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Social Skills for Adults with ADD

Social Skills for Adults with ADD

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Published by natpray78

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Published by: natpray78 on Feb 19, 2010
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01/20/2013

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www.help4adhd.org
1-800-233-4050
15
WHAT WE KNOW
Soia Skis in Adtswith AD/HD
I
ndividuals with AD/HD oen experience socialdiculties, social rejection, and interpersonalrelationship problems as a result o their inattention,impulsivity, and hyperactivity. Such negative interpersonaloutcomes cause emotional pain and suering. Tey also
appear to contribute to the development o co-morbid mood and anxiety disorders. Tis sheet will:describe the ways in which the core symptoms o AD/HD can result in socialand interpersonal relationship problemssummarize research on childrens social skills and AD/HDdescribe the implications o this research or adult AD/HDsuggest approaches to assessing social and interpersonal diculties in adultswith AD/HDsuggest ways to treat social and interpersonal problems in adults with AD/HDBecause very little research has been published regarding social skills in adultswith AD/HD, the suggestions given in this sheet are based primarily upon soundclinical practices and upward extrapolations rom the research on childrenssocial skills and AD/HD.
OvErAll ImpAcT Of AD/HD ON SOcIAl INTErAcTIONS
It is not dicult to understand the reasons why individuals with AD/HD oenstruggle in social situations. Interacting successully with peers and signicantadults is one o the most important aspects o a child’s development, yet 50 to
 
What We KnoW
15
 
Social SkillS in adultS with ad/hd
60 percent o children with AD/HD have diculty with peer relationships.
1
Over 25 percent o Americansexperience chronic loneliness.
2
One can only speculatethat the gure is much higher or adults with AD/HD.o interact eectively with others, an individual mustbe attentive, responsible and able to control impulsivebehaviors.
3
Adults with AD/HD are oen inattentiveand orgetul and typically lack impulse control. BecauseAD/HD is an “invisible disability,” oen unrecognized by those who may be unamiliar with the disorder, socially inappropriate behaviors that are the result o AD/HDsymptoms are oen attributed to other causes. Tat is,people oen perceive these behaviors and the individualwho commits them as rude, sel-centered, irresponsible,lazy, ill-mannered, and a host o other negativepersonality attributes. Over time, such negative labelslead to social rejection o the individual withAD/HD. Social rejection causes emotional pain inthe lives o many o the children and adults who haveAD/HD and can create havoc and lower sel-esteemthroughout the lie span. In relationships and marriages,the inappropriate social behavior may anger the partneror spouse without AD/HD, who may eventually “burnout” and give up on the relationship or marriage.Educating individuals with AD/HD, their signicantothers, and their riends about AD/HD and the ways inwhich it aects social skills and interpersonal behaviorscan help alleviate much o the confict and blame. At thesame time, the individual with AD/HD needs to learnstrategies to become as procient as possible in the areao social skills. With proper assessment, treatment andeducation, individuals with AD/HD can learn to interactwith others eectively in a way that enhances theirsocial lie.
AD/HD AND THE AcquISITION OfSOcIAl SKIllS
Social skills are generally acquired through incidentallearning: watching people, copying the behavior o others,practicing, and getting eedback. Most people start thisprocess during early childhood. Social skills are practicedand honed by “playing grown-up” and through otherchildhood activities. Te ner points o social interactionsare sharpened by observation and peer eedback.Children with AD/HD oen miss these details. Tey may pick up bits and pieces o what is appropriate butlack an overall view o social expectations. Unortunately,as adults, they oen realize “something” is missing butare never quite sure what that “something” may be.Social acceptance can be viewed as a spiral going up ordown. Individuals who exhibit appropriate social skillsare rewarded with more acceptance rom those withwhom they interact and are encouraged to develop evenbetter social skills. For those with AD/HD, the spiraloen goes downward. Teir lack o social skills leads topeer rejection, which then limits opportunities to learnsocial skills, which leads to more rejection, and so on.Social punishment includes rejection, avoidance, andother, less subtle means o exhibiting one’s disapprovaltowards another person.It is important to note that people do not oen let theoending individual know the nature o the social violation. Pointing out that a social skill error is beingcommitted is oen considered socially inappropriate.Tus, people are oen le on their own to try to improvetheir social skills without understanding exactly whatareas need improvement.
rESEArcH ON cHIlDrEN WITH AD/HDAND SOcIAl SKIllS
Researchers have ound that the social challenges o children with AD/HD include disturbed relationshipswith their peers, diculty making and keeping riends,and deciencies in appropriate social behavior.
4,5,6,7
 Long-term outcome studies suggest that these problemscontinue into adolescence and adulthood and impedethe social adjustment o adults with AD/HD.
8
 At rst, these diculties o children with AD/HD wereconceptualized as a decit in appropriate social skills,such that the children had not acquired the appropriatesocial behaviors. Based upon this model, social skillstraining, which is commonly conducted with groups
“Because AD/HD is an “invisibledisability,” … socially inappropriatebehaviors that are the result o AD/HD symptoms are oten attributed toother causes.
 
