How You Can Be a Friendship Coach for Your Child with ADHD

by Amori Yee Mikami, PhD

MADISON HAS ADHD and her parents expend great efforts helping her to focus during homework time, to keep her backpack organized, and to remember to transport her materials to and from school. However, they are beginning to notice that while other children in their daughter’s third-grade class get together for playdates and birthday parties, these invitations don’t arrive for Madison. More concerning is the fact that Madison herself is suddenly realizing that she is left out. Madison’s mother says the child recently told her that she “wished she didn’t have to go to school anymore so that her best friends could just be her family.”

Many parents of children with ADHD are used to investing hard work into helping their children succeed academically. This is not surprising, given that most treatments focus on these children’s (very real) academic difficulties. Parents are less accustomed to handling their children’s social challenges, however, and there are fewer instructions available to them about how to help their children make friends. As in Madison’s family, many parents are not aware of the significance of their child’s social problems until some time after their child is diagnosed with ADHD. Yet, as is also illustrated by Madison’s situation, difficulties with peers can be hurtful and can reduce a child’s engagement in school, which ultimately hampers academic learning.

Common friendship problems in children with ADHD

Research suggests that the majority of elementary school-aged children with ADHD have nobody, or at most one other child, in their classroom who they would call a friend and who would similarly refer to the child with ADHD as a friend. Even when children with ADHD do have friends, the friendships tend to be less supportive and more conflict-filled than those of children without ADHD. Also, the friendships of children with ADHD are more likely to be “on again, off again” and marked by frequent declarations of “I’m not your friend anymore.”

Why do children with ADHD struggle with friendships? One reason is because the core symptoms of ADHD can interfere with these relationships. For example, what if the child with ADHD wants to play with toy cars but the peer is bored and would prefer to play something else? Because of inattention, a child with ADHD may not pick up on this social cue (the peer looks unenthused, starts looking around the room). A child with ADHD may also be unable to inhibit the overriding desire to play with the cars, even if he or she is aware that the peer is becoming bored.

As another example, what happens when the child with ADHD wins or loses a game? Because of poor impulse control, some children with ADHD will gloat with happiness upon winning or throw a tantrum out of frustration when losing. It can be difficult for children with ADHD to regulate their emotions and calm themselves down during times like these, but such behaviors can be extremely off-putting to peers.

Even if friendship difficulties begin with the behavior of the child with ADHD, the way peers respond can further the problem. The child with ADHD may develop a negative reputation among his or her classmates. Once this occurs, peers become disinclined to judge the child with ADHD objectively, so that even when he or she is behaving well, peers may never change their impressions. Children new to the classroom may hear negative things about the child with ADHD from peers, and this can make it tough for the child with ADHD ever to make friends.

Being excluded from social events such as playdates or birthday parties is also a common occurrence. Unfortunately, this can deprive the child with ADHD of opportunities to practice (and to get better at) social skills and to build friendships. The lack of social opportunities can compound the social-skill problems the child with ADHD had to begin with, which leads to the child with ADHD falling further behind peers in the friendship domain.

Become a friendship coach for your child

Does your elementary school-aged child with ADHD have social issues? Just as you can help your child succeed academically, you can help your child to make and keep friends. Here are some guidelines.

Build on a positive parent-child relationship. Children will be more likely to listen to constructive feedback and guidance about their friendship problems if they feel their parent is on their side. Think about the parallel with your own life: Do you want to improve your performance for a caring, positive boss, or for a critical boss who you can never please? In order to do this:
Spend special time with just you and your child alone, doing a fun activity without you directing, teaching, or criticizing your child.
Pick your battles wisely. If your child is doing ten things wrong, focus on the most crucial one or two first. Most adults and children can only handle working on one or two things at a time before they feel overwhelmed.
If your child is upset, try to be empathetic and listen to your child’s feelings first for ten minutes before you jump in and suggest what your child could do differently next time. If the problem is already in the past, then delaying ten minutes before you give constructive suggestions will not hurt anything.

