Having positive peer relationships and friendships is important for all children. Unfortunately, many kids with attention deficit hyperactivity disorder (ADHD) have a hard time making and keeping friends and being accepted within the larger peer group. The impulsiveness, hyperactivity, and inattention associated with ADHD can wreak havoc in a child's attempts to connect with others in positive ways. Read more about the ways ADHD-related difficulties can affect social acceptance.
Not being accepted by one's peer group, feeling isolated, different, unlikeable and alone -- this is perhaps the most painful aspect of ADHD-related impairments and these experiences carry long-lasting effects. Positive connections with others are so important. Though kids with ADHD desperately want to make friends and be liked by the group, they often just don't know how. The good news is that you can help your child develop these social skills and competencies.
Increasing Your Child's Social Awareness
Research finds that children with ADHD tend to be extremely poor monitors of their own social behavior. They often do not have a clear understanding or awareness about social situations and the reactions they provoke in others. They may feel that an interaction with a peer went well, for example, when it clearly did not. ADHD-related difficulties can result in weaknesses in this ability to accurately assess or "read" a social situation, self-evaluate, self-monitor, and adjust as necessary. These skills must be taught directly to your child.
Teach Skills Directly and Practice, Practice, Practice
Children with ADHD tend to have a hard time learning from past experiences. They often react without thinking through consequences. One way to help these kids is to provide immediate and frequent feedback about inappropriate behavior or social miscues. Role-playing can be very helpful to teach, model, and practice positive social skills, as well as ways to respond to challenging situations like teasing.
Focus on one or two areas that are most difficult for your child, so that the learning process doesn't become too overwhelming and so that your child is more likely to experience successes. Keep in mind that many kids with ADHD have difficulty with the basics like starting and maintaining a conversation or interacting with another person in a reciprocal manner (for example, listening, asking about the other child's ideas or feelings, taking turns in the conversation, or showing interest in the other child), negotiating and resolving conflicts as they arise, sharing, maintaining personal space, and even speaking in a normal tone of voice that isn't too loud.
Clearly identify and give information to your child about social rules and the behaviors you want to see. Practice these prosocial skills again and again and again. Shape positive behaviors with immediate rewards.
Create Opportunities for Friendship Development
For preschool and elementary school age children, play dates provide a wonderful opportunity for parents to coach and model positive peer interactions for their child and for the child to practice these new skills. Set up these play times between your child and one or two friends at a time -- rather than a group of friends. Structure the play time so that your child can be most successful. Be thoughtful about the length of time the play date will run and the activities that will keep your child most interested. Think of yourself as your child's "friendship coach." Learn more about being a friendship coach to your child.
As a child gets older, peer relationships and friendships are often more complicated, but it is equally important for you to continue to be involved and to facilitate positive peer interactions. The middle school and high school years can be brutal for a child who struggles socially. Even if a child remains unaccepted by the peer group at large, having at least one good friend during these years can often protect the child from the full-on negative effects of ostracism by the peer group.
Research and get involved in groups in your community that foster positive peer relationships and social skills development -- Boy Scouts, Indian Guides, Girl Scouts, Girls on the Run, sports teams, etc. Make sure the group leaders or coaches are familiar with ADHD and can create a supportive and positive environment for learning prosocial skills.
Communicate with the school, coaches, and neighborhood parents, so that you know what is going on with your child and with whom your child is spending time. A child's peer group and the characteristics of this group have a strong influence on the individuals within the group. A middle or high school age child who has experienced social isolation and repeated rejection and simply wants to "belong" somewhere is often more vulnerable to moving into any peer group that will be accepting -- even when that group is a negative influence.
Work With the School to Improve Peer Status
Once a child is labeled by his or her peer group in a negative way because of social skills deficits, it can be very hard to dispel this reputation. In fact, having a negative reputation is perhaps one of the largest obstacles your child may have to overcome socially. Studies have found that the negative peer status of children with ADHD is often already established by early-to-middle elementary school years and this reputation can stick with the child even as he or she begins to make positive changes in social skills. For this reason, it can be helpful for parents to work with their child's teachers, coaches, etc. to try to address these reputational effects.
Young children often look to their teacher when forming social preferences about their peers. A teacher's warmth, patience, acceptance, and gentle redirection can serve as a model for the peer group and have some effect on a child's social status. Establish a positive working relationship with your child's teacher. Share about your child's areas of strength and interests, as well as areas of weaknesses, and strategies you have found to be most helpful in minimizing those weaknesses.
When a child has experienced failures in the classroom, it becomes even more and more important for the child's teacher to consciously find ways to draw positive attention to that child. One way to do this is to assign the child special tasks and responsibilities in the presence of the other children in the classroom. Make sure these are responsibilities in which your child can experience success and develop better feelings of self-worth and acceptance within the classroom. Doing this also provides opportunities for the peer group to view your child in a positive light and may help to stop the group process of peer rejection. Pairing the child up with a compassionate "buddy" within the classroom can also help facilitate social acceptance.
Don't forget the basics. Collaborate with your child's teacher to make sure the classroom environment is as "ADHD friendly" as possible so that your child is better able to manage ADHD symptoms. Work together with the teacher (and coach or other adult caregiver) on effective behavior management approaches, as well as social skills training.
Medication, when appropriate, is often helpful in reducing the negative behaviors that peers find off-putting. If your child is on medication to help manage symptoms of ADHD, be sure to work closely and collaboratively with your child's doctor. In order for medication to provide the optimal benefit that it can in helping to manage the core ADHD symptoms, there is often an ongoing need to monitor, fine-tune, and make adjustments along the way.
Additional Reading: 6 Things You Need to Know About ADHD
Betsy Hoza, PhD, Peer Functioning in Children With ADHD. Journal of Pediatric Psychology, 32(6) pp. 655-663, 2007.
Betsy Hoza, Sylvie Mrug, Alyson Gerdes; Stephen Hinshaw; William Bukowski; Joel Gold; Helena Kraemer; William Pelham, Jr.; Timothy Wigal; L. Eugene Arnold; What Aspects of Peer Relationships Are Impaired in Children With Attention Deficit/Hyperactivity Disorder?,Journal of Consulting and Clinical Psychology, 2005, Vol. 73, No. 3, 411-423.
Russell Barkley, Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, the Guilford Press, 2005.