ADHD Children and Immature Social Skills

Many problems children with ADHD face have a direct relationship with poor social skills. Here's an analysis plus strategies for enhancing your ADHD child's social skills.

Problems with impulse control, attention, and related issues, means that our ADHD children tend to find integrating with their peers very difficult.

Our children with ADHD will often butt into conversations, not wait their turn in a queue or in a game. They often think of something which they really need to say before they forget it. Generally not being able to communicate at the same level as their peers - it is generally felt through a lot of the research which has been carried out, that children with conditions like ADHD develop at approximately 3 years below their peers in their emotional and comprehension abilities. This makes it very difficult for them to interact with other children of the same age. They will very often get on really well with younger children who they obviously feel more able to communicate with or with older children or adults; as they do not feel as threatened when in conversation or interaction with these groups.

It is very difficult for them to understand all that is going on around them due to lack of attention and concentration they will often not be able to follow the flow of conversation and therefore will then often make inappropriate remarks to get back to the centre of attention!

What Causes Children with ADHD to Have Peer Problems?

However, first we need to consider a number of the main problems which hamper our children from being able to interact as well with their peers.

These can include:

a)Inhibited peer interactions or social relationships - the children may appear solitary, preferring their own company, even resisting any "invasion" of their space by others. They may seek interaction but are uncertain how to approach other children, fail to give out or read the appropriate social signals, and do not appreciate how behaviour may need to vary according to circumstances. They may appear actively anti-social.

b)Limited communication - vocabulary knowledge and articulator skills may be adequate but there is poor use of language, and communication may be one-sided and eventually break down altogether. There may be an obsessive repetition of the same questions or, at least, an insistence on focusing upon one topic. Understanding is often literal with an inability to understand humour or idioms. Tone of voice tends to be monotonous, the face may remain expressionless, and there is minimal use or understanding of non-verbal signals (including when the other person is becoming irritated).

c)A lack of imaginative play or flexible thinking - there is a common lack of true interactive play with other children so that the children with ADHD may focus upon individual activities and appear obsessed with some particular object or set of objects. They may seek to impose their choice of games upon others and may not be able to take part in "pretend" games.

Children with ADHD also commonly fail to understand that other people may have and are entitled to have opinions, attitudes, or knowledge which differ from their own. They are likely to assume, instead, that others share their outlook and will be immediately able to tune into what they say and to understand what they are talking about without the need for introduction. If there is no awareness of what someone else might be thinking or feeling, it will not be possible to make sense of that person's actions or to anticipate their reactions to a given situation or event.

Other difficulties which can include a resistance to change and anxiety at the prospect of an interruption to routines ( or distress/anger if someone makes any change in the way toys or belongings have been set out). They really do prefer things to stay the same.

Other Difficulties Faced by ADHD Children

Some of our children may also have awkward motor skills, a clumsiness, and impaired ability to run or throw or catch. Where, some children may show an exaggerated response to touch or sound, or display a sensory defensiveness.

Finally, these children may show a kind of innocence in not recognising teasing but a tendency to comply with being told to perform some unacceptable or silly action and then fail to comprehend why the other children laugh at them or why they are the ones who end up getting into trouble, they are also then unable to explain why they have done these things so will often end up lying about them, some can almost convince you that black is white as they are so adamant about things which can then lead them into even more trouble. The other thing that often ends up happening is that they get so used to getting into trouble and others being believed over them that they start to lose self esteem, confidence and sense of self worth with is a very sad and serious consequence of their lack of social skills.

In respect of anxiety, the technique involving "Social Stories" may be very helpful in individual work with a given child to reduce his or her anxiety over some identified activity or circumstance during the school day, with the implication that, if the negative thoughts and anticipations can be largely eliminated, the child will no longer feel the need to set him/herself apart or avoid significant parts of the school experience.

For example, in the initial description of the use of Social Stories, Gray (1995) refers to a child who is intimidated by the general noise in the dining hall but is encouraged to recognise that there is no need for anxiety so that (s)he can join peers in what is a particularly important, socially-speaking, part of the school day. Research has confirmed that this approach is very useful for the ADHD child given its visual format, the use of simple language, the explicitness, and availability for repeated usage.

It needs also to be remembered that the child with ADHD may experience a range of negative emotions but not be able to label them or to express them to other people. The implication is for some help in recognising anxiety, in establishing some message or signal by which the child can make clear when anxiety or stress or anger is building up, and taking time to explore the reasons behind the feelings.

