While ADHD is characterized by inattention, hyperactivity, and impulsivity, there are a wide variety of other issues that children and families face. This list includes organization, behavior, and parent-child relationships. However, we focus here on two areas that are often important yet given little attention: peer relationships and appropriate activities for children with ADHD.
Peer Relationships
Children with ADHD often have significant difficulty in their peer relationships. In fact, research has shown that children with ADHD are much more likely to experience peer problems, including:
Difficulty making friends
Being bossy and demanding with other children
Frequently “burning through” friendships
Teasing and bullying
Teasing and bullying others
Being rejected or disliked by other children
Children with ADHD have a significantly higher rate of social difficulties than typically functioning children. They are 3 times more likely to report peer problems than other children, and 10 times more likely to report problems making friends or maintain friendships. These difficulties may be due to the core symptoms of ADHD, which often impairs children’s ability to successfully interact with peers. For example:
Hyperactivity and impulsivity are often associated with aggression, interrupting, social intrusion, and other disruptive social behaviors.
Children who are inattentive may seem shy or withdrawn, or have difficulty initiating social interactions.
Children with ADHD often have difficulty controlling their emotions, and may be very reactive in social settings.
Children with ADHD may have poor social skills. They may be more likely to interrupt, attempt to dominate social interactions, change topics in conversation, and have difficulty focusing on social activities.
These difficulties may result in children with ADHD choosing inappropriate peers as friends. Children with ADHD often demonstrate a preference for peers that are older or younger than them rather than same-aged peers. Children with ADHD also often associate with peers that also have emotional or behavioral difficulties. Having poor peer relationships, either through difficult peer interactions or having inappropriate friends, puts children at significant risk of emotional and behavioral difficulties. Children with difficult peer relationships are more likely to experience
Anxiety
Depression
School refusal
Behavior problems
Improving Peer Relationships
Although there is no definitive means to improve peer relationships, there are steps that can be taken to enhance and promote the social relationships of children with ADHD. Children with ADHD may benefit from:
Social skills training. This helps children learn the social skills required to understand, initiate, and maintain appropriate social interactions and monitor their behavior around others.
Anger management training, which can help children improve the way they express anger or frustration and reduce outbursts towards others.
Structured social interactions with friendly and tolerant peers, to help develop and practice appropriate social skills.
Peer Coaching or “Buddy” programs, where a child with ADHD is assisted in social interactions by a more socially appropriate peer.
Social activities that the child has interest and skill in, such as sports teams, scouts, music groups, or other shared interests.
Ensuring that social interactions are monitored by adults to prevent bullying and teasing.
Activities for Children with ADHD
Symptoms of ADHD occur across contexts in the child's life, meaning that children with ADHD often have similar difficulties in after-school activities as they experience in school. Symptoms of inattention, hyperactivity, and impulsivity may cause children to have difficulty following rules of activities (i.e., sports) and behave poorly. To be set up for success, children with ADHD should be involved in appropriate after-school activities with the proper preparation and circumstances. This may include:
Provide the child with necessary tools to succeed. If a child is medicated during the school day and performs well, continue to medicate the child during the after-school activity.
Select activities for the child in which they are interested in and are likely to be successful.
Make sure that instructors/coaches of after-school activities are experienced in managing the needs of children with ADHD. Be sure to communicate about the child’s needs with instructors/coaches to ensure that the child is successful.
Select activities that provide a structured routine for children. Children with ADHD are much more likely to be successful in activities that provide adequate structure and routine.
Be aware of the child’s fatigue at the end of the school day. Many children with ADHD become more overactive and poorly behaved when fatigued.
Activities to Select
Certain types of activities tend to have a more positive outcome with children with ADHD. Below are some suggested activities, although you should work with your child to identify their interests.
Activities with 1:1 instruction: Children with ADHD are often have difficulty focusing in group settings, and are less likely to be distracted in 1:1 instruction. Some common activities with 1:1 instruction include tennis, music lessons, and martial arts.
Active activities: Children with ADHD strongly benefit from physical activity and are more likely to prefer active activities. Hyperactivity is less likely to cause difficulties for children in active activities than in ones where they are sitting around. Some common active activities include swimming, running, soccer, basketball and dance.
Activities that require a single focus: Children with ADHD can often focus if only required to focus on one specific thing at a time. Activities requiring intense focus may also help improve their ability to focus in other parts of their life. Some common activities include swimming, running, archery, golf, and horseback riding
Activities that promote self-control: Activities that are highly structured and teach self-discipline can be very beneficial to children with ADHD. Martial arts is a good example of such activities
Activities that help build self-esteem: Children with ADHD often have difficulty sticking with activities, in part because they become easily frustrated when tasks are difficult. Activities that produce tangible rewards or help build self-esteem can be very rewarding to children with ADHD, and they may be more inclined to stick with these activities when they are difficult. Some common activities include community service projects, gardening, and art.
Activities to Avoid
All kids with and without ADHD are unique, and have different interests and talents. While an activity may be challenging for some children with ADHD, others children with ADHD may enjoy and succeed at them. However, there are certain types of activities that are inherently more difficult for children with ADHD. Specifically:
Activities that have long periods of inactivity: Children with ADHD have a very low threshold for inactivity and boredom, and may have difficulty with activities that require them to spend long periods of time inactive or waiting for their turn.
Activities that they do not hold their interest: Children with ADHD are much more successful at maintaining focus and behaving appropriately when they are interested in a task. It is not advisable to enroll children in activities for which they have no interest regardless of whether or not they have ADHD.
Activities that require divided attention: Children with ADHD have difficulty concentrating on multiple areas at the same time, and may struggle with activities that require them to shift their focus too frequently.
Activities that require fine motor skills: Many children with ADHD have somewhat less well-developed fine motor skills than their peers, and may thus struggle with activities that place too high a demand on fine motor control.
This does not mean that children with ADHD can not be successful in activities such as those listed above. However, parents should exercise caution before enrolling children with ADHD n activities that are more likely to be challenging for them.
