About half of all children with attention deficit–hyperactivity disorder (ADHD) have significant problems with their peer relationships. These social difficulties appear to be related to a high rate of intrusive behavior, deficits in conversation and reciprocity, social–cognitive biases, and poor emotional regulation. Social skills interventions have been advocated to teach children and adolescents how to interact more successfully with their peers. To date, few studies have systematically evaluated social skills interventions for children with ADHD. However, studies with children and adolescents who are disruptive have pointed to serious limitations in the generalization of treatment effects to the natural environment and questionable changes in peer relationships as a result of these treatments. These limitations and potentially useful adjunctive and alternative treatment strategies are discussed, including careful attention to setting events, the strategic use of peers, and the impact of medications on peer interactions.
Get full access to this article
View all access options for this article.
References
1.
Anderson, C. G., Rush, D., Ayllon, T., & Kandel, H. (1987). Journal of Child and Adolescent Psychotherap., 4, 294–298.
2.
Barkley, R. A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford.
3.
Barkley, R. A., Fischer, M., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria, I: An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546–557.
4.
Berndt, T. J. (1982). Contributions of peer relationships to children's development. In T. J. Berndt & G. W. Ladd (Eds.), Peer relationships in child development. New York: Wiley.
5.
Bierman, K. L. (1986). Process of change during social skills training with preadolescents and its relation to treatment outcome. Child Development, 57, 230–240.
6.
Bierman, K. L., & Furman, W. (1984). The effect of social skills training and peer involvement on the social adjustment of preadolescents. Child Development, 55, 151–162.
7.
Camp, B. W., Blom, G. B., Hebert, F., & van Doornick, W. J. (1977). Think Aloud: A program for developing self-control in young aggressive boys. Journal of Abnormal Child Psychology, 5, 157–169.
8.
Campbell, S. B., & Paulauskas, S. (1979). Peer relations in hyperactive children. Journal of Child Psychology and Psychiatry, 20, 223–245.
9.
Chandler, L. K., Fowler, S. A., & Lubeck, R. C. (1992). An analysis of the effects of multiple setting events on the social behavior of preschool children with special needs. Journal of Applied Behavior Analysis, 25, 249–264.
10.
Clark, M. L., Cheyne, J. A., Cunningham, C. E., & Siegel, L. S. (1988). Dyadic peer interactions and task orientation in attention deficit disordered boys. Journal of Abnormal Child Psychology, 16, 1–15.
11.
Cowen, E. L., Pederson, A., Babigian, H., Izzo, L. D., & Trost, M. A. (1973). Longterm follow-up of early detected vulnerable children. Journal of Consulting and Clinical Psychology, 41, 438–446.
12.
Cunningham, C. E., & Siegel, L. S. (1987). Peer interactions of normal and attention-deficit disordered boys during free-play, cooperative task, and simulated classroom situations. Journal of Abnormal Child Psychology, 15, 247–268.
13.
Cunningham, C. E., Siegel, L. S., & Offord, D. R. (1985). A developmental dose-response analysis of the effects of methylphenidate on the peer interactions of attention deficit disordered boys. Journal of Child Psychology and Psychiatry, 26, 955–971.
14.
Deluty, R. H. (1981). Alternative-thinking ability of aggressive, assertive, and submissive children. Cognitive Therapy and Research, 5, 309–312.
15.
Dodge, K. A. (1980). Social cognition and children's aggressive behavior. Child Development, 51, 162–170.
16.
Dodge, K. A. (1983). Behavioral antecedents of peer social status. Child Development, 54, 1386–1399.
17.
Dodge, K. A., & Coie, J. D. (1987). Social information processing factors in reactive and proactive aggression in children's peer group. Journal of Personality and Social Psychology, 6, 1146–1158.
18.
Dodge, K. A., & Newman, J. P. (1981). Biased decision making processes in aggressive boys. Journal of Abnormal Psychology, 90, 375–379.
19.
Dumas, M. C. (1993). The relative contributions of peer evaluation and behavior to the sociometric evaluation process and children's memories of evaluated children. Unpublished doctoral dissertation, California School of Professional Psychology–San Diego.
20.
Dumas, M. C., Guevremont, D. C., Anastopoulous, A. D., Murphy, K., & Barkley, R. A. (1993, November). Conversational skills of ADHD, ADHD/ODD, and normal adolescents. Paper presented at the Association for Advancement of Behavior Therapy, Atlanta, GA.
