Predominantly Inattentive ADHD and Social Difficulties

Children with ADHD tend to have problems with their social skills. The problems that Predominantly Inattentive ADHD (ADHD-PI) children have are very different than the problems that the Hyperactive/Impulsive ADHD (ADHD-HI) children and the Combined type ADHD (ADHD-CB) children have but all children with ADHD run the risk of having fewer friends, of feeling lonely, of having problems with self esteem, and of suffering emotionally because of social skills that are immature or otherwise lacking.

A study done at Mt Sinai Hospital in New York looked at the social skill of kids with ADHD-PI and the social skills of kids with ADHD-C. The researchers controlled for comorbidities such as conduct disorder and Oppositional Defiance Disorder and what they discovered was that both these groups had social skills issues but the problems that they had were, not surprisingly, quite different. This is what they concluded; "Children with PI were impaired in assertiveness, whereas children with C were deficient in self-control. These findings indicate that AD/HD subtypes differ in the nature of their social dysfunction independent of comorbidity."

All children with ADHD also suffer from emotional maturity issues which affect their social skills.  Whereas at first glance it would seem that the self control issues that the Combined and Hyperactive/Impulsive subtypes have would be thoroughly disruptive to the establishment of long term friendships, the assertiveness issues of the Predominantly Inattentive are no less damaging to the child's ability to make and keep friends.

Predominantly Inattentive children tend to be shy, withdrawn, and prefer to play on their own in the safety of their own 'world'.  Many Predominantly Inattentive children tend to have an easier time relating to children that are a few years younger than them as these children present much less of a threat to them than their peers do.

Children with ADHD are often left out of playgroups, school cliques, and social invitations because of their lack of social skills.  School can be miserable for the child that constantly feels left out.  Many children dislike the academics of school but look forward to school because they enjoy the social aspect of spending time in the classroom with their friends.   Children with ADHD, who are struggling with the attention required at school and who do not engage socially with friends in the classroom, find life in the classroom to be sheer torture. Considering that children often spend 7-8 hours at school a day, it is not surprising that so many children with ADHD also suffer from anxiety and depression.

Good schools pay as much attention to a child's social development as to a child's academic development and a teacher can often help a child with both assertiveness and self control but the most important instruction of social skills must come from parents.  There is good news on that front.  Several published studies report that not only can social skills can be learned but that parents can play a significant roll in helping children learn these skills.

I will devote my next post to what we know about teaching socials skills to kids with ADHD.