The differing subtypes are not entirely homogeneous with regards to their social problems. People with Combined type ADHD (ADHD-C) or Hyperactive/Impulsive ADHD (ADHD-HI) may be more likely to behave impulsively or even aggressively towards their peers and they may be inappropriate in their social reactions and interactions. People with Inattentive ADHD may be less argumentative, impulsive or assertive but they will be equally sensitive to social feedback while appearing to others as self absorbed and uninterested in pursuing friendships.
All the ADHD subtypes may miss social cues, may have little awareness of their effect on others and may be emotionally immature. People with ADD and ADHD tend to socialize better with people who are much younger of much older as the social structure of these social interactions are better defined.
Teacher and parental coaching can be helpful for improving social skills. A study in the August, 2010 Journal of '"Abnormal Child Psychology" by Dr. AY Mikami demonstrated that parental coaching can be helpful for improving social skills in children with ADHD. In this study parents received instruction in how to arrange social settings in which their children were likely to succeed socially. The parents received eight, 90-minute sessions of instructions while the children received not treatment. The researchers found that children with parents who received training were more likely to be perceived by teachers to have better social skills though the teachers were unaware of which parents had received treatment.
Other studies have shown long term social skill improvements in people with ADHD when:
- People with Combined type (ADHD-C) and Hyperactive Impulsive ADHD (ADHD-HI) receive training in cooperation, self control, and empathy.
- People with ADHD-PI receive training in assertiveness, appearing approachable, and simple communication.
- All ADHD subtypes benefit from training in improving communication, empathy, and social interactions
- Role playing is used as a training tool. Role playing exercises break down complex social situations into smaller components and individual social skills can then be trained one at a time.
- Modeling tools are used for training. Modeling tools involve the use of a model to perform the desired social actions and behaviors while the individual with ADHD carefully observes the actions of the model.
- Social skills' training is a family affair and parents, siblings, and other family members are participate in the training.
- The social situation is a one on one.
- The social situation is of a limited length.
- The social interaction is with an older or younger person.
Social skills difficulties are common in people with ADHD. It is imperative that the social skills difficulties of people with ADHD be treated as the lack of positive social interactions is frequently cited as a common cause of low self esteem and depression. Individuals with ADHD who are impulsive, argumentative or oppositional are greatly improved by the use of ADHD medication and social skills training has been proven to be an effective tool for improving the social skills of people with ADHD.
Social skills training is available from many child psychiatrist and psychologist and is also sometimes offered by Occupational Therapist. Another therapy that can be tried at home is called Calm Kids and it was devised by a learning specialist. I have not tried this program but my neighbor reports that the Calm Kid program made a world of difference in the social skills of her 8 year old. Her son is more socially appropriate, more focused and less disorganized she reports as a result of the MP3s that come with this program. The Calm Kids link is here:
I'm interested in what Brain Balance – http://www.brainbalancecenters.com – has to say about the issue: that all neurobehavioral disorders have in common an underlying condition called functional disconnection syndrome. Their stance is that through diet, behavior modification, brain exercises and educational techniques that help make connections, you can reduce or eliminate symptoms. While their site doesn’t really talk cause (environment, genetics, etc.) it is worth a read, particularly the “truth” section. I think it gets to the heart of what you can DO once your loved one is affected. They are brain based, not drug based so it's a much more natural approach to improving brain function.
ReplyDeleteMy son goes to a private school, and this is the one issue that I wonder if would be better served in a public school arena. We don't have any social skills group, and my cuing doesn't seem to help. He's read a couple of books on social skills, but they seem more geared towards those children with Asperger's (I guess social skills deficits point to ADHD being on the very low end of the autism spectrum. Have you touched on this yet?). Anyway, I just saw on CNN that those with ADHD have a four times likely chance of having depression, and I have to believe that difficulty with social skills negatively impacts mental health.
ReplyDeleteJennifer, I'm going to check your link. That program sounds similar to Brain Gym.
I think I'm over-commenting on this blog, but I'm so thrilled to have this forum to learn and discuss!
This research proves exactly what us parents already see daily. It is good to have research confirm what we know. The social skill thing is one of our biggest struggles. My 7 year old rarely has empathy for others, and she does choose to play with kids much younger then herself. I'm ok with her playing with younger children because I understanf this is her social development stage. I figure that at 7 she is about 2-3 years behind in her social skills. We recently went to a playdate at the local Children's museum with about 5 other girls her age. She made a friend with a 5 year old none of us knew, and played happily with her the entire time.
ReplyDeleteDoes anyone know where I can read up on children and adults who mature much slower mentally than average due to ADD? Especially on the web. Also anyone ever use homeopathy for inattentive ADD? Would I go to a doctor for bext results rather than buy VAXA? Does it work? I got to tell you, I am an adult. I think that I act ok when I am at a round table event or something but I have no friends. It sucks. Is it that we inattentives just dont initiate? Is there a class anyone can take on initiation rather than assertion?
ReplyDeleteAnyone ever heard of hanging upside down for a holistic ADD treatment? I have heard of this for a Depression treatment.
ReplyDeleteThanks so much for all your comments and there is absolutely no such thing, in my opinion as over commenting. I think this really should be a conversation as there is so much to learn.
ReplyDeleteI found a study that indicated that the yoga sirsasana (headstand) practice impacts the autonomic nervous system. I would guess that if this posture helps depression it could not hurt ADHD. The autonomic nervous sytem in involved in stress response and in Neurotransmitter regulation. The regulation of neurotransmitters is thought to be at the heart of the problem of both ADHD and depression. Depression affects between 30% and 60% or people with ADHD and some people believe that people with Inattentive ADHD are more likely to have a co-morbidity of depression.
Russell Barkley has reported that people with ADHD are 30% less mature than people without this diagnosis. Studies performed using functional Magnetic Resonance are now proving that what Barkley reported seeing clinically is also now able to be demonstrated physiologically using brain imaging. Russell Barkley is the only author that I know of that has written about this immaturity. His web site can be found at the left.
The brains behind Brain Balance is a physician, Dr. Robert Melillo, author of Neurobehavioral Disorders of Childhood and the co-founder of Brain Balance Achievement Centers. We are learning more every day about how ADD/ADHD relate to autistic spectrum disorders, other developmental disorders and co-morbid disorders such as oppositional defiance and Tourette's disease. Dr. Melillo uses brain plasticity interventions to treat the brain's functional problems related to these disorders. Dr. Melillo has reported on how the function of the brain can be affected and improved using interventions such as allergen removal, cognitive behavioral processing and other non-medication modalities. I believe that we gain information on these treatment modalities using concrete evidence such as functional MRI we will be better able to understand how ADHD changes brain function and also better understand the effects of different interventions on improving brain function.
Also I do think that researchers are coming to see a relationship between ADHD and Autism spectrum disorder. Some folks believe that peer pressure improves the social skills of kids with ADHD as they tend to be less disruptive as they age. I do not know if peer pressure would help the other subtypes of ADHD but I doubt it would help the inattentive. I would see peer pressure as a move in the exact wrong direction for people with ADHD-PI. My inattentive son does wonderfully and loves to play with kids that are about 2 years younger than him. I think that this is fine and any social interaction is excellent for building social skills.
ReplyDeleteThanks to all of you for these insightful comments!!
I think that a person who has abundant social anxiety in addition to ADHD would find peer pressure more crippling than helpful.
ReplyDeleteThat is exactly what I think!
ReplyDeleteHi I’m a Graduate student researcher. I was wondering if possible I could get anyone feelings about Daily Report Cards?
ReplyDeleteI took an informal survey of ADHD parents and teachers and they all agreed that a weekly report is plenty. The kids felt as though they were over scrutinized as it is and the parents felt as though too much reporting would be inefficient.
ReplyDeleteThank you so much for this site! I have been searching for ANYTHING specificlly regarding PI ADD. My daughter was severely premature. We are so fortunate to have her, she has no indentifiable signs of her micro preemie days except..
ReplyDeleteI have been researching and suspecting this since she was 3 1/2! She is now 11. She does well in school, so teachers have been telling me she doesn't fit the mold for ADD. I finally said "enough" and she is being tested the end of this year.
Now that she is older she is able to verbalize that she does not really like groups. She also says that she is in la la land alot. Says she just stares or fixates on stuff that other poeple don't notice.
Her teachers each year comment that they do not know how she has done so well - she is always daydreaming.
Socially, my stomach is often in a knot because she really does not do well with girls her age and in groups. It's not the kids don't like her, its that they don't even know she is there! She is lost in the crowd...always. Although she does not complain, I see that she gets nervous when trying to hold conversations with her peers. Often I see peers greet her or attempt to approach her, and she does not even know they are there): I want to help her before her self esteem is damaged beyond repair.
Again - thank you!!!
These kids are so similar in so many ways. It is hard to watch from our angle and all we can do is be there for them and make sure that they know that we see and appreciate them. Thanks for writing!!
ReplyDelete