By Laurie Jacobs, M.A., CCC-SLP
Children with Attention Deficit Hyperactivity Disorder (ADHD) face substantial social difficulties at school, but in the face of their learning challenges, these issues are often overlooked. Kids are either mislabeled as “behavior problems,” or their social issues are just slight enough to slide under the radar. As a result, they don’t qualify for professional services and are left to survive on their own in the harsh social environment of the American school.
Inattention. Impulsivity. Hyperactivity. Lack of empathy. These are well-known ADHD traits, and they are ones that prohibit 50-60% of children with the disorder from making friends and establishing healthy peer relationships (National Resource Center on ADHD). Most children acquire social skills through general experience and observation: watching their parents, copying the behavior of schoolmates, and learning from feedback. Over time, they pick up the nuances of conversation and are able to ascertain how their actions impact others.
However, because of the nature of their condition, children with ADHD miss many of these lessons. They never fully master the subtle social cues that allow for interpersonal success. They aren’t able to perceive what works and what doesn’t, so they repeat ineffective behaviors and experience repeated interpersonal rejection, which eventually leads to low self-esteem, depression, and anxiety. Long-term outcome studies have suggested that these problems only worsen as children grow into adulthood.
Fortunately for the millions of American children with ADHD, research by the Intragency Committee of Learning Disabilities and others has demonstrated that social skills training helps afflicted children to approach normal functioning in their personal and academic lives. Social competence training techniques can be implemented in any and every environment from school and home to community events and Internet chat rooms.
So where do we start? Well, as the adults in the ADHD child’s life, the first thing we must do is pay attention. In order to determine if social skills training will help a particular child, we must assess the nature and severity of his social deficits. Formal methods for doing so include standardized testing, but I prefer to interview the child’s caregiver and observe him interacting with his environment. Teachers can do this too, by watching the child during unstructured activities such as recess, and by using support staff to make note of breakdown times.
When I work with children with ADHD, I apply several “low-tech” (no technology) and “high-tech” (using technology) devices to teach social skills. Some of the successful low-tech applications are as follows:
- Create an “emotions scrapbook” using magazines and photographs
- Employ social skill workbooks and board games such as Do Watch Listen Say (Quill) and Boardmaker (Mayer-Johnson)
- Engage in one-to-one thematic and pretend play
- Form social skill groups with the child’s peers
- Read single-themed social stories and comic strips with the child
- Perform “social autopsies,” dissecting social situations as they occur in a non-accusatory, non-punishing way
All of these low-tech techniques facilitate the learning of critical social skills. In recent years, new technology and high-tech devices have allowed for the development of computer-based, interactive training methods. Such techniques are highly effective because they are designed to facilitate learning while providing opportunities to pause and discuss information, and to replay scenarios for greater recall and understanding. Specific high-tech exercises include:
- Using voice-recording systems to help the child identify topic maintenance, intonation and preseveration
- Watching television and videos, such as age-appropriate sitcoms or child-friendly soap operas, that feature dramatic emotions and social scenarios
- Practicing vivo or video modeling by having the child watch live players re-enact a social situation, or by taping the child and his peers in a social situation
- Using computer programs that depict social scenarios and asking the child to determine what should be said or done next
Available social training software includes the CD-ROM series from Social Skill Builder, which teaches children and adolescents the “rules” of social communication. Social Skill Builder’s CD-ROMs, My School Day, My Community, and the new School Rules Volumes 1 and 2, use interactive video sequences to imitate real-life social scenarios where children commonly interact with peers.
While social skills training can be implemented in many formats, it’s important to choose a method that allows the child to practice everything from appropriate social touch and speech volume to appropriate classroom behavior and lunchtime interaction in a safe, non-threatening environment. It should allow children to carry learned skills into everyday social interactions so that they can catch up to their peers and build the proper foundation for a happy, well-adjusted adulthood.