What We KnoW
15
 
Social SkillS in adultS with ad/hd
o children, became a widely accepted treatmentmodality. In the typical social skills training group,the therapist targets specic social behaviors, provides verbal instructions and demonstrations o the targetbehavior, and coaches the children to role-play the targetbehaviors with one another. Te therapist also providespositive eedback and urges the group to provide positiveeedback to one another or using the appropriate socialbehavior. Te children are instructed to apply theirnewly acquired skills in their daily lives.More recently, AD/HD has been re-conceptualized as animpairment o the executive or controlling unctions o the brain.
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It ollows rom this conceptualization that thesocial decits o the individual with AD/HD may not beprimarily the result o a lack o social skills, but rather alack o eciency in reliably using social skills that havealready been acquired. Social skills training addressesthe lack o skills, but does not address inecient use o existing skills. Medication produces direct changes in theexecutive unction o the brain and may thereore helpchildren with AD/HD more reliably use newly acquiredsocial skills. Researchers have also added componentsto social skills training that help children with AD/HDreliably apply what they have learned in various settings.o accomplish this goal, parents and teachers are trainedto prompt and reinorce children with AD/HD to usenewly acquired social skills at home and in school.Only a small number o controlled investigations havestudied the eectiveness o social skills training orchildren with AD/HD. Tese studies have ound thatsocial skills training improves the children’s knowledgeo social skills and improves their social behavior athome as judged by parents, and these positive changeslast up to the 3 or 4 month ollow-up periods in thestudies.
7,10,11,12
However, these changes only partially generalize to school and other environments.Researchers have also ound that embedding social skillstraining within an intensive behavioral intervention,such as a specialized summer camp program, is a highly eective way o increasing the chances that the childrenwill maintain and generalize the gains that they havemade.
13
Tere is no research yet that addresses thequestion o whether children with AD/HD who benetrom social skills training have more riends, are betteraccepted by their peers, and have better interpersonalrelationships as they move into adolescence andadulthood. Clearly, this is an area where more research isnecessary.
SpEcIfIc AD/HD SympTOmS ANDSOcIAl SKIllS
i
ips or identiying subtext:
14
Look or clues in your environment to help youdecipher the subtext. Be mindul o alternativepossibilities. Be observant.Be aware o body language, tone o voice, behavior,or the look o someone’s eyes to better interpret whatthey are saying.Look at a person's choice o words to better detect thesubtext. (“I’d love to go” probably means yes. “I youwant to” means probably not, but I’ll do it.)Actions speak louder than words. I someone’s wordssay one thing but their actions reveal another, itwould be wise to consider that their actions might berevealing their true eelings.Find a guide to help you with this hidden language.Compare your understanding o reality with theirunderstanding o reality. I there is a discrepancy, youmight want to try the other person’s interpretationand see what happens, especially i you usually get itwrong.Learn to interpret polite behavior. Polite behavioroen disguises actual eelings.Be alert to what others are doing. Look around orclues about proper behavior, dress, seating, parkingand the like.A momentary lapse in attention may result in the adultwith AD/HD missing important inormation in a socialinteraction. I a simple sentence like “Let's meet at thepark at noon,” becomes simply “Let's meet at noon,” thelistener with AD/HD misses the crucial inormationabout the location o the meeting. Te speaker may become rustrated or annoyed when the listener askswhere the meeting will take place, believing that thelistener intentionally wasn't paying attention and didn’t value what they had to say. Or even worse, the individualwith AD/HD goes to the wrong place, yielding conusionand even anger in the partner. Unortunately, oenneither the speaker nor listener realizes that importantinormation has been missed until it is too late.A related social skills diculty or many with AD/HDinvolves missing the subtle nuances o communication.Tose with AD/HD will oen have diculty “readingbetween the lines” or understanding subtext. It is dicultenough or most to attend to the text o conversationswithout the additional strain o needing to be aware

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