21.
Elder, J. P., Edelstein, B. A., & Narick, M. M. (1979). Adolescent psychiatric patients: Modifying aggressive behavior with social skills training. Behavior Modification, 3, 161–178.
22.
Feindler, E. L., Ecton, R. B., Kingsley, D., & Dubey, D. R. (1986). Group anger control training for institutionalized psychiatric male adolescents. Behavior Therapy, 17, 109–123.
23.
Feindler, E. L., Marriott, S. A., & Iwata, M. (1984). Group anger control training for junior high school delinquents. Cognitive Therapy and Research, 8, 299–311.
24.
Fischer, M., Barkley, R. A., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria, II: Academic, attentional, and neuropsychological status. Journal of Consulting and Clinical Psychology, 58, 580–588.
25.
Foster, S., DeLawyer, D. D., & Guevremont, D. C. (1985). Selecting target behaviors for social skills training in children and adolescents. In K. D. Gadow (Ed.), Advances in learning and behavior disabilitie. (Vol. 4, pp. 77–132). Greenwich, CT: JAI.
26.
French, D. C. (1988). Heterogeneity of peer-rejected boys: Aggressive and non-aggressive subtypes. Child Development, 59, 976–985.
27.
Granger, D. A., Whalen, C. A., & Henker, B. (1993). Perceptions of methylphenidate effects on hyperactive children's peer interactions. Journal of Abnormal Child Psychology, 21, 535–549.
28.
Grenell, M. M., Glass, C. R., & Katz, K. S. (1987). Hyperactive children and peer interaction: Knowledge and performance of social skills. Journal of Abnormal Child Psychology, 15, 1–13.
29.
Guevremont, D. C. (1990). Social skills and peer relationship training. In R. A. Barkley (Ed.), Attention deficit hyperactivity disorder: A handbook for diagnosis and treatmen. (pp. 540–572). New York: Guilford.
30.
Guevremont, D. C., & Dumas, M. C. (1993). An analysis of setting events and the social behavior of ADHD boys. Unpublished manuscript, University of Massachusetts Medical Center, Worcester, MA.
31.
Guevremont, D. C., & Foster, S. (1993). Impact of problem-solving on aggressive boys: Skill acquisition, behavior change, and generalization. Journal of Abnormal Child Psychology, 21, 13–27.
32.
Guevremont, D. C., MacMillan, V., Shawchuck, C. R., & Hansen, D. J. (1989). A peer-mediated intervention with clinic-referred socially isolated girls. Behavior Modification, 13, 32–50.
33.
Hamlett, K. W., Pellegrinni, D. S., & Conners, C. K. (1987). An investigation of executive processes in the problem-solving of attention deficit disorder-hyperactive children. Journal of Pediatric Psychology, 12, 227–240.
34.
Hansen, D. J., St. Lawrence, J. S., & Christoff, K. A. (1989). Group conversational-skills training with inpatient children and adolescents. Behavior Modification, 13, 4–31.
35.
Hansen, D. J., Watson-Perczel, M., & Christopher, J. M. (1989). Clinical issues in social-training with adolescents. Clinical Psychology Review, 9, 365–391.
36.
Hinshaw, S. P., Henker, B., & Whalen, C. K. (1984). Self-control in hyperactive boys in anger-inducing situations: Effects of cognitive–behavioral training and of methylphenidate. Journal of Abnormal Child Psychology, 12, 55–77.
37.
Hoy, E., Weiss, G., Minde, J., & Cohen, N. (1978). The hyperactive child at adolescence: Emotional, social, and cognitive functioning. Journal of Abnormal Child Psychology, 6, 311–324.
38.
Hymel, S. (1986). Interpretation of peer behavior: Affective bias in childhood and adolescence. Child Development, 57, 431–445.
39.
Kazdin, A. E., Esveldt-Dawson, K., French, N. H., & Unis, A. S. (1987). Problem-solving skills training and relationship therapy in the treatment of anti-social child behavior. Journal of Consulting and Clinical Psychology, 55, 76–85.
40.
Ladd, G. W. (1981). Effectiveness of a social learning method for enhancing children's social interactions and peer acceptance. Child Development, 52, 171–178.
41.
LaGreca, A. M., & Santogrossi, D. (1989). Social skills training with elementary school students: A behavioral group approach. Journal of Consulting and Clinical Psychology, 48, 220–227.
42.
