Tips for Parents: Improving Social Skills in Children with ADHD
Crawford, M.
2009
Davidson Institute for Talent Development

This Tips for Parents article is from a seminar hosted by Melanie Crawford, who provides advice on improving the social skills of children with ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) struggle with peer interaction for a number of reasons. A child’s overactivity and impulsivity can sometimes be aversive to other children. Children with ADHD can also be blunt or overly frank with their peers. Further, children with ADHD often have difficulty linking current behaviors to long-term outcomes. Thus, social skills that do not have an immediate payoff (e.g., sharing, cooperating, and taking turns) may not seem worthwhile to them. Below are a number of strategies used to improve social skills in children with ADHD.

HOME-BASED SOCIAL SKILLS TRAINING PROGRAM:

While home-based interventions don’t always translate to other settings. Working with your child at home can’t hurt and can often be very effective in improving social relationship skills. Below is a home-based social skills training program borrowed from Russell Barkley (a well known ADHD researcher). You can read about it in more detail in chapter 13 of his book Taking Charge of ADHD: The Complete Authoritative Guide for Parents, Revised Edition.

  1. Establish a home reward program such as token system.
  2. Focus on one or two social behaviors that you would like to see increased in your child’s daily behavior (i.e., sharing, turn taking, keeping hands to self, not being bossy).
  3. Write the targeted behaviors on a chart and post it where you and the child can see them.
  4. When you have a chance to observe your child in social interaction, quietly review with him/her the skills you are working on that week and remind him/her that he/she can earn points for trying out these new skills or loose points for unacceptable behavior.
  5. Monitor your child during social interaction more closely than you would typically. Give him/her praise and award points for trying out skills and/or otherwise behaving well with peers. Make sure to wait for a natural break in the action to reward and praise. If you do this out of earshot from other children it is less likely to be embarrassing.
  6. Several times each week, set aside time to review with your child the new social skill/s that you are working on. Explain the skill you would like your child to use, model the behavior, and practice with your child through role play (you should give them points for doing this as well). Then repeat steps above.
  7. You can also try to video your child’s play interactions with siblings or other consenting friends. It is probably not wise to say why you are videotaping or call much attention to it as you want to capture typical behavior. Make your review of the tape positive and constructive. First focus on the things your child did well and then pick out one or two behaviors that were inappropriate. Then follow step 6 to teach your child what to do instead.

EMOTION EDUCATION:

If your child is struggling because he/she is having trouble reading social cues, he/she may also benefit from something called emotion education, which is usually included in most social skills training programs/therapies. For this type of intervention, children learn to better understand and read others’ emotions as well as their own. While some children learn these behaviors through observation, others need to be explicitly taught how to infer what others are thinking and feeling. You can work on these skills by asking questions like “How do you know if someone is (mad, sad, happy, etc.)? What does their face look like? How do you know when you are feeling sad? What does it feel like in your body?” You can also play games like emotion charades where you and your child would act out different emotions and try to guess what the other is feeling. Many schools also offer social skills/friendship groups which teach these types of skills. The book Skills Training for Children with Behavior Disorders, a Parent and Therapist Guidebook by Michael Bloomquist is also a good resource. It has many exercises to target emotion education as well as social skills training.

SOCIAL SKILLS GROUPS:

Children with ADHD also generally benefit from more formal social skills training focused on helping them develop strategies for emotion regulation, friendship skills, skills for understanding thoughts and feeling, conversation skills, as well as social problem solving skills. This therapy is often best implemented in the group setting where children have the opportunity to practice newly acquired skills with peers as well as meet other children with similar difficulties. However, social skills training may also be implemented within the context of individual therapy. Social skills groups are commonly offered within the school setting, but may also be available through a local therapist or mental health clinics in the community.

MEDICATION:

There is a great amount of evidence that stimulant medications (i.e., Ritalin) improve peer relationships in children with ADHD (less is known about non-stimulants such as Strattera). The medication reduces overactivity and impulsivity as well as improves attention, which in turn, leads to improved social interaction with peers.

GROUP ACTIVITIES:

There are also some group activities that are more conducive to social skills development. Look for group activities without a competitive atmosphere that emphasize cooperation, and are structured (i.e. scouts, 4H, church youth groups). Your child may be most successful in situations that incorporate cooperative learning, which involves a group of children working together as a team to complete a common goal (i.e., building a model, conducting a science experiment, building a fort in the back yard). These types of activities generally increase liking and positive feeling towards group members. In general, activities that involve structure and adult supervision are best for children with ADHD.


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