Gresa ÇARKAXHİU BULUT, Sebla GÖKÇE, Funda GÜMÜŞTAŞ

Yeni Normale Uyum Sağlamak: Çevrim-içi Eğitim Döneminde DEHB’li Çocukların Davranışsal Belirtilerindeki Değişimler

Amaç: Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) gibi nörogelişimsel bozuklukları olan çocuklar, COVID-19 pandemisinin neden olduğu sıkıntılar ve ilişkili sosyal izolasyon önlemleri nedeniyle, özellikle hassas bir grup olarak kabul edilmektedir. Bu çalışmada, COVID-19 pandemisinde DEHB'li çocukların semptomlarındaki değişikliklerin incelemesi amaçlanmıştır. Metod: Sosyodemografik veriler ve Swanson, Nolan ve Pelham ölçeği (SNAP-IV) ebeveyn formu kullanılarak ölçülen DEHB semptom skorları, pandemi öncesinde aynı eğitim yılındaki hasta dosyalarından elde edilmiştir. Pandemiyle ilgili sorulara ek olarak, ebeveynlerden çocuklarının mevcut durumlarını değerlendirmek için SNAP formunu tekrar doldurmaları istenmiştir. Bulgular: Toplam 104 katılımcının yaş ortalaması 10.5 (SS=2.4) olup örneklemin %28.8’i kızlardan oluşmaktadır. Katılımcıların karantina öncesi ve sırasında DEHB semptom skorlarında anlamlı bir fark saptanmamıştır. Düzenli çevrim içi eğitim alan katılımcıların dışsallaştırma problemleri anlamlı derecede daha düşük bulunmuştur. Yeni başlangıçlı olumsuz duygusal problemler yaşayan ebeveynlere sahip çocuklarda içe yönelim sorunları anlamlı derecede daha yüksek oranda görülmüştür. Babaları evden çalışan katılımcıların içe yönelim sorunları, babaları ofiste çalışan veya işsiz olan çocuklara kıyasla anlamlı ölçüde daha düşük bulunmuştur. Sonuç: Pandemi, katılımcıların temel DEHB semptomlarında belirgin değişikliğe yol açmamıştır. Pandemi döneminde DEHB'li çocuk ve ergenlerin esenlik halinin sürdürülmesinde eğitim planlamasının yanı sıra, ebeveynlerin esenlik düzeyinin ve istihdam olanaklarının en önemli faktörler arasında yer aldığı görülmektedir.

Anahtar Kelimeler:

DEHB, Covid-19, Çevrim İçi Eğitim, Davranışsal Belirtiler, Çocuklar

Adapting to a New Normal: Changes in Behavioral Symptoms in Children with ADHD During Online Education

Objective: Children with neurodevelopmental disorders, such as Attention-Deficit Hyperactivity Disorder (ADHD), are considered a particularly vulnerable group due to the distress caused by the COVID-19 pandemic and associated social isolation measures. This study aimed to examine the alterations in symptoms of children with ADHD during the COVID-19 outbreak. Methods: Sociodemographic data and ADHD symptom scores, measured using the Swanson, Nolan, and Pelham scale (SNAP-IV) parent form, were obtained from patient files from the same educational year prior to the pandemic. In addition to pandemic-related inquiries, parents were requested to complete the SNAP form again to assess their children's current conditions. Results: Of the total 104 cases, 28.8% were female with a mean age of 10.5 (SD=2.4). There were no significant differences in ADHD symptom scores before and during quarantine. Participants who received regular online education had a significantly lower rate of externalizing problems. Children with parents who developed new onset negative emotional problems exhibited a significantly higher rate of internalizing problems. Participants whose fathers worked from home had a significantly lower rate of internalizing problems compared to children with fathers working in an office or who were unemployed. Conclusions: The pandemic did not induce changes in the core symptoms of ADHD. It is inferred that educational planning for children, parental well-being, and accommodating parents' employment opportunities are among the most critical factors in maintaining the well-being of children and adolescents with ADHD during the pandemic period.

