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The Toll of COVID-2019 on Diverse, Urban Children With Attention Deficit Hyperactivity Disorder and Their Families: A Case Series

The COVID-19 pandemic has disproportionately affected families from racial and ethnic minority and economically disadvantaged backgrounds,1,2 who are more likely to experience crowded living conditions, hold essential jobs, have underlying health conditions, and face barriers to accessing health care.3 Children from these households are further burdened by less access to technology and support for online learning, reduced physical activity, and higher rates of food insecurity.4,5 Children from socioeconomically disadvantaged backgrounds with neurodevelopmental disabilities such as attention-deficit/hyperactivity disorder (ADHD) may experience even more dramatic hardship during the pandemic. Children with ADHD often require special supports for learning (e.g., Individualized Education Programs) that are not available at home. Their symptoms may pose a challenge for social distancing guidelines and, thus, a safe return to in-person school.6 Lack of structure and physical activity, excessive screen time, fear, and stress could heighten emotional and behavioral problems, particularly for children with ADHD.7,8 To better understand the impact of the pandemic on diverse children with ADHD from socioeconomically disadvantaged backgrounds, we conducted a case series including 19 children with ADHD and their parents, recruited from treatment settings at an urban safety net hospital.