Categories: 2010, April
A MOTHER IS CONCERNED about her eight-year-old daughter, Taylor. While Taylor usually makes a good first impression when she meets other children, it’s extremely hard for her to develop lasting friendships. Mom wants to help her daughter develop deeper connections with others, but she doesn’t know how to help. For Taylor, joining in a game or group activity is easy; maintaining friendships is not. Within minutes, it becomes clear that as much as Taylor likes to play, she likes to play her way. In her easygoing manner, she shifts the play toward something she’d like to do and assumes the other children will join her. When they don’t, she becomes confused and frustrated. Time and time again, instead of ending up with a group to play with, Taylor winds up playing alone. Brendan is an eleven-year-old boy who continuously provokes others around him. He talks nonstop in class, preventing others from getting their work done. His desk is such a mess that his stuff always ends up on other classmates’ desks. He blurts out answers in class, which frustrates the teacher. He taunts the girls at recess to get them to pay attention to him. When they walk away, he is disappointed and hurt. Brendan doesn’t understand why the kids in class won’t talk to him. The girls whisper behind his back, and the boys call him names like “Stupid” and “Big Mouth.” Brendan comes home most days feeling hurt and confused. Both Brendan and Taylor have ADHD. Like many children with ADHD, they struggle to make and keep friends. Brendan is not purposely trying to drive others crazy with his provocative behavior nor is Taylor intentionally driving kids away when she is bossy. In fact, they are desperately trying to make connections with their peers. They just don’t know how. I have spent the last twenty years as a social skills group therapist helping children make and keep friends. So many of the children I see in counseling have the same problem—feeling left out and lonely. I recall an eight-year-old boy named Brian saying, "I feel like I live on my OWN planet, and everyone else lives on THIS one." I created a social skills training program for children and their parents in 1990 to help Brian and countless others make the friends they so wanted. Feeling alone and disconnected from peers is a distressing thing for a child to experience. And it's not only the children who suffer. As parents, you also feel frustrated and hopeless at not knowing how to help your children make the friends they so strongly desire. Children affected by ADHD, in particular, have unique social challenges that frequently get in the way of acquiring good social skills. Social challenges The child with ADHD frequently exhibits a constellation of characteristics that may interfere with successful social development. The child with ADHD is often impulsive. When a child lacks the adequate pause between impulse and action, social blunders inevitably occur. Poor listening skills are a common byproduct of impulsivity. Because Brendan is unable to pause before speaking or acting, he's distracted and fools around during class. His peers and his teachers become annoyed by his constant verbal and nonverbal interruptions. The child with ADHD may be insensitive to subtle interpersonal cues. Being able to recognize and understand other people’s body language and facial expressions requires kids to constantly scan their environment for clues that will guide their social actions. Because kids with ADHD often struggle to stay tuned in to their environments, they frequently misread social signals. Misinterpretations may lead to overreacting to ambiguous social situations. They can also lead to under-reacting. The kids who don’t see these signals may be insensitive to the feedback cues others are giving them, leading to anger from peers who feel that their “social hints” are being ignored. When Taylor’s peers become frustrated with her controlling behavior, she doesn't heed their dirty looks and verbal pleas. Taylor’s ADHD gets in the way of her being able to learn from the reactions of her peers. She struggles to go with the flow of others. A child affected by ADHD can’t control what captures his or her attention. Any internal or external stimulation can be distracting to a child with ADHD. Because Brendan tends to fade in and out of conversations, he frequently misunderstands directions and thus has difficulty following through on instructions accurately. This frustrates him as well as his peers. Children with ADHD have a hard time learning from experience, whether the experience is positive or negative. When a child who does not have ADHD makes a social mistake and receives a hostile reaction from a peer, chances are high that the same mistake won’t happen again. The child with ADHD, on the other hand, may make a mistake repeatedly before learning not to do it again. The child with ADHD has trouble applying past experiences to future problems and is unable to predict the consequences of his/her actions. Even though Taylor is given feedback by her peers in the form of pleas, dirty looks, and distancing behavior, she continues to struggle to learn the errors of her ways. She doesn’t change her behavior when it isn’t working for her. Children with ADHD may have a difficult time predicting audience response. A child who does not have ADHD is able to see himself or herself through another child’s eyes. This self-reflection informs his or her behavior. Children with ADHD get themselves into social binds without being aware of their predicament or of how they got there because they lack awareness of the consequences of their social behavior. Taylor is unable to see that her bossy behavior may turn the other girls off. When they distance themselves from her, she is unable to see what she did to make that happen. How you can help Some children can’t learn social skills on their own—they need help. Your involvement as a parent is essential to help your child learn new skills and use them in a variety of settings. You already help your child to develop social skills by modeling good social