Keywords:

ADHD, Covid-19, Online education, Behavioral symptoms, Children,

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1. Polanczyk G, De Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-48.
2. Kendall T, Taylor E, Perez A, Taylor C. Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance. BMJ. 2008;337.
3. Moore DA, Richardson M, Gwernan-Jones R, Thompson-Coon J, Stein K, Rogers M, Garside R, Logan S, Ford TJ. Non-pharmacological interventions for ADHD in school settings: An overarching synthesis of systematic reviews. J Atten Disord. 2019;23(3):220-33.
4. Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018;5(2):175-86.
5. Kadesjö B, Gillberg C. The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry. 2001;42(4):487-92.
6. Hodgkins P, Setyawan J, Mitra D, Davis K, Quintero J, Fridman M, Shaw M, Harpin V. Management of ADHD in children across Europe: patient demographics, physician characteristics and treatment patterns. Eur J Pediatr. 2013;172:895-906.
7. Pliszka S, The AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894-921.
8. Barkley RA. Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: The Guilford Press; 2006.
9. Cortese S, Asherson P, Sonuga-Barke E, Banaschewski T, Brandeis D, Buitelaar J, Coghill D, Daley D, Danckaerts M, Dittmann RW. ADHD management during the COVID-19 pandemic: guidance from the European ADHD Guidelines Group. Lancet Child Adolesc. Health. 2020;4(6):412-14.
10. Masi A, Mendoza Diaz A, Tully L, Azim SI, Woolfenden S, Efron D, Eapen V. Impact of the COVID‐19 pandemic on the well‐being of children with neurodevelopmental disabilities and their parents. J Paediatr Child Health. 2021;57(5):631-36.
11. Sciberras E, Patel P, Stokes MA, Coghill D, Middeldorp CM, Bellgrove MA, Becker SP, Efron D, Stringaris A, Faraone SV. Physical health, media use, and mental health in children and adolescents with ADHD during the COVID-19 pandemic in Australia. J Atten Disord. 2022;26(4):549-62.
12. Zhang J, Shuai L, Yu H, Wang Z, Qiu M, Lu L, Cao X, Xia W, Wang Y, Chen R. Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak. Asian J Psychiatr. 2020;51:102077.
13. Bobo E, Lin L, Acquaviva E, Caci H, Franc N, Gamon L, Picot M, Pupier F, Speranza M, Falissard B. How do children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) experience lockdown during the COVID-19 outbreak? Encephale. 2020:46(3S):85-92.
14. Jensen PS, Hinshaw SP, Swanson JM, Greenhill LL, Conners CK, Arnold LE, Abikoff HB, Elliott G, Hechtman L, Hoza B. Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22(1):60-73.
15. Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, Long D, Snell G. Mental health impacts of the COVID‐19 pandemic on children and youth–a systematic review. Child Adolesc Ment Health. 2022;27(2):173-89. 16. de Miranda DM, da Silva Athanasio B, Oliveira ACS, Simoes-e-Silva AC. How is COVID-19 pandemic impacting mental health of children and adolescents? Int. J. Disaster Risk Reduct. 2020;51:101845.
17. Loades ME, Chatburn E, Higson-Sweeney N, Reynolds S, Shafran R, Brigden A, Linney C, McManus MN, Borwick C, Crawley E. Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218-39.
18. Viner R, Russell S, Saulle R, Croker H, Stansfield C, Packer J, Nicholls D, Goddings A-L, Bonell C, Hudson L. School closures during social lockdown and mental health, health behaviors, and well-being among children and adolescents during the first COVID-19 wave: a systematic review. JAMA pediatrics. 2022;176(4):400–9.
19. Li Y, Wang A, Wu Y, Han N, Huang H. Impact of the COVID-19 pandemic on the mental health of college students: a systematic review and meta-analysis. Front Psychol. 2021;12:669119.
20. Hawes MT, Szenczy AK, Klein DN, Hajcak G, Nelson BD. Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychol Med. 2022;52(14):3222-30.
21. Panchal U, Salazar de Pablo G, Franco M, Moreno C, Parellada M, Arango C, Fusar-Poli P. The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. Eur Child Adolesc Psychiatry. 2023;32(7):1151-77.
22. Breaux R, Dvorsky MR, Marsh NP, Green CD, Cash AR, Shroff DM, Buchen N, Langberg JM, Becker SP. Prospective impact of COVID‐19 on mental health functioning in adolescents with and without ADHD: Protective role of emotion regulation abilities. J Child Psychol Psychiatry. 2021;62(9):1132-39.
23. Becker SP, Breaux R, Cusick CN, Dvorsky MR, Marsh NP, Sciberras E, Langberg JM. Remote learning during COVID-19: Examining school practices, service continuation, and difficulties for adolescents with and without attention-deficit/hyperactivity disorder. J Adolesc Health. 2020;67(6):769-77.

ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez