How parents can help children with ADHD thrive in friendships

“Vibrant” is how Caroline Poisson describes her seven-year-old son. “He’s incredible, enthusiastic and curious,” she said. “And then there’s a side of what we call kryptonite and we talk about his ADHD brain, where there are some things that are just really hard for him.” Like many kids with ADHD, Poisson’s son struggles with executive function skills – the cognitive abilities that help people plan, stay organized, pay attention, control emotions and make decisions. Without a good grasp on these skills it can be hard to make friends and strengthen the social skills needed to navigate adulthood.

Parents of kids with ADHD often say their kids miss social cues, such as when peers are bored, hurt or offended, according to Amori Mikami, a psychology professor at the University of British Columbia in Canada. “It can lead to a lot of outbursts or temper tantrums or whining and complaining or arguing with the friend,” she said. Mikami researches peer relationships, specifically focusing on children with ADHD. Additionally, she developed a parental friendship coaching (PFC) model where parents of elementary school-age kids can learn to support their child in making friends.

PFC programs can be found in participating mental health centers or specialized ADHD treatment centers. If a PFC program is not offered nearby, Mikami recommended sharing a link to the treatment manual with a local provider who has experience providing behavioral parent training for families of kids with ADHD and can work with the family to implement the treatment.

Participants meet with mental health professionals and other parents of kids with ADHD for 10 sessions over several weeks to practice strategies to improve their child’s social behavior. While the parental friendship coaching model can be used individually, a group format lends itself to community and collaboration among parents. Research trials of PFC have shown improvement in children’s social behaviors such as taking turns, sharing and negotiating. A key goal for many parents who use this approach is to help their child have successful playdates and — ideally — deepen their friendships.

Poisson, who found a PFC program online, had been in counseling herself after her son’s diagnosis and felt the program was a way that she could build on that support to help her son. Families where kids have started to be excluded from social activities with peers, are the ones who usually benefit from this program, according to Mikami. “The whole idea is that if your child doesn’t have any friends right now and really just doesn’t have the social skills to make friends, then throwing them in there on their own is too much and they need more scaffolding,” she said.

Building a strong parent-child relationship

When parents start PFC, the first things they focus on are strategies to strengthen their bond with their child. The parental friendship coaching model encourages parents like Poisson to spend special time connecting with their child so they’re more likely to be receptive to feedback. Examples of special time may include sitting with their child as they draw and narrating the process or letting the child teach the parent a game.

At times, Poisson’s son resisted her feedback when she tried to help him develop better friendship behaviors. “Many parents, especially parents of kids with ADHD, have had the experience where they tell their child something – and maybe it’s even really good advice – but it’s like the brick wall goes up. The child gets very defensive,” said Mikami. “That defensiveness often comes from kids just anticipating that they’re going to do something wrong and they’re going to get a lot of corrective feedback, even if in the parent’s mind it is very well meaning.” Poisson noticed that when she spent special time with her son, his oppositional behavior decreased.

Liubov Delegan, who immigrated from Ukraine to Vancouver, Canada around the time of her eight-year-old son’s ADHD diagnosis, said the parental friendship coaching program taught her to use active listening to strengthen her relationship with her child. Active listening means listening without jumping in with advice or criticism. When Delegan did that, she noticed that she asked her child more questions. “It gave more connection. It’s like ‘I can hear you. I hear what you’re saying and I’m interested in your opinion,’” she said.

Nurturing children’s friendship skills

Once the parent-child relationship is strong and secure, the PFC program guides parents in nurturing their child’s friendship skills, including negotiation, conflict resolution and perspective taking. Parents are uniquely positioned to be friendship coaches because they have a deep understanding of their child’s strengths, challenges and individual needs. While a child’s therapist can provide tips and strategies, parents have access to real time situations and can provide in-the-moment support. “It can be really hard for the child to learn the skills in therapy and then remember to apply them when they’re with their peers in a totally different situation outside of therapy,” said Mikami.

At a family game night, for example, parents may help their child improve social skills by incorporating breaks if the child gets worked up or praising the child when they are able to stay calm. Additionally, a parent might talk with a child about social cues to look for in playmates that show they might be bored.

To build her son’s friendship skills, Poisson used PFC’s corrective feedback strategies. When her son interacted with his peers she’d put emphasis on the behavior she’d like to see in the moment instead of focusing on what her son was doing wrong. “When you have kids with ADHD, it’s not intrinsic to them. They’re not able to necessarily pick up on all those social cues,” said Poisson. Before playdates, Poisson now ”frontloads” her son by talking to him about what it means to be a good friend and how a good friend might act.

Setting up successful playdates

Lastly, the PFC model helps parents learn how to structure successful playdates for their child.

“If you know your child is only likely to behave well in a certain situation for 30 minutes, set your first playdate for 30 minutes,” suggested Mikami. Other factors that are helpful include picking an appropriate friend for the playdate — a peer who has similar interests and encourages good behavior. A parent of a child with ADHD may initially choose to host playdates because they have more control over the environment than if their child is a guest at a peer’s house.

Although parents may feel the need to check in frequently during playdates, they learn in the PFC program that it’s important to make sure that their child experiences quality one-on-one time with their friend. Mikami said that there are ways for parents to monitor without being intrusive, such as doing laundry during the playdate, which requires walking in and out of the child’s room a few times. “Hopefully a lot of the coaching can be done before or after the playdate, not in front of the peer or not pulling the child out in the middle in a way that would look weird to the peer. That’s compromising autonomy.”

Instead of trying to stop things from happening, Poisson accepted the occasional bad playdate as part of the process. “And then we just reflect. ‘What were you doing?’ and ‘What were they doing’ and ‘What could you do?’” she said. Poisson found that when she let go of her own anxieties about how the playdates were going, she got better outcomes. Ultimately Poisson felt that her son’s playdates got better as she used the parental friendship coaching approach. “The biggest thing was for me to just kind of back off a little bit, trust him, use what they had given us, and then just see how it played out,” she said.

Parents aren’t supposed to be their child’s friendship coach forever, according to Mikami. “It’s meant to be an investment in the early stages of a relationship. And so once your child gains more of these friendship skills and hits it off with a peer, then parents should have a plan to back off,” she said.

Parental friendship coaching is one of many ways to improve social outcomes for kids with ADHD. Mikami encouraged parents to be kind to themselves as they try to meet their child’s needs. “Your child is a different, independent and sentient living being and is not going to do everything the way that you hope and everything is not going to work the way that you hope, whether your child has ADHD or is neurotypical,” said Mikami.

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