It is likely that a significant source may be the apparent unpredictability of the world, with the child with ADHD developing rituals by which to increase feelings of stability. Everything must remain in a certain place ; activities must be followed in the same sequence ... and the "free" social and play activities of various groups of children during school break times may be a particular source of the perceptions of unpredictability and feelings of insecurity, with the child motivated by a wish to escape from this setting.

Social Skills Groups Can Help Your ADHD Child Develop Social Skills

There are a number of ways to help our children to overcome a lot of these problems. Obviously professional Social Skills Groups are the best option and all of our children would really benefit from these. However, these are so rarely available that it is probably a good idea to try to incorporate as much as we can into daily life until these groups start to appear.

Social Skills Groups can be found via the local Child and Adolescent Mental Health Services, some schools will run these during the school day for small groups and also the local Social Services Children's Service can arrange to hold these. The thing is that it does not cost a great deal in money terms to set something like this up and there are a lot of great materials around which you can get to help with this. Check out our Books and Resources Section - Social Skills.

I found a copy of a great board game basically called "The Social Skills Game" which I got a copy of and lent to my son's small school unit. Some of the children and teachers have written some great reviews for this. For an initial layout of approximately £40, this can be used over and over with many groups of children so it would be a great investment for many schools who would be prepared to work with a group of up to say 6 children for no more than about 15 minutes twice or three times a week either during lesson time or maybe over a break time or lunch time. One of the bits I found the children loved when we used this was the part where they each had to whisper something, then they had to shout it as loud as they could. Well, of course, they all tried to out-shout each other, but it was great fun and they did learn a lot from it.

There are also a lot of activity and other books including The Social Stories Book by Carol Grey which is based on cartoon strip of everyday things. The book can be used to discuss appropriate situations and how to handle things. A CD Rom called Gaining Face was also used at the school. This has various faces to enable the child to learn about facial expressions.

On a larger scale, there is an Interactive CD Rom from Behaviour UK called the Conduct Files which can be purchased by the LEA and used in a number of schools on a license basis. The CD is for both primary school and senior school age groups and uses video clips and then questions to ask the children how they could handle the situation better than the child on the video.

It all depends on how much the group is able to invest, but anything that is purchased can be used for a number of years with a lot of children. So these more than pay for themselves over time.

All of these are, of course, available for parents to purchase as well so maybe a group of parents could get together and get some of these to use with their own group of children to help them as no particular qualifications are really needed to do this. Obviously, to have groups run by professionals is probably the best option as then there are people there who can work with the children on other levels as well. In addition, it's very likely that after doing one of two of the sessions, some children may have specific questions which may be best dealt with by a therapist, teacher or social worker. But on the whole, parents are quite able to run these groups as a starting point at least. This may also provide the evidence which could then be passed onto the authorities to show what need there is in your area for such groups to be run officially.

What Else Can Be Done to Improve Social Skills and Peer Interaction?

As mentioned above, it is possible to do a lot of things in everyday circumstances and with our children on our own. However, as we go through a number of things which are important for them to be able to learn, our children often start to question things which they may have come across and do not understand. Some of these may be better answered by a professional running a specific group as they can go through things from a less emotionally-attached point-of-view. Unfortunately, until these groups become more common, then we must do the best we can to help our children learn some of the vital skills they need to reach their full potential.

Once you have worked on these things with your own individual child, then try to involve other children as well. These could be other classmates who do not have specific problems, or siblings, or even other children who have similar problems to your own child, to get them used to working in a group. Try out some of the skills you are working on with them. You will need to be there in the middle of things even if you have a friend over to play a game to make sure that they are sticking to the rules, taking turns and actually playing with the friend, rather than just being in the same room! It can be fairly intensive, so short periods of doing this is quite enough for both you and your child or tempers can start to fray!

REFERENCES

• Roeyers H. 1996 The influence of non-handicapped peers on the social interaction of children with a pervasive developmental disorder. Journal of Autism and Developmental Disorders 26 307-320
• Novotini M 2000 What Does Everyone Else Know That I Don't
• Connor M 2002 Promoting Social Skills among Children with Asperger Syndrome (ASD)
• Gray C My Social Stories Book
• Searkle Y, Streng I The Social Skills Game (Lifegames)
• Behaviour UK Conduct Files
• Team Asperger Gaining Face, CD Rom Game