If impulsive behavior — dominating play, interrupting, jumping from one thing to the next — keeps other kids away, medication is probably necessary. In fact, your child may need to be "covered" by meds even after the school day ends. "Kids who are having trouble with social skills may need meds all day, every day," says Carole Watkins, M.D., a Baltimore psychiatrist.
Puberty may occasion a new look at medication or dose. Lumpkin says, "When hormones start changing, what's worked up until that point will probably need to be changed."
ADHD medication alone may not be enough. One mom from Hartford, Wisconsin, found that temporarily adding the antipsychotic drug Risperdal on top of her son's usual ADHD meds had a double payoff. "It calmed him down," she says. "He went up to A's and B's in school, and it allowed him to make a friend."
Groups and Teams
Stephanie Bixler's son, Matthew, now nine, struggled with friendships for years. "He pushed away every kid who tried to be his friend," says Bixler, a resident of Lemoore, California. "His play was so chaotic that others had a hard time wanting to be around him. He was also greedy with his toys."
She credits team sports with much of Matthew's recent success. "He started to realize everything wasn't about him," she says. "As the team concept sank in, it overflowed into his play. After two seasons of baseball and two seasons of football, we are now seeing him develop healthy friendships."
But if your child expresses an interest in Little League or another structured athletic organization, proceed with caution. Call the coach before the first practice, and discuss whether your child would fit in. If you decide to take the plunge, accompany your child to meet the coach or another child who will be on the team before the first get-together. Remember, transitions are hard for kids with ADHD.
For many of our kids, getting involved with a "friendship group" may be a better option.
Patience and Perspective
Most socially isolated children find their way — eventually. They get a better handle on their behavior, along with a broader perspective on the dynamics of friendship. And once kids hit adolescence, they tend to act on the powerful urge to "fit in." As Zakreski puts it, "By high school, the vast majority of kids with ADHD do end up fitting in somewhere."
The same experts who urge parental involvement (and who urge counseling for kids who seem stuck in the "lone wolf" role) say it's important that parents not worry too much about a socially isolated child.
A child doesn't need to be in the "in" group or get invited to lots of parties. In fact, studies show that having even a single close friend is all it takes to develop social self-confidence. This friend doesn't even have to be a peer. "It can be a neighbor, a teacher, a grandparent," says Lumpkin. "Once that connection is made, it can become the vehicle for kids to listen and make some changes in their lives."
Teasing and playful banter are an inevitable part of childhood, but kids with ADHD often don't know how to respond. Parents should encourage their children to stand up to teasing without overreacting, which might escalate the problem.