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Understanding the Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on Childhood Friendships

Updated: May 20

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental disorders in childhood. Children with ADHD often struggle with paying attention, controlling impulsive behaviors, or managing excessive physical movement. There are two main subtypes of ADHD – inattentive and hyperactive/impulsive – though some children exhibit a combination of both. 


What Does Attention-Deficit/Hyperactivity Disorder (ADHD) Look Like in Children? 

The patterns of behavior seen in Attention-deficit/hyperactivity disorder can significantly interfere with a child's development and daily functioning, impacting academic performance, social interactions, and overall well-being. With recognition of ADHDs impact on a child’s development and daily functioning parents and caregivers must understand more about this disorder and how it manifests. Foundational knowledge of this disorder can prompt early recognition and intervention that can make a substantial difference in a child's life trajectory. 


While behaviors like inattention, hyperactivity, and impulsivity are common to some degree in all children, what sets ADHD apart is the severity and persistence of these behaviors. Children without ADHD may exhibit such behaviors occasionally, but for those with Attention-deficit/hyperactivity disorder, these patterns are more frequent, intense, and disruptive compared to peers of the same age and developmental level. 

A friend group of children with backpacks heading to school. Showing positive signs of friendship and social behavior.

Inattention vs. Hyperactivity: Subtypes of ADHD in Children 

While some children exhibit characteristics of both subtypes, understanding the core presentations of inattention and hyperactivity is crucial for identifying ADHD and developing appropriate strategies to support these children in their daily lives, including fostering healthy social interactions and friendships. 



The inattentive subtype of ADHD manifests in children as limited attention spans, distractibility, forgetfulness, and procrastination. These patterns of inattention can present in several ways: 

  • Trouble organizing activities and tasks. 

  • Being easily distracted by external stimuli. 

  • Avoidance of tasks that require sustained focus and effort, such as homework. 

  • Difficulty following instructions, even simple ones. 

  • Appearing not to listen, even when spoken to directly. 

  • Forgetfulness in daily activities and routines. 

  • A spacey or unmotivated demeanor. 

Children with the inattentive subtype may struggle to remain engaged and on task, often appearing as though their minds are elsewhere. 


The hyperactive subtype of ADHD is characterized by difficulty with self-control, restlessness, and an inability to remain still or engage quietly. Common patterns of hyperactivity in children include: 

  • A constant need for motion or fidgeting. 

  • Excessive talking or interrupting others. 

  • Difficulty waiting their turn. 

  • Frequently interrupting others or intruding on activities. 

  • Acting impulsively without considering the consequences. 

  • Struggling to engage in quiet activities.  

Navigating Friendships in Children With ADHD 

ADHD impacts every aspect of a child's life, including the ability to form and maintain friendships. While academic and behavioral challenges are more widely discussed, the social and emotional difficulties faced by children with ADHD are just as significant. 


As children begin to navigate the world around them, their peers become increasingly important. Peer relationships aid in fostering a sense of belonging, help to understand group dynamics, and teach crucial social skills, boosting self-esteem and overall well-being. These interactions teach identity, social cues, and proper behavior. Friendships in childhood are more than just having someone to play with; it is the foundation upon which vital life skills are built. 


The Core Challenges: Social Cognition and Emotional Regulation 

For children with ADHD, building and maintaining successful friendships requires navigating two significant hurdles within the disorder: social cognition and emotional regulation. 

Social cognition refers to the ability to identify and interpret social cues, understand mental states, emotions, motives, and desires. It is the emotional intelligence that guides how children engage with those around them.  


Emotional regulation involves having an appropriate emotional response, energy level, and control for different situations. It is crucial for positive interactions, managing distress levels, and understanding emotions in relation to the world.  


Social Cognition 

For a child with ADHD, social cognition poses a significant challenge. Their heightened emotions, behavioral struggles, and difficulty perceiving others' perspectives hinder their ability to navigate social interactions effectively. These skills are less intuitive for them, leading their peers to perceive them as different due to their inconsistent engagement in age-appropriate behavior. 