skills yourself and by creating situations in which your child can practice. For example, when you invite children over to play or get your child involved in extracurricular activities, you are helping him or her build social skills. As the parent of a child affected by ADHD, you may need to be your child’s “social coach” in order to address the social challenges highlighted above. Raise your child’s social IQ by using the following techniques and strategies: Talk to your child about the need for social skills. During a quiet time of the day, discuss with your child the importance of making friends and getting along with others. An ideal time is when your child is complaining to you about a social incident with another child. Tell your child you are going to try to help him or her learn the skills needed to be “an even better friend than he or she already is.” Set a social goal with your child. It’s important to be as specific as possible when setting a goal, and to set only one goal at a time. The goal must be a goal that your child sees as important. For example, Brendan’s mom and dad may want him to stop interrupting others during conversations, but if he doesn’t agree or doesn’t feel able to meet the goal, he will not succeed. If Brendan agrees, his goal might read: “Brendan will interrupt in conversation fifty percent less this week than last week.” (Note: Before you can set an attainable goal, you need to know your child’s current level of functioning. You’ll need at least a week to observe your child at the same time each day before you can set a realistic goal for improvement.) Carefully arrange a supervised, time-limited date for your child to spend with other children to practice newly learned social skills. Many children with ADHD may be unable to spend hours playing with another child. It’s too much time to negotiate the complicated interactions of play. Instead, set up a play date that is limited in length. Make sure the date ends on a positive note whenever possible. Children tend to remember more vividly the last fifteen minutes of an interaction. Review social goals with your child prior to social outings. For instance, "Tell me, Taylor, what are you going to do when you first get to the birthday party?" "Well, Dad, I'm going to walk up to the birthday girl and wish her a happy birthday. Then I'm going to walk over to where the other kids are playing and try to go with their flow." "That's right, Taylor, you've got it!" Choose play activities that are intrinsically simple and enticing. Keep the activities easy in terms of attention span and stimulation. Ask a friend to a highly attractive event like ice skating or a trip to the movies. These occasions minimize the need for intense social interaction, and thus increase the likelihood of social success for your child with ADHD. Involve your child's teachers and guidance counselors in helping to reinforce social goals. For example, Brendan’s teacher could use check-off sheets to give his parents daily feedback on his progress on his goal of decreasing his interruptions in class. This encourages accountability and consistency for Brendan. Videotape or audiotape your child at home. Sometimes children affected by ADHD have trouble seeing themselves through others’ eyes. Review these tapes with your child to increase self-observation and awareness. Prompt your child to think about the feelings and reactions of others. Ask your child to think about the needs of others. Help your child understand the motivations and feelings of others by observing out loud what others’ faces and bodies are telling us. For instance, you might say, “How do you think the other girls feel when you only want to play what you want to play, Taylor?” “How do you think the girls feel when you taunt them at recess, Brendan?” Consider a social skills group Some children do need more individualized attention. If you are frustrated with your child’s progress, there are other options you can pursue. First, consult with your school’s guidance counselor. Many schools conduct social skills groups to help children develop positive social behaviors. Although these groups are generally time-limited (meeting for less than twelve weeks) and brief (usually a half-hour long), they are effective in reinforcing the skills you are teaching your child at home. In addition, a school group can work nicely in combination with an outside therapy group. Social skills training programs are cropping up around the country. The experienced group leader uses group structure and dynamics to reinforce agreed-upon goals. The group becomes a microcosm for the social arena at school or in the neighborhood. Group members act as mentors for each other. They practice skills together through role play, give each other positive feedback and constructive criticism, and gain strength from knowing that they are not alone with their social struggles. Before you enroll your child in a social skills program, research it thoroughly. Find out the experience level of the people leading the groups. Make sure the program is more than a few months long to ensure skills are learned. Choose one that includes parents so that you and your child can practice skills together in between sessions. WITH CONCERTED EFFORT AND DILIGENT PRACTICE, children with ADHD can learn social skills and raise their social IQs. When children have good social skills, they get along better with their peers, develop positive self-esteem, and are more likely to experience both social and professional success as adults.
When the Solution Becomes a
Tuckman, PsyD, MBA
RESEARCH CLEARLY SHOWS THAT PEOPLE WITH AD/HD are
more likely to run into troub...
by Marie S. Paxson
OVER THE PAST FEW YEARS I have watched my lifelong
friend, Michelle, as she coped with her young adult daughter’s
by Marie S. Paxson
THIS ISSUE IS DEVOTED TO COPING with AD/HD when other
conditions are also present. I’ve done presentations using...
Priorities for 2010
by Cynthia A. Smith, JD, MS
EVERY OTHER YEAR CHADD'S PUBLIC POLICY COMMITTEE oversees
revisions to the organization’s publ...
Show All Categories