It is important to note that children with ADHD are not a monolith and that our students experience symptoms along a spectrum, all of which contribute differently to problems with socialization and friendship development. The following post attempts to illuminate some of the noteworthy social dilemmas that children with ADHD face.
Students with ADHD often struggle with peer rejection due to hyperactivity-impulsivity, emotional dysregulation, and even the stigma of having an IEP/504 (Mikami & Normand 2015, DeWitt 2011). Students -- especially those socialized as girls -- may sometimes choose to “mask,” or hide their ADHD symptoms, in order to be accepted by their neurotypical classmates (ADHD/AS/Dyslexia Family Resources Brussels [AFRB] 2009). Children also may deal with rejection sensitivity, which means that they react in ways that are perceived to be extreme or inappropriate to peer rejection (e.g., shutting down, social withdrawal, explosive anger or sadness) (Bhandari 2020, HowToADHD, Lechene 2020). Because of "conduct problems" (Kok et. al. 2016, pg. 1) related to a deficiency in dopamine that helps children to "regulate emotional responses" (Duggal and Hammond 2020), children with ADHD may acquire the stigma of being unstable, unpredictable, or overly sensitive. Persistent inattention may also contribute to students' missed social cues; forgetfulness around social commitments; and the initiation of plans, relationships, and conversations (San Diego ADHD Center for Success). Additionally, sensory issues such as those that accompany the co-morbid condition of sensory processing disorder (SPD) may make children with ADHD adverse to physical touch such as hugging (sensory-avoidant) or, alternatively, a need to be touched and held all of the time (sensory-seeking) (Varnel 2019, San Diego ADHD Center for Success). The misunderstandings and stigmas that accompany the manifestation of symptoms contribute to a chain reaction of emotional instability caused by and causing unsteady friendships.
A literature review conducted by Kok et. al. around peer functioning in girls with ADHD states that "all of the thirteen studies included reported that girls with ADHD, compared to TD (typically developing) girls, demonstrated increased difficulties in the domains of friendship, peer interaction, social skills and functioning, peer victimization and externalizing behavior" (pg. 1). (Gender differences are discussed more explicitly in the post Struggles & Stigma for Girls* with ADHD.) Mikami and Normand note similar findings, citing children with ADHD's "difficulties in being accepted and befriended by peers, ... poor quality and stability in any friendships they do have.... and their tendency to have fewer, or no, reciprocated friendships" (Mikami & Normand 2015, pg. 30). They add that studies tend to focus on changing ADHD students' "inappropriate" behaviors and less on "effective treatments" for peer rejection, "multifaceted peer group factors" (such as the frequent development of cliques in school communities), and ableist framings of how children with ADHD should act (pg. 30). This handbook attempts to explore these gaps in research and suggest future directions for not only helping students with ADHD acquire important social-emotional skills but also "investigate approaches that help the typically developing peer group to reduce stigma about ADHD behaviors and enhance acceptability of individual differences" (pg. 35).
Because ADHD is in many ways an invisible disability -- meaning a student could have ADHD and someone wouldn't be able to tell by looking at them -- they may be labeled as careless, unsympathetic, and rude in the school community (CHADD) and be subject to "exclusionary behavior" and "reputational bias" that corroborate stigma and low self-esteem (Mikami & Normand 2015, pg. 32). Yet, as Mikami and Normand suggest, it is also important to analyze how children's interactions -- which are inevitably informed by ableist power dynamics and a need to conform -- and the negative behaviors of neurotypical children exacerbate the social-emotional challenges of students with ADHD. I explore this multidimensional relationship further in the page Friendship Development.
@stina905 ADHD can make some things hard we don’t even realize it affects. #bffgoals #friends #adhdprobs #tiktoktherapist #connection
♬ original sound - [ matt t ]
@nylabyo #adhdtiktok #adhdinwomen #adhdprobs #adhdfriends #friendship #adhd #love #peace
♬ original sound - julestheunicorn
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