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ADHD AND SOCIAL DIFFICULTIES

Attention-deficit/hyperactivity disorder (ADHD) is associated with functional impairments in different areas of life, and one such area is social functioning. Social difficulties present in a variety of forms and can lead to conflicts with family and peers. In order to face the common issues that occur in the social life of children and adolescents with ADHD, is important to learn more about them.

How can we explain social difficulties in children with ADHD?

The core symptoms of ADHD – inattention and hyperactivity/impulsivity – by their very nature, would be expected to make effective functioning with peers difficult. Whereas problems with inattention likely limit opportunities to acquire social skills through observational learning and to attend to social cues necessary for effective social interaction, hyperactive and impulsive behaviors contribute to generally unrestrained and overbearing social behavior that makes children with ADHD aversive to peers. Inattentive behaviors in social situations might impair the children’s ability to pay attention to their friends, potentially harming the reciprocity, sensitivity, conflict resolution, and commitment necessary to establish and maintain high-quality friendships.It’s important not to confuse symptoms of ADHD with selfishness and egocentrism because researchers offer an explanation of the role that social cognition plays in the peer relationship problems:

  • Children with ADHD have trouble understanding a social situation from someone else’s perspective.
  • Children with ADHD tend to overestimate their social competence more than typical children.
  • They tend to see their peers’ ambiguous provocations as hostile and to suggest less adaptive strategies solving hypothetical social conflicts than typical children, which could have negative effects on friendship.
  • Some children with ADHD may prioritize social goals such as sensation seeking and fun over compliance with rules.

What can parents do to alleviate their children’s social difficulties?

Given the aforementioned difficulties, it is necessary to consider some practical advice for parents of children with ADHD. Family influences that contribute to children’s peer-related social competence are:

  • Parental fostering of the child’s peer social network

The frequency of play dates organized by parents for their children is associated with improved social skills. Parents can also teach their children how to behave in a way that promotes friendship during playdates. The friendship facilitating behaviors of parents during play dates are more strongly related to positive peer relationships for children with ADHD than for typical children.

  • Parental attitudes and beliefs about their child’s social competence

Parental warmth, together with reasonable levels of control, combines to produce positive child outcomes. It’s also important for parents to deal with any negative feelings they may have, since these feelings make it more difficult for them to react appropriately and effectively to the challenges of socialization.

  • Importance of peer relations and strategies to assist socialization

Parents can role-play social situations with their child and discuss some aspects of behavior and attitudes that can be modified. The child can also benefit from being a part of a sport or another group activity of interest, so they can work on team skills.

  • Modeling social behavior

The quality of parents-child interactions, positive attitudes, and effective communication are important, but so is modeling social behavior. In this case, actions speak louder than words. For example, a parent saying that it’s wrong to throw things when upset but at the same time dealing with frustration in an aggressive manner doesn’t contribute positively to the child’s social skills. Parents support the development of prosocial norms by their own positive coping with frustration and distress, usage of explanations about the impact of one’s behavior on others, and through being an active source of social support. Parents who discuss social skills with their children and model good examples of social skills in their interpersonal relationships, increase the probability of their children having positive interactions with their peers. Given the importance of parental modeling, parents should also learn some useful techniques such as problem solving and goal setting.

References:

  1. Soucisse M.M., Maisonneuve M., Normand S. Friendship Problems in Children with ADHD What Do We Know and What Can We Do? 2015. Perspectives on Language and Literacy.
  2. Classi P, Milton D, Ward S, Sarsour K, Johnston J. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization. Child Adolesc Psychiatry Ment Health. 2012;6:33. doi: 10.1186/1753-2000-6-33.
  3. Hoza B. Peer Functioning in Children with ADHD. Ambul Pediatr. 2007 ; 7(1 Suppl): 101–106. doi:10.1016/j.ambp.2006.04.011.

