As children, teens, and their families continue to navigate both online school and in-person classes with masks and physical distancing, the management of mental health symptoms during the COVID-19 pandemic has proved particularly problematic. How can we support students’ needs when we are learning in such a different way? The answer often lies in using the current mental health systems both within and outside of schools to ensure that students continue to learn despite the challenges posed by the pandemic.

Difficulty concentrating and participating during online and/or in-person classes is a common problem for children with Attention-Deficit/Hyperactivity Disorder (ADHD) and many anxiety disorders. Not only are these diagnoses increasing during the pandemic, these core symptoms are causing particular difficulty for parents, educators, and students.. Parents and educators are exhausted, and students are feeling overwhelmed and ineffective. The good news is that mental health providers in schools and communities are perfectly poised to manage these symptoms with evidence-based interventions.

INTERVENTION 1: LEAVING THE CAMERA ON

One of the most common interventions for students receiving Section 504 accommodations and/or Special Education services in schools is the use of “preferential seating.” This can be a helpful strategy for anyone who struggles with focus, which is a common symptom of Attention-Deficit/Hyperactivity Disorder (ADHD), as well as Generalized Anxiety Disorder (GAD). For students participating in online classes, the equivalent intervention to “preferential seating” is often “leaving the camera on.” Leaving the camera on can increase focus during online classes and allows for teachers to better connect with those students who are more likely to get distracted. Leaving the camera on is also an excellent way to increase social interaction and provide opportunities for exposure practice if students are worried about being seen or speaking up in class.

Parents, teachers, and providers should consider the individual needs and goals of the student to determine how often the camera is left on, who will be checking in with the student, and what reinforcers will work best. For example, many educators recognize that some students might feel embarrassed about the location they are calling from or may have family members in the background during calls. However, for a student with social anxiety, it may be helpful to practice leaving the camera on for a few minutes per class or for small group discussions in order to facilitate participation and reduce anxiety or embarrassment over time.

INTERVENTION 2: CHECK-IN/CHECK-OUT

Another common intervention for students is a Check-In/Check-Out (CICO) system. Typically, a CICO intervention involves a paper chart that a student’s teachers can initial throughout the school day to monitor progress towards a predetermined set of behavioral and/or academic goals. When utilized with online school, the CICO system can involve online Check-In (morning) and Check-Out (afternoon) meetings with a trusted adult to monitor progress.

For a student with a Section 504 Plan, the trusted adult might be a teacher or coach, and often for students in Special Education the trusted adult is their case manager. In any iteration of this intervention, CICO can be used to monitor and reinforce progress in a way that involves more positivity and less conflict. For students with anxiety, a CICO goal might be to leave their camera on for a few minutes per class period. For students with ADHD, a goal might be to create a daily checklist of assignments to be completed. Each goal should be individualized to the student and their support team, and each goal should be reinforced with a motivating prize or privilege.

NEXT STEPS

Parents, teachers, and mental health providers are important team members for any student’s success in achieving their academic and mental health goals. The use of Section 504 and/or Special Education services certainly looks different in a pandemic, but the above strategies can be helpful in managing some of the most common symptoms getting in the way during online classes. Parents and students can ask their school-based or community-based mental health providers for support in using these interventions most effectively.