By Anthony Kane, MD
Developing healthy social relationships is critical in the development of a child. Children who learn to relate well to others are more likely to become happy well adjusted adults. Difficulty in making and keeping friends leads to feelings of low self-esteem and these feelings usually continue into adulthood.
In addition, childhood friendships provide a critical buffer against stress and help to protect against psychological and psychiatric problems. Children who lack these positive interactions frequently develop a number of emotional problems. Children with poor social skills do poorly in school. They are at risk for delinquency, academic failure, and school drop out.
ADHD children often lack the social skills that are essential to success in life. These children can be socially inept. Their lack of interpersonal skills may cause them a multitude of difficulties. More than half of these children have difficulty making and maintaining friendships. Even though the inattentiveness, impulsiveness, and restlessness frequently persist into adult life, these problems are of less importance as the ADD ADHD child gets older. The main difficulty ADHD people encounter as they reach maturity is their inability to interact appropriately with others.
As ADHD children grow older, their social problems seem to get worse. Their inappropriate behavior leads to further social rejection and exacerbates their inability to relate to others appropriately. As these children mature into adults, they are more likely to have difficulty finding and maintaining successful careers. This is not surprising since social aptitude can make or break careers and relationships in the adult world.
Having a Special Friendship
In the past, most of the ADHD research and treatment programs involving social interactions focused on how to improve the child's general standing among his peers. The results were less than satisfactory. The reason is that once the group views a child as an outcast, this label is hard to overcome. Even if the child changes the behaviors that originally caused this label, a reputation as a social outcast stays with him.
Fortunately, a study published in the April 2003 issue of the Journal of Attention Disorders took a new look at ADHD and peer relationships. The study focuses on the affects of helping ADHD children develop a single good friend. The researchers studied 209 5-12 year old children who participated in an intensive 8-week summer ADD ADHD child behavior treatment program.
The program was set up along the lines of a summer day camp. In addition to the usual components of such a program, like social skills training and behavioral training, the researchers added a "buddy system" to the program. The "buddy system" was implemented to promote the development of friendship skills. The program involved pairing each child with an age and gender matched "buddy". Buddies were also paired based on similarities in behavioral, athletic, and academic competencies and on whether children lived close enough together that play dates could occur outside of camp.
The parents were encouraged to have the child meet with his buddy outside of the time of the program. The goal was to have the children develop and maintain a single good friendship during the length of the program.
Results of the Buddy Program
Some of the results were as expected. Children who were more aggressive did not achieve as close a relationship with their buddy as the other children.
However, researchers uncovered two other points that are important to us. According to the evaluation by the staff, those children whose parents supported the buddy program by arranging play times outside of the camp setting, tended to form better relationships. More importantly, the children also felt themselves to more successful in making and sustaining the friendship.
Another important finding is that the type of buddy a child had affected his own academic success during the program. The more antisocial behavior a child's buddy displayed, the less likely teachers were to see academic or behavioral improvement in the child. Conversely, when a child's buddy was less antisocial, children were more likely to be regarded by teachers as making academic and behavioral gains.
What Does This Mean to Us?
How can you apply the results of this study? First, even if your ADHD child is suffering because his peers do not like him, you can significantly improve his situation by helping him find one or a few close friends.
However, there is a point of caution. What type of child becomes your child's close friend may have a significant impact on his academic standing and social behavior. The study showed that a well-behaved child will influence your child to behave better. Okay so you knew that already. But, we're scientists. Just because something is blatantly obvious to anyone else doesn't mean that it's obvious to us. So for us this is a major finding.
This just emphasizes how important it is for parents to monitor with whom their children play. You must work hard to keep your child from associating with antisocial peers. This can be critically important in preventing your child from developing antisocial behavior.
A final noteworthy point is that the success of a child making a close relationship with his buddy was largely related to how supportive the parents were. That means that you as a parent can influence your child and help him to develop a special close friend. You have the ability to direct your child properly so as to help him or her avoid one of the most devastating long term effects of having ADHD. It is up to you to help your child.
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