Teaching Social Skills to Children with Inattentive ADHD or ADD

Children with Predominantly Inattentive ADHD (ADHD-PI, also known as ADD), have difficulty with social skills. These children tend to lack assertiveness and frequently have difficulties in social situations that require interactions with more than one person or with people that they do not know.   They sometimes have problems with a sluggish cognitive tempo which may awkwardly delay their response to social interactions These kids may also be perceived by their peers as being as self centered and egotistical because they can appear standoffish as a result of their inattentiveness.

The good news is assertiveness and social skills can be taught. Extensive research has been done of teaching social skills to children with ADHD.  Children with Combined type (ADHD-C) and Hyperactive Impulsive ADHD (ADHD-HI) need training in cooperation, self control, and empathy.  Children with ADHD-PI need help with assertiveness, appearing approachable, and simple communication.  Studies have shown that social skills' training is extremely effective in improving communication, assertiveness, empathy, and social interactions. More importantly these studies have shown long term benefits in improving the school experience of children with ADHD.

I found two studies that looked at social skills training in children with ADHD-PI.  It seems that children with ADHD-PI are helped more by social skills training programs that children with combined type ADHD or children with ADHD and co-morbid Oppositional Defiance Disorder.

The first study performed on 59 children at the Children's Hospital-Boston found that children with ADHD-PI were helped more with social skills training than were children with the combined type of ADHD.  The children received 8 weeks of social skills training after which; "Children with ADHD-I improved in assertion skills more than children with ADHD-C."

The second study is ongoing and is taking place in Berkley.  Researchers at the University of California are conducting a longitudinal study of children with ADHD-PI. They are using a tool called the Child Life and Attention Skills Program (CLAS) to teach ADHD-PI children and parents both attention skills and social skills. The researchers are still recruiting participants but the first set of results, published a few years ago, concluded that; "Children randomized to the Child Life and Attention Skills Program were reported to have significantly fewer inattention and sluggish cognitive tempo symptoms, and significantly improved social and organizational skills, relative to the control group."  If you happen to live in the San Francisco area, you can contact the Department of Psychiatry at UC Berkley here to participate in this study.

Children with ADHD are generally aware of social cues.  They do not need to be taught to 'read' people's reactions to them.  Being unaware of social cues is one of the hallmarks of children and adults with Asberger's syndrome but it is generally not a problem for children with ADHD.  Children with ADHD-C and ADHD-HI have difficulty with self control but are still aware of the social impression that they are making.  Children with ADHD-PI are often keelnly aware of their social awkwardness and tend to avoid situations that will cause them to be embarrassed.

The social skills training tools that have worked the best to train children with ADHD include exercises that break down complex social situations into smaller components and train, one at a time, each component of the social interaction.  Role playing games are helpful as is modeling which involves having the child watch a model exhibiting the desired behavior. 

Social skills' training is generally a family affair.   Parents, siblings, and other family members are encouraged to participate in the training, provide encouragement to the children in training, and to help reinforce the behaviors that are being trained.  I will discuss the specific exercises, role playing, and other tools that have proved useful in my next post.

In conclusion, social skills' training has proven to be extremely beneficial in improving the self confidence and school experience of children with ADHD.  This training may be especially useful to children with a diagnosis of ADHD-PI.

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7 comments:

  1. Thanks for the post!

    From what I know it's more than just lack of assertiveness.PI people tend to direct negative emotions towards the inside instead of the outside - instead of becoming angry and rebellious like most people they become anxious and depressed.Instead of confronting authorities they pick up a pattern of "passive manipulation".

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  2. Me again

    You seem to know a few things about sluggish cognitive tempo. I would be glad to see a post (or few) about it.

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  3. Yes, you are right. There can be a component of this negative internal language that we have spoken about before. T

    The Automatice Negative Thought (A.N.T.) training is very successful for that problem. But,thanks, I need to remember the role that that plays as a component of this whole social picture!!

    I have also neglected to write at length about Sluggish Cognitive Tempo part of this puzzle. I will promise to post on that very soon.

    Thanks so much, both of you, for reminding my inattentive mind of what I have yet to talk about.

    What would I do without you?? (probably not much. Thanks so much!!)

    Tess

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  4. I really like your emphasis on breaking down social skills into small parts. This is how change occurs; learning one piece at a time!

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  5. I am so glad this is helpful. Thank you for reading!!

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  6. "Children with ADHD-PI are often keenly aware of their social awkwardness and tend to avoid situations that will cause them to be embarrassed."

    This is me all over. I wish I'd had this training as a child.

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