Give friendship feedback. Try to keep the ratio of positive to negative feedback at about 4:1. Research has shown that this is a ratio that keeps adults happy with their marriages and jobs; children are no different. It is exceptionally hard to maintain this high ratio when parenting children with ADHD because of children’s behavior problems; most parents report they are nowhere near this ratio. In order to get there:
Start by praising for twenty-five percent correct. This actually encourages your child to try harder than if you wait around for your child to do something a hundred percent correct before you praise and your child never or rarely manages to do it.
Don’t spoil the praise by putting in a backhanded criticism, such as “You did a good job today, but why can’t you do this all the time?”
When your child has behaved badly and you do need to address the problem behavior:
Keep it specific to the behavior that needs to be changed and not about character.
Try to talk about the behavior that just occurred and not about what may have happened in the past.
If you feel yourself getting angry, it is okay to say to your child, “I am getting upset and I don’t want to say something I don’t mean. Let’s take a break to calm down.”
See the sidebar titled "Giving Your Child Friendship Feedback" for more tips about giving good friendship feedback.

Identify good potential friends. These should be same-age peers who seem already inclined to like your child (or at the least don’t dislike your child), share common interests with your child, and won’t be a bad or destructive influence. It’s more important to choose the right match for your child than to choose the most popular child in the class. Ideally you also want a peer who has a parent who can provide the supervision your child needs, and who will understand your child’s behavior.

Children with ADHD can be poor judges of who likes and does not like them. This may be because they miss social cues about liking from peers, or it may be because they want to have more friends than they truly do. You can help your child sort out who is a good potential friend by getting involved in your child’s activities to observe for yourself which peers seem to get along with your child or not. In order to identify good potential friends:
Ask your child who he or she likes to play with and why, and what they do together.
Ask the teacher (or group leader of an extracurricular activity) who in the class might be a good potential friend for your child.
Volunteer to help out in the classroom and in your child’s activities. Observe the children there to see who would be a good potential friend.
Hang out during activities and network with other parents. You will get to know them and they will be more likely to invite your child places.
If your child consistently wants to play with one peer who you think is a bad influence, make a pact with your child that the two of you will invite over someone else for two playdates first, and then if your child still wants to, you can invite over the peer that your child wants.

Arrange fun playdates. Playdates are the cornerstones to deepening friendships among elementary schoolchildren. Aim for one to two good, high-quality, supervised playdates per week for your child. If right now your child is having zero good playdates, however, it is more important to have one good playdate every month than to pack in two playdates per week where the quality suffers. See the sidebar below titled "Tips for Playdates" for tips on playdates.

Tips for supporting your teen socially

These friendship-coaching tips are best geared to parents of children with ADHD who are ages five through eleven. However, it is common for social problems to persist in adolescence. If you are the parent of a teenager, you can still help your son or daughter to make friends, but you must remember that it is normal for teenagers to not want their parents to be as involved in their social lives. So, as parents, you will have to find a nonintrusive way to remain helpful.

Try to develop a supportive relationship so that your teenager is willing to come to you for social advice. You can still foster social opportunities where your teenager can meet friends. This might not be through playdates, but rather through helping your teen to get involved in extracurricular activities or clubs.

As a parent, you can still give a teenager feedback about social skills, but it is important to include the teenager in this discussion collaboratively instead of just telling the teenager what needs to be changed. For example, you might ask in a nonjudgmental way how the teenager would like to be seen by his or her peers, and how the teenager thinks he or she is currently seen by peers. If there is a discrepancy between these two descriptions, you might state that you would like to help him or her to be perceived by peers in the way that he or she would like.

Take-home messages

Remind yourself that your child will have better and worse days as he or she is working on being a better friend. We all have ups and downs ourselves. Try not to get too discouraged with yourself or with your child when there are minor setbacks, so long your child’s friendship-making skills are improving overall.

Also, remember that your child does not need to be the most popular boy or girl in the class. In fact, sometimes children who are the most popular develop other problems. The goal is for your child to maintain a small group of close friends who truly like one another and can turn to each other for support. If you can invest in helping your child develop a few strong friendships, then this will set the stage for your child to become a happy and well-adjusted adult.

Giving Your Child Friendship Feedback

Here are some tips and examples of helpful and not-so-helpful comments from parents to children.

1. Keep it brief. It will be easier for your child to follow what you say.
Poor: In this last playdate you talked with your friend early on about who should go first, which your friend wanted to do, and I think that was helpful to lead to your friend feeling welcomed by you as a guest here.
Better: Nice job letting your friend go first.