Landau, S., & Milich, R. (1988). Social communication patterns of attention deficit disordered boys. Journal of Abnormal Child Psychology, 16, 69–81.
43.
Lee, D. Y., Hallberg, E. T., & Hassard, H. (1979). Effects of assertion training on aggressive behavior of adolescents. Journal of Counseling Psychology, 26, 459–461.
44.
Lochman, J. E. (1985). Effects of different treatment lengths in cognitive-behavioral interventions with aggressive boys. Child Psychiatry and Human Development, 16, 45–56.
45.
Lochman, J. E., Burch, P. R., Curry, J. F., & Lampron, L. B. (1984). Treatment and generalization effects of cognitive behavioral and goal setting interventions with aggressive boys. Journal of Consulting and Clinical Psychology, 52, 915–916.
46.
Lochman, J. E., & Curry, J. F. (1986). Effects of social-problem solving training and self-instructional training with aggressive boys. Journal of Clinical Child Psychology, 15, 159–164.
47.
Maloney, D. M., Harper, T. M., Braukmann, C. J., Fixen, D. L., Phillips, E. L., & Wolf, M. M. (1976). Teaching conversation-related skills to predelinquent girls. Journal of Applied Behavior Analysi., 9, 371.
48.
Mendelson, W., Johnson, N., & Stewart, M. (1971). Hyperactive children as teenagers: A follow-up study. Journal of Nervous and Mental Diseases, 153, 273–279.
49.
Milich, R., & Dodge, K. A. (1984). Social information processing in child psychiatric populations. Journal of Abnormal Child Psychology, 12, 471–490.
50.
Milich, R., & Landau, S. (1982). Socialization and peer relations in hyperactive children. In K. D. Gadow & I. Bialer (Eds.), Advances in learning and behavior disabilitie. (Vol. 1, pp. 283–339). Greenwich, CT: JAI.
51.
Milich, R., Landau, S., Kilby, G., & Whitten, P. (1982). Preschool peer perceptions of the behavior of hyperactive and aggressive children. Journal of Abnormal Child Psychology, 10, 497–510.
52.
Oden, S., & Asher, S. R. (1977). Coaching children in social skills for friendship making. Child Development, 48, 495–506.
53.
Parker, J. G., & Asher, S. R. (1987). Peer relations and later personal adjustment: Are low-accepted children at risk?Psychological Bulleti., 102, 357–389.
54.
Pelham, W. E., & Bender, M. E. (1982). Peer relations in hyperactive children: Descriptions and treatment. In D. Gadow & I. Bialer (Eds.), Advances in learning and behavioral disabilitie. (Vol. 1, pp. 365–436). Greenwich, CT: JAI.
55.
Robins, L. N. (1966). Deviant children grown up. Baltimore: Williams & Wilkins.
56.
Spence, S. H., & Marzillier, J. S. (1979). Social skills training with adolescent male offenders–I. Short-term effects. Behaviour Research and Therapy, 17, 7–16.
57.
Spence, S. H., & Marzillier, J. S. (1981). Social skills training with adolescent male offenders–II. Short-term, long-term, and generalized effects. Behaviour Research and Therapy, 19, 349–368.
58.
Strain, P. S., & Fox, J. J. (1981). Peers as behavior change agents for withdrawn classmates. In A. E. Kazdin & B. B. Lahey (Eds.), Advances in child clinical psycholog. (pp. 167–198). New York: Plenum.
59.
Weiss, G., Hechtman, L., Milroy, T., & Perlman, T. (1985). Psychiatric status of hyperactives as adults: A controlled prospective 15-year follow-up of 63 hyperactive children. Journal of the Academy of Child Psychiatry, 24, 211–221.
60.
Whalen, C. K., Henker, B., Collins, B., Finck, D., & Dotemoto, S. (1979). The social ecology of hyperactive boys: Medication effects in structured classroom environments. Journal of Applied Behavior Analysis, 12, 65–81.
61.
Whalen, C. K., Henker, B., Collins, B. E., McAuliffe, S., & Vaux, A. (1979). Peer interactions in structured communication task: Comparisons of normal and hyperactive boys and of methylphenidate (Ritalin) and placebo effects. Child Development, 50, 388–401.
62.
Yu, P., Harris, G. E., Slovits, B. L., & Franklin, L. (1986). A social problem-solving intervention for children at high risk for later psychopathology. Journal of Consulting and Clinical Psychology, 13, 30–40.
