When we think of Attention-Deficit/Hyperactivity Disorder (AD/HD), a condition that affects 3% to 5% of all children and adolescents, we tend to focus on deficits associated with attention, impulsivity, hyperactivity, and executive functions. These include difficulties with problem solving, planning, organization, flexibility, and working memory. However, what we fail to acknowledge is the impact these weaknesses have on socialization. Executive dysfunction, along with behavioral and mood dysregulation, negatively interfere when children and adolescents with AD/HD attempt to connect with their peers in a positive way. They may dominate interactions, have difficulty cooperating, become easily overwhelmed or emotionally reactive, or get bored and “check out” when engaging with friends (Low, 2018).
The resulting negative interpersonal outcomes appear to result in loneliness and low self-esteem, as well as the development of co-morbid mood and anxiety disorders. And despite repeated negative interactions characterized by conflict and rejection, individuals with AD/HD have difficulty learning from previous experiences, making it challenging to predict how others may respond to them and change their behaviors the next time. However, there are ways that you can help your child learn and build on the social skills they have.
An important first step is to increase your child’s awareness about the importance of social skills and how their behavior may negatively impact their interactions with peers. The aforementioned AD/HD-related difficulties can result in poor self-monitoring and difficulty assessing social situations, making it challenging for children and adolescents to adjust their behavior as necessary. After having a discussion with your child about these factors, you can come up with 2-3 behaviors that may be interfering in social relationships. Once these are established, make SMART goals (Specific, Measurable, Attainable, Realistic, Time-Limited) for one or two of those behaviors, using social reinforcers as a way to encourage your child to work on interactions.
Skill-building can take place using a variety of techniques. Given the difficulties that children with AD/HD have learning from past experiences, due to reacting impulsively rather than responding thoughtfully, they tend to benefit from immediate and frequent feedback regarding their behavior. One way to provide this is to engage in role-playing and modeling to help them practice positive social skills and respond to challenging situations (e.g., arguments, teasing). Also, remind your child of the goals prior to entering into different social situations and praise them when you notice prosocial behaviors in their interactions with you or others, such as remaining on-topic, maintaining a calm voice and body, sharing, and exhibiting flexibility.
If you find that your child is struggling behaviorally and emotionally to such an extent that their behavior is negatively interfering socially, academically and adaptively, they may benefit from individual therapy or social skills training. If you or your child are struggling with related difficulties, or if you are concerned that your child may be experiencing difficulties related to AD/HD, please contact our office to be connected with one of our well-trained providers.