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KEEPING IT POSITIVE WHILE PARENTING A CHILD WITH ADHD

Attention Deficit/Hyperactivity Disorder is a complex syndrome involving a myriad of symptoms including hyperactivity, inattention, forgetfulness, and impulsivity that is often comorbid with a number of cognitive and behavioral disorders. As stressful as this can be for a child suffering from symptoms of ADHD, it can be just as stressful for parents and caregivers of these children. Parenting a child with ADHD can be difficult and often discouraging. This is an important point since it is commonly known that how parents react can have huge impacts on the success of their children.

Feelings of Inadequacy

Although parenting always encompasses feelings of doubt and worry, parents of children with ADHD report more frequent negative feelings such as:

  • inadequacy of their parenting
  • anger at their child
  • worry about the success and futures of their children
  • guilt of not being able to provide adequate help
  • feelings helplessness about not being able to control child behaviors
  • isolation (socially) due to fear of a public behavioral issue
  • anxiety and depression

The lack of ability of parents to be able to help their children and control the symptoms of ADHD plays a large part of the total parental stress. In a study published in the Journal of Abnormal Child Psychology in 2011, researchers found that many of the feelings of depression, discouragement, and inadequacy in parenting experienced by parents resulted from their perception that their children were not responsive to behavior correction techniques that were employed. In other words, most parental stress stems from a perceived inability to control the behavioral issues of their children. A separate study by psychologists at the University of Irvine, CA, investigated the intricacies of this relationship between parental stress and ADHD behaviors. In this study, researchers had mothers of children with ADHD keep a journal and record entries as to their moods/feelings and their children’s behaviors. Separate journals were also kept by the children recording their own behaviors. The study uncovered a direct association between negative mood and stress of the mothers in the study and the presence of typical ADHD behaviors such as hyperactivity and impulsivity2. Furthermore, other research has shown links between dysfunctional parenting styles and increased ADHD symptoms reported in children3.

Given these results, one can imagine a daunting positive feedback loop where ADHD symptoms and behaviors cause heightened parental stress. Stress leads to dysfunctional and negative parenting behaviors, which in turn, exacerbates ADHD behaviors.

The Power of Positive Perception

The key to less stress and better outcomes in the child/parent relationship is to remain positive. Fortunately, not all of the research out there has a grim outlook. One study focused on parent perceptions using a group of parents who view their child’s ADHD-associated behaviors as being indicative of underlying positive traits. For instance, a parent of a child who is inattentive in class views this as a sign that the child is bored with the material due to superior intelligence. Another example of this type of parent perception would be the view that children who exhibit hyperactivity do so because they possess a heightened sensitivity to the world around them. The study, which was published in the Journal of Attention Disorders, focused on this group of parents who had children with ADHD and compared them to a control group, who did not associate their child’s ADHD symptoms with any positive traits. The researchers found that parents in the “positive perception” group reported less frequent negative interactions with their children and overall experienced less stress and negative emotions in dealings with their children. While not all parents view ADHD-associated behaviors in a positive light, it is still possible to positively influence parenting of children with ADHD. One technique that is achieving good results is parent training (PT), a complex program of family treatment which emphasizes teaching parents how to react more positively to their child’s behaviors. PT aims to change parenting behaviors for the better by replacing dysfunctional or ineffective parenting techniques with functional ones, and by focusing on the parental use of positive reinforcement. The desired result is to greatly improve parent/child interactions, thereby improving child behavioral outcomes and alleviating parental stress.

  1. Glaz, T. et. al. Parents’ reactions to youths’ hyperactivity, impulsivity, and attention problems. 2011. J. Abnorm. Child Psychol. Nov;39(8): 1125-35.
  2. Whalen, C.K., et. al. Dissecting Daily Distress in Mothers of children with ADHD: an Electronic Diary Study. 2011. J. Fam. Psychol. Jun;25(3): 402-11.
  3. Ullsperger, J.M., et.al. Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder? 2016. J. Abnorm. child Psychol. Jan;44(1): 167-178.
  4. Lench, H.C. et. al. Exasperating or Exceptional? Parents’ interpretations of their child’s ADHD behavior. 2013. J. Atten. Disord. Feb;17(2): 141-51.

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