Challenges in Common
Kids with ADHD have many traits in common with some children with Autistic Spectrum Disorders (ASD) – namely those with high-functioning autism. 18% of ADHD children tested also have autistic traits, according to researchers at Massachusetts General Hospital. Both ADHD kids and those with ASD have psychosocial difficulties and are more likely to be rejected by peers, experience behavioral problems at school, have difficulties with siblings, and get into fights. Mood disorders, anxiety, and language disorders are common in both groups as well. Developing social skills is especially important for these kids to avoid the trauma of peer rejection in childhood.
Some of the triggers for ASD kids are also challenges for ADHD kids: Overstimulation from smells, sounds, and sights can overwhelm a child. Difficulty understanding abstract uses of language create frustration when children interpret jokes or idioms literally. Not picking up on social nuances can make it difficult to “fit in,” and impulsive or self-stimulating behavior can make a child a target for teasing. But social skills can be practiced and learned, and your child can get better at sharing, picking up on social cues, and making friends.
Developing social skills is an ongoing process, but here are three strategies you can employ at home to help.
1. Play games together.
Not video games, but board games. The kind of games that require sitting down together, taking turns and interacting. Discuss the rules, take turns, and let your child practice frustration tolerance. It’s important that you don’t let them cheat or win every time! They might resist playing these games (after all, Minecraft is more fun and does not require taking turns), but one of the lessons here is that you sometimes need to play what the other person wants to play. If your child wants to play with you, get them to play a game of your choosing before an activity of their choice. You could also try a reward. In my house, the kids can earn a token for 35 minutes of screen time to use on a non-school night if they play a board game together or with me.
Getting them to play can be tedious at first, especially if you are doing it right and insisting they play fair, but they will start to enjoy it. Make them practice exactly what is difficult for them. That might mean making them play by the rules, or if your child is very rigid (an ASD trait), you may suggest a new rule to let them practice tolerating a change when playing with others. Explain why it’s important to play this way with others and discuss how other kids are likely to react if your child cannot be flexible or is intolerant of losing. I know it’s not the easiest way to play a board game, but think of it as skills-building.
Over time, they will learn to appreciate that playing games with others involves some winning and some losing and that taking turns and being flexible makes them better friends. For a few ideas, here are our favorite games:
Ravensburger Labyrinth: Gain the advantage over the other players by inserting the extra tile to move walls and open passages of the Labyrinth. Learn cause and effect, planning and strategy, association, recognition, and taking turns. Ages 8 and up(but my son has played this from age 6). For 1-4 players.
Ravensburger Enchanted Forest: The king’s castle in the enchanted forest reveals the treasures you must find. Roll the die to determine the distance you move, making your way to the trees to see what treasures are hidden under them. Once you’ve found the treasure, make your way to the castle so that you can announce where it is. The first player to correctly announce the location of three treasures wins! For ages 6 and up. 1 – 4 players.
Indigo Family Game: Indigo is a board game of intricate pathways and twists with players competing to gather precious gems, including the blue sapphire. Gameplay involves laying pathways along the board on which players move gems toward the exits on the board’s edge. Indigo is a quick-play game with simple instructions for 2-4 players, ages 8 and up.
2. Practice Social Review
“Social review” is a method of developing social skills by observing social interactions together to learn from them. Due to difficulties understanding nonverbal communication and body language, ADHD and ASD kids may not notice subtle clues when another person needs more personal space. When someone is not interested in the topic of conversation or wants to change the subject, most people rely on signals like the person looking away or crossing their arms, but these clues must be taught to some children. If social review is used in formal treatment, a child might be videotaped having interactions with others and given an opportunity to watch it afterward to discuss their perceptions.The adult can reflect back what the child or teen thought about it as well as how they interpreted the interaction.
A DIY alternative to formal social review is to observe the interactions of others when you’re out with your child or to watch TV shows together on mute. In this way, you can focus not on the content of what is being said, but the context. Ask your child to notice if the conversation is taking place in a private place or a public space? Do you see one person leaning away when the other person is talking? That indicates they need more space or feel overwhelmed. Do you see turn-taking or sharing? If not, do you see arguing or an upset facial expression? What other facial expressions do you see? Do you see any touching? Is it casual, like a hand touching a shoulder or closer like a hug? Why is one or the other probably more appropriate here? This can be adapted to the developmental stage and needs of your child. You might focus on appropriate touching, issues of personal space, or even the effects of poor hygiene in interactions, depending on your child.
3. Use Social Narratives
It is often difficult for autistic children to identify what others think and feel, making it hard to predict how other people might act in a given situation. Adapting to changes in routine is particularly challenging for both ADHD and ASD kids. Inaccurate expectations can be a setup for disappointment, so helping a child predict what they can expect, as well as variations that could occur, can help minimize meltdowns.
Social narratives are descriptions of situations or processes that are provided in whatever way works best for your child’s learning style. Narratives may be presented in writing or with pictures; some even use video. For my kids, verbal narratives work well, but I use writing for new routines and rules. This strategy is great for preparing a child for an upcoming event or change (moving or vacation), for clarifying expectations (how things are different at Grandma’s house), or for any situation that might be overwhelming or likely to elicit a reaction (unmet expectations at a Christmas visit, for example).
The narrative is simply a “story” that helps them anticipate what they may encounter. This is your chance to tell them what is expected (and what isn’t, if they tend to get disappointed easily), as well as how others may behave or what they might ask or say. You can also plan ahead what to do if your child does get overwhelmed. Is there a safe place to get away or a way to handle overstimulation? This should be tailored to your specific child with an understanding of his (or her) perspective. The better you understand his perceptions, anxieties, and triggers, the better you can provide relevant information that can help.
If you are going to a family Thanksgiving dinner and you know he gets overwhelmed by noise and physical touch, take time to explain that he may be seated close to others and their elbows may bump him as they eat. Warm him that people will talk over each other and sometimes get loud and appear to argue, but that’s common at family gatherings. If the expectation is that he wait to eat until a prayer is said, explain this now. Discuss why certain people may touch his head or hair or that others might ask for a kiss. Talk about how to politely decline. Mention possible variations to the new situation, too, so that he can adapt to those.
Social narratives, or “stories” are widely used for kids with ASD. Here is great resources on the subject, written by a women who pioneered the use of “social stories” for kids with ASD: The New Social Story Book: Teach Everyday Social Skills to Children with Autism or Asperger’s Syndrome and their Peers. Carol Gray developed the Social Story in 1991 to promote social understanding in children with autism spectrum disorders (ASD). The New Social Story Book offers over 150 of the most requested Social Stories, each one professionally written by Carol Gray. This resource includes a CD-ROM of Social Stories, which allows you to make child-specific changes to them without having to re-type the narrative. Perfect for parents and teachers!
These are three proactive rather than reactive ways to develop social skills and address the difficulties faced by many children with ADHD and ASD. Managing the strong reactions of our children can be trying, but ongoing social skills training can go a long way to helping them learn the flexibility and adaptability we all need to navigate social situations.
Let me know if you have success with any of these techniques!
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