2. Be specific. Your child needs to know exactly what behavior is expected.
Poor: Nobody likes it if you are a bad sport when you lose.
Better: If you lose you can say “good game” to the winner.

3. Stay in the present. This is especially important when you are giving negative feedback; the child can’t do anything about the past.
Poor: You always have to move your guest’s pieces in games. You did that today with your guest, you did it the last time we had a playdate too, and your teacher says this is a problem at school too.
Better: I think that your guest today wanted to move his own pieces in the game. Next time, you move your own when it’s your turn and let your guest move his own when it’s his turn.

4. Stay positive. Catch your child being good to encourage more of that behavior in the future.
Poor: You shared your dolls but then you really didn’t share your video games after that. You need to work harder on sharing the whole time.
Better: Awesome job sharing your dolls so well! Your friend really liked that.

Tips for Playdates

BEFORE THE PLAYDATE
Choose the right friend to invite over (see the section on identifying good potential friends).
Have your child and the friend decide in advance what they would like to do during the playdate. Then, plan the activity with your child and don’t leave a lot of unstructured downtime.
Put away (with your child) any toys that your child doesn’t want the guest to touch.
Have snacks on hand in case there is a period of boredom. Then you can bring out snacks and revitalize the interaction.
If there are poor friendship behaviors that your child consistently shows, pick no more than one or two to talk to your child about in advance. Tell your child you’ll be watching out for him or her to do well in these areas and (if necessary) you will give your child a reward afterwards for behaving well. Remember to tell your child the positive behavior you would like to see and to pick a standard that is slightly above your child’s current performance, but not so far above that it is unattainable.
Make the first playdate last no longer than one hour. Make it a shorter amount of time if you are not sure your child can behave for one hour. The guest should leave on a good note.

DURING THE PLAYDATE
If your child is showing minor behavior problems, calmly whisper a reminder in his ear.
If the behavior problems are more severe or if the reminder doesn’t work, ask to see your child in the other room and tell your child what behaviors need to be changed. If you do it privately with your child, it won’t make the guest feel awkward. If your child is behaving that poorly, the guest will have already noticed that, and will be relieved that you are doing something about it.
Unless the problems are so severe that someone is in danger, don’t send the guest home. The guest shouldn’t be punished for your child’s misbehavior. Plus, your child loses the opportunity to socialize. Give your child a different punishment afterwards. Then, ask yourself what you could do differently next time before the playdate to reduce the likelihood that this will happen again.

AFTER THE PLAYDATE
If true, tell the other parent that the children had a good time and you hope they can get together again.
Use the principles of effective feedback to tell your child specifically what was and was not good friendship-making. Remember the 4:1 ratio and to praise for even twenty-five percent correct.
If you had a contract with your child about how to behave, then give your child the rewards that you promised if your child showed these target behaviors.

When ADHD Runs in Families

Sometimes parents of children with ADHD have ADHD symptoms, too. This can make being a friendship coach for the child easier in some ways and more challenging in others. Here are some tips to remember:

Empathize with your child.
Having ADHD yourself can make you more patient and understanding when dealing with your child’s friendship difficulties. This has the positive benefit of building a good parent-child relationship so that your child trusts you to be on his side and help him as a friendship coach. Also, having ADHD may help you better anticipate your child’s social behaviors and needs.

Take things one step at a time.
Some parents with ADHD struggle with providing the level of structured, organized playdate that is recommended here. Just pick one friendship-coaching tip from this article that is realistic to try with your child first, and focus on doing that one tip well. It might help to write on your calendar which friendship-coaching tip you have chosen so that you are reminded about your goal. Once you practice the tip it will get easier, and then you can work on adding another friendship coaching tip later.

Work together as a team.
Some parents with ADHD have difficulty networking with other parents, similar to the difficulties that their child with ADHD has in relating to the other children. You and your child might both set a goal that, during soccer practice, both of you will talk to other adults and children to each think about one potential friend to invite for a playdate. Remember to celebrate your successes as a team afterward, too.

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Amori Yee Mikami, PhD, is an assistant professor of psychology at the University of Virginia. She is licensed as a clinical psychologist in the state of Virginia. Focused on youth with ADHD, her research aims to understand why some children have difficulties with peer relationships, and what might be the consequences of these social problems. Mikami received CHADD’s 2006 Young Scientist Award.

This article can be found on the CHADD website by clicking here.