The Importance of Therapy for Social Development in ADHD Children

The Importance of Therapy for Social Development in ADHD Children

Children with ADHD (same as ADD or Attention Deficit/Hyperactivity Disorder) often have difficulty with social development.  In fact, we know that the cortex of the brain in an ADHD may be three years behind his or her peers.  This is very significant when you look at social development in kids with ADHD.  Child psychologists have believed for years that children with ADHD are about 3 years behind their peers in social development.  Think about it for a moment – this means that an 8 year-old in 3rd grade may have the social skills of a 5 year-old in Kindergarten.   Imagine how this gap becomes even more noticeable in middle school or high school.

Remember that the three-year difference does not pertain to intellectual development, but to executive functions such as attention, concentration, emotional regulation, and flexibility.  These are very important to the development of social skills.  One of the key components to social skill development and practice is observation of others and picking up on social cues and social norms.  Without this ability, a child will have difficulty fitting in.  A child who overreacts to situations due to poor emotional regulation or who can’t roll with changes in routine or rules set by the group due to rigidity will rate lower on the ever-present “popularity scale”.

Medication, behavior modification, or many forms of psychotherapy usually do not help ADHD kids improve their social skills.  It takes a “coach” to recognize a child’s lagging skills that are making it difficult to learn social skills, as well as identify specific social settings where the difficulty occurs and then help the child to learn and apply those skills successfully.  Some research indicates that the best coach may be an informed parent who is being guided by a professional to help their child.  While social skills groups might be helpful, there is a lot of evidence that one-on-one coaching works best.

Related: ADHD Medications for Children 

When seeking out a professional to work with you and your child to improve behavior, be sure to ask them about how he or she addresses social skills.  They should be able to tell you what materials they use and how they will work with your child to help them develop specific skills.  This is often done in therapy sessions.  With younger children, teaching some of these skills during play therapy can be helpful.  A therapist should also encourage parents to learn the material (usually tips and scripts along with materials to help a child accurately identify feelings in others) so that parents can coach and reinforce the practice of these skills at home and in other social settings.

In the Total Focus Program, I have provided some coaching tips for parents, along with a feelings chart, social rules chart, and an audio program using the letters in the word FRIEND to stand for the key concepts necessary to make and maintain friendships that are easy for children to understand and use.  This makes it easy to use, as well as forming a team between the child and parent(s).

When children have difficulty with social skills, it can be reflected in a number of ways including low self-esteem, avoidance of social situations, resistance to going to school, preferring to play with younger children or hang out with adults, being bullied, or being a bully.  These are serious consequences that are easily and frequently attributed to other causes.  Often by observing a child interacting with peers, a lack of social skills can be identified.  There are more formal ways to assess social skill development that can be conducted by a school psychologist, counselor, or speech/language therapist.

The primary use of labeling (diagnosing in the health professions and classification in the educational setting) is about getting payment or funding for services.  In order to really help children, we have to get past labeling and develop a full understanding of the unique set of strengths and obstacles that each child has.

Since children will often deny problems with kids at school either because they are embarrassed or because they don’t recognize they exist, parents need to do a little detective work if they suspect social problems.  Talking to siblings who attend the same school, observing your child at school or at a playground or park, talking with teachers or other school professionals, asking other parents, and consulting with your child’s mental health professional are the best places to start.

Seek professional help when you think it’s necessary.  Get referrals from school, your pediatrician, your local CHADD chapter, a university-based child psychology or child psychiatry program, or go online.  I have found these books about social thinking to be very helpful. This link will take you to a collection on where you will also find materials by my other go to source, Dr. Jed Baker.

Don’t worry! With the proper resources, time, patience, and encouragement, children with problems with social skills can be helped and begin to enjoy and benefit from social relationships with their peers.

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