Children with attention deficit disorder (ADD ADHD) often struggle to make friends. Use these parenting strategies to help your ADHD child build stronger social skills.
by Gay Edelman
Eight-year-old Josh stands alone at the edge of the playground, watching the other kids play. He'd like to join them but has no idea how.
Eleven-year-old Tina sits on the porch steps in tears. From the next block, she can hear the sounds of a birthday party to which she wasn't invited — even though she thought the birthday girl was her good friend.
Fourteen-year-old Tom spends all his free time alone, on his computer. No one calls him, and he calls no one.
Is anything sadder — or more frightening to parents — than a friendless child with attention deficit disorder (ADD ADHD)? "Parents fall apart crying about their child's situation," says Richard Lavoie, a special-education consultant in Barnstable, Massachusetts, and the author of It's So Much Work to Be Your Friend. "And it's never about academics. It's always about the pain of social isolation their child is facing."
It's hard to overstate the importance of friendships. Mary Fowler, the Fair Haven, New Jersey-based author of Maybe You Know My Teen and the mother of an ADD son, says that having close childhood friends can make "the difference between things going well, or becoming a hard-to-manage teen, dropping out, abusing substances, and being in trouble with the law." Experts say that having positive social relations in childhood is a better predictor of adult happiness than is I.Q. or academic achievement. "Friendships are not a luxury," says Lavoie. "They're a necessity."
All parents worry about their children's friendships. But for parents of ADHD children, the concerns are especially pressing. Making friends requires hundreds of skills—talking, listening, sharing, and so on. These skills do not come naturally to children with ADHD.
"They miss social cues that other kids learn by osmosis," says Carol Brady, Ph.D., a clinical psychologist in Houston. "Having ADD is like trying to watch six TVs at once. While you're deciding which one to pay attention to, some subtle information passes you by."
ADHD children have friendship trouble for all sorts of reasons. Some aren't good listeners. Some yammer on and on about a specific interest — oblivious to the fact that other children might not share the interest. Others drive away potential friends by impulsively blurting out unkind comments.
One mother in Hawaii says her "mother hen" daughter alienates peers by trying to micromanage their lives.
In some cases it's unclear what the precise problem is. "I just think some kids have an air around them that other kids pick up on as a target," says one mother, worn out from years of worrying about her ADD child's awkwardness and social isolation.
For young children, a lack of social skills may not be a serious problem. If a six-year-old says or does something untoward, for example, other children may ask why, but are unlikely to take offense. What's more, young kids typically have a hands-on "social director"—a parent or caregiver who solicits play dates and stays on hand to make sure they go smoothly.
But as children get older, social interactions become more complicated—and children with ADD fall behind. This was certainly true for Jay Edmond, a 15-year-old from Burlington, North Carolina. Jay's mother, Jodi, says that his odd comments and disruptive behavior became too much for his peers. "Kids he had been friends with started steering clear," she says. "By middle school, he was a marked kid. The more the kids pushed him away, the more outrageous his behavior got."
What about teenagers? "By high school, parents of all kids need to be backing off and letting them manage their own relationships," says Rick Zakreski, Ph.D., a clinical psychologist in Shrewsbury, New Jersey. "In high school, there usually are so many possible activities that they're likely to find a niche. Keep an open mind. Don't judge his group by appearances."
But don't back off too far: A recent study of nearly 12,000 seventh- through twelfth-graders discovered that teens who have warm relationships with their parents—they talk often, share activities, and are affectionate with each other—also tend to have good friendships.
Parental involvement is essential if ADD kids are to make and keep friends. That can mean something as simple as helping your child initiate conversations and "supervising from the window," as one parent puts it. It can mean driving your child to another town to visit a potential friend. It can mean attending a parents' workshop given in conjunction with your child's friendship group, or talking to your child's therapist.
"Some of the hardest work I do is with the parents of ADD children," says Avie Lumpkin, an ADD coach in Alameda, California. "They are good parents, and they have worked hard, but they may be trying the traditional parenting things, which don't work."
ADD kids often have little sense of how they're perceived by their peers, and they commit social gaffes without realizing they've done so. Another kid will give them a shove, and they'll fail to realize that calling the kid a "jerk" a moment ago had anything to do it. Or they'll have no idea that a game broke up because they kept ignoring the rules.
To help, Lavoie urges parents to conduct what he calls a "social autopsy": Parents and child discuss what went wrong, why it happened, and what the child could (not should) do differently next time. Be as sensitive and as tactful with your child as you would be with a close adult friend; too much negative feedback can damage your child's self-esteem. When your child has a successful interaction, congratulate him.
According to Michael Thompson, author of Best Friends Worst Enemies, one of the most effective things parents can do is to set a good example. In addition to socializing frequently, that means making an effort to forge friendships with the parents of your child's peers. Thompson also recommends enlisting the support of your child's teachers, and staying connected to the community through clubs, religious organizations, and so on.
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."
ADD 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 ADD 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."
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 ADDers.
For many ADD kids, getting involved with a "friendship group" may be a better option.
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 ADD do end up fitting in somewhere." Goth kids may look scary, but they may actually be less into drugs than the more clean-cut kids.
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 ADD kids often don't know how to respond. Parents should encourage their children to stand up to teasing without overreacting, which might escalate the problem.