinner). Remember, when children are bored, they are more likely to engage in problem behavior.

Reinforce positive behaviors frequently. For example, provide verbal and descriptive praise (“Ava, you are doing such a nice job putting your toys away”). Tangible or activity rewards also can be provided for good behavior (e.g., 5 minutes of extra screen time, access to a small toy, or engaging in special activity with parent or sibling)

If you are prepared with a “bank” of activities in advance to keep your child engaged (prevent negative behaviors associated with boredom and frustration) you can ease frustrations for both yourself and your child. A great way to do this is to make a box of activity ideas. Spend time with your child brainstorming different ideas to add to the idea box, and write them down. Then plan a time when your child can select an activity out of the box. Some suggestions include: crafts, such as scrapbooking, collecting, etc., neighborhood nature walks, reading aloud, art projects, bike rides, outdoor science experiments, charades and skits, board or card games, interactive computer or video games and/or develop a treasure hunt.

Managing anxieties in young children is a high priority for everyone right now. Anxiety and worry can manifest behaviorally wherein your child may revert to behaviors they displayed when they were younger (e.g., whining) or your child may display behaviors to get your attention (e.g., begging, crying). An important first step in this process is to help your child identify when they are feeling anxious or worried. Ask them to describe how they are feeling. For example, you might say, “You look upset to me. Can you tell me how you are feeling?”

If they are feeling worried or anxious, you can tell them that it is natural to be worried or nervous at times (i.e., that there are times that you are also worried and anxious). You can then tell them how you handle stress and serve as a role model for them in coping with challenges associated with COVID-19. Be honest and accurate about social distancing and why routines are changing (at a developmentally appropriate level), but focus on the positive (e.g., “Isn’t it great that we have more time to spend together!”). Empathize with your child’s feelings but do not reinforce fears (e.g., “I know you are nervous about the virus, but there are things we can do to keep from getting sick. Let’s practice those things together”).

Introduce relaxation strategies at times when the child is not anxious so that they are ready to use them when they are feeling nervous (e.g. belly breathing; practice deep breathing with a balloon) can also be a successful strategy for managing anxieties.

Communicate

Clarification is key

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Use effective limit-setting strategies to manage challenging behavior

Because the COVID-19 crisis is requiring families to stay at home on a consistent basis, it is inevitable that some conflicts between you and your child will arise. Strategies that are effective in managing children’s challenging behaviors can be used to prevent and/or respond to parent-child conflict situations.

Set your child up for success by making sure expectations and rules are clearly stated: “you must keep your hands to yourself when you play with your sister”- you also can provide non-examples such as hitting, kicking, pinching; you must stay in our backyard when playing outside. Please stay inside the fence." Consider posting visual reminders for preschoolers who cannot read.

Employ use of  “when/then” statements by stating what the child is to do (when you...) followed by what the reward will be (then…). An example would be “When you brush your teeth, then you can play with your brother."

Be consistent with your expectations for child behavior and how you react to your child’s actions.  If a behavior or activity is not allowed at Time A (e.g., morning routine), it should also not be allowed at Time B (e.g., bedtime), unless it is part of a child’s reward/ reinforcement plan. For example, if your child is not allowed to play with toys in the family room, they should not be allowed to do so at any point during the day- unless they earn time playing with toys in the family room from their reward plan.

Issuing effective commands and directives clarifies expectations. When giving a directive, say the child’s name and make eye contact to get their attention before stating what you want them to do. Once you gain their attention positively state your expectation. That is, tell the child what you want them to do rather than what you do NOT want them to do.

Remember to issue one directive at a time (e.g., “Please put your model airplane in the box”, not “Please put your model airplane in the box, put your other toys away, then come to the table for dinner”). Also, make it very clear what you want them to do using words that are as specific as possible: don't use: “Put your stuff away before dinner.” Do use: “Put your cars away.” Once the child responds you should move on to the next task, “Put your monster toys away.” Another example of how to change your directives includes "Get ready for breakfast" to “First, put your clothes on, then we will have breakfast.”

Praise your child when they follow instructions. Remember, descriptive praise lets your child know exactly what they did correctly (e.g., “Thank you for putting your shirt on as soon as I asked.”) Re-issue the command if they do not follow instructions. Consider using “When/Then” statement or setting expectation for what will happen if child does not comply (e.g., “If you can’t finish getting dressed in the next minute, we won’t have time to play before breakfast”).

Mindset

Be optimistic

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Practice thinking optimistically about your parenting

Pessimistic thoughts about your parenting may be common at this time because of new stressors, changes in routine, and anxiety about the COVID-19 situation. For example, you may think that you are a bad parent because your child is having problems managing their behavior or emotions. Pessimistic thoughts include believing that a challenging situation is all your fault and you have no control, that it will always be like this, and that other areas of life or circumstances outside the specific problem situation are also just as unmanageable (“My child is tantruming again, this ALWAYS happens during dinner time now.”) These thoughts can not only impact your feelings but also your behavior (...you may be more likely to yell at your child or other family members).

Try to identify a distraction to interrupt pessimistic thinking. Remind yourself to take deep breaths, remember a funny saying that makes you laugh, or a line from your favorite song. Do your best to replace the negative thought with a more optimistic thought. The more you do this, the easier it will become. See the larger picture and keep things in perspective - think to yourself “My child is tantruming at dinner time now, but they ate dinner without any problems last week. I have strategies I can use to prevent them tantruming before dinner tomorrow and things will be better.”

Keep a journal of your thoughts (positive and negative) and work to reframe pessimistic thoughts into positive thoughts about your parenting.

External Resources

General resources

The American Psychological Association Division 54 (Society of Pediatric Psychology) compiled this list of Covid-19 Resources for parent, teachers, and caregivers to refer to:

ADHD-specific resources

Topic: