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Predominantly Inattentive children tend to be shy, withdrawn, and prefer to play on their own in the safety of their own 'world'.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.


  1. This comment really doesn't have much to do with this post but I feel I needed to reach out to you. First of all Tessa I want to say thank you. Finding your blog was like being handed a hot coffee from an old friend. We are at the beginning stages of getting my 7 son tested for ADHD-PI and after reading your blog as well as countless books I know exactly which side he got or from. The descriptions of an ADHD-pi head are exactly what goes on in my head. I have flashes of brilliance in my job, then I wonder when they are going to figure out I'm a fraud (I've been an secretary for 11 years with the same manager). Your posts on nutrition and routines for your family have helped a lot and we have even implemented some of it.

    I wanted to ask a couple of questions. I was wondering how an adult would go about getting tested? And would an official diagnosis make any difference?

    Keep up the good work and I would love to chat more

  2. Maura, Thanks so much for your kind comments. I love the coffee image! Most psychiatrist will give you a battery of questions to answer and then will decide if more testing is needed or if they are pretty convinced that you have ADHD. I feel that it makes a difference to have a diagnosis if your level of impairment is significant. If you feel that you are performing pretty poorly in many of your life endeavors then for the sake of your self esteem or for the sake of your job and family, treatment is in order. If you are getting along pretty well then some behavioral interventions such as getting help with organization, writing down goals, etc may be all you need. Keep me posted and thanks so much for reading!!

  3. Hi. I just found a link to your blog today. I have ADHD and so does my 8-year-old son. I have a Master in Education, but did not see the symptoms in either him or me until last year. Now I can see I had symptoms all along. I had a lot of problems with making friends in school. I was very shy and always self-conscious and would convince myself that no one liked me so I would just stay to myself. I still do that to some extent...

  4. It is so interesting. My 11 year old had his best friend over yesterday and I had to gently remind him several times that he had a friend over. He would sometimes hide in his room for a while as though he needed down time or something. Brain rest I guess from all that social stress stuff going on...


Note: Only a member of this blog may post a comment.