When a child experiences inattentiveness due to ADHD, they may appear disinterested or defiant to their peers, despite not intending to be. Understanding social cues, such as when to speak and how to regulate volume or intensity, can be particularly challenging for them. 


Additionally, hyperactivity, another characteristic of ADHD, can manifest in behaviors that seem overly aggressive or excited to others. Their tendency to "over behave," such as not waiting their turn or unintentionally intruding on activities, can strain social interactions as peers perceive their behavior as inappropriate or hurtful, even though the child may not fully grasp the impact due to difficulties in self and other perception. 


Emotional Regulation 

Emotional regulation is particularly complex for those with ADHD. The foundational mechanisms of regulation, such as behavior control and expression, are the same areas impacted by the disorder, intensifying the complexity of managing emotions. 


Children with ADHD exhibit diverse ways of expressing their emotions, often characterized by intensity and exacerbation. These intense emotions can heighten sensory experiences and potentially trigger dysregulated behavior. 


It is important to note that these emotional responses are not inherently "bad" or "good" and may not always align with intention. Due to limited self-perception and understanding, children with ADHD may match the intensity of their emotions, leading to perceived overreactions or exaggerated responses in comparison to the situation at hand.  


The interaction of various triggers and responses can disrupt social, emotional, and environmental patterns, further complicating the regulation of emotions. For example, these children frequently experience heightened frustration due to the learning and comprehension challenges associated with ADHD.  


Given their limited self-perception and understanding, children with ADHD often require additional support in self-soothing and calming techniques to regulate their emotions effectively. 

Parent hugging child with care. Promoting healthy relationship and care.

Strategies For Fostering Social and Emotional Growth 

While the social and emotional challenges posed by ADHD can seem intimidating, there are strategies that parents, caregivers, and peers can employ to help children further develop these crucial skills. The foundation of nurturing these skills lies in practice and observation – children learn best when they can actively engage in and witness the desired behaviors. 


By incorporating these strategies into a child's daily routine, you will be equipping them with the tools they need to build and sustain meaningful friendships – a vital component of their overall well-being and personal growth. 


Taking Turns and Sharing 

One of the fundamental building blocks of friendship is the ability to take turns and share. Demonstrate these behaviors explicitly with the child, showing them how to politely wait their turn and share their toys or possessions. Reward them when they exhibit these behaviors appropriately and reinforce the positive emotions associated with sharing and taking turns by using phrases like "please" and "thank you." 


Resolving Conflict 

Conflict resolution is another vital skill for maintaining friendships. When conflicts arise, take the time to identify the root cause of the heightened emotions or disagreement. This momentary pause allows the child to practice self-soothing techniques rather than acting on impulse. Work with them on developing emotional impulse control, and approach the situation neutrally, showing them the cause-and-effect of their actions. 

Focused Attention 

Engage the child in activities that require their focused attention, maintaining both verbal and non-verbal cues to model active listening skills. Encourage them to mirror these behaviors, immersing them in the experience of communication while minimizing distractions. This practice will help them develop the attentiveness and display of understanding necessary for successful social interactions. 


Arranging Playdates 

While group settings such as school and afterschool activities can be overstimulating for children with ADHD, arranging one-on-one playdates can provide a safe environment for them to practice their friendship skills. These individual interactions often allow children with ADHD to thrive and feel confident as they interact with a peer in a minimally distracting environment. It may also provide the unique opportunity to be present during these social interactions, you can guide them through conflict resolution, turn-taking, and maintaining attention when needed all while observing areas that may need some extra work.  


In conclusion, ADHD poses unique challenges for children, affecting their social and emotional development. Understanding the core presentations of ADHD, including inattention and hyperactivity, is essential for accurate diagnosis and tailored support. While the social and emotional challenges posed by ADHD can appear overwhelming, there are strategies that parents, caregivers, and peers can employ to help children further develop these crucial skills. By addressing the interrelated issues of social cognition and emotional regulation, caregivers can provide crucial support, fostering the growth and well-being of children with ADHD. Through patience, consistency, and understanding, we can empower these children to thrive socially and emotionally, laying the foundation for a fulfilling life. 

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