Socialization Program Improves Peer Relations for ADHD Children

Attention deficit hyperactivity disorder (ADHD) is characterized by a number of symptoms including impulsivity, risky behavior, cognitive challenges, and attention impairment. These traits can make it especially hard for children with ADHD to be readily accepted by their peers. The erratic behaviors that are exhibited by ADHD children tend to create an environment of isolation and even ridicule. The culminating effect of these circumstances can lead ADHD children to develop negative coping strategies that are manifested externally and internally. Substance misuse, risky sexual behavior, oppositional attitudes, depression, and anxiety are among some of the psychological issues that often co-occur with ADHD.

Because socialization and peer acceptance are critical to self-esteem and identity formation, Amori Yee Mikami of the Department of Psychology at the University of British Columbia in Canada wanted to see if focusing on this area of impairment could help ADHD children improve their overall sense of well-being. Mikami recently led a study that compared two peer interventions, Making Socially Accepting Inclusive Classrooms (MOSAIC) and contingency management training (COMET). Both approaches aim to improve socially appropriate behavior in ADHD children, but MOSAIC also teaches peers how to be more accepting of ADHD kids. Mikami randomly assigned 24 ADHD children and 113 peer control participants, all ranging in age from 6 to 9, to one of the two 1-day programs.

At the end of the program, Mikami discovered that although both programs resulted in similar behavior changes for the ADHD children, MOSAIC provided tools that enabled the ADHD children and peers to develop reciprocating friendships. This was one facet of socialization that was lacking prior to MOSAIC. The elements of MOSAIC that teach tolerance and acceptance by focusing on positive character traits helps peers recognize the value of the ADHD children and reduces social stigma for the ADHD children themselves. These conditions serve to boost self-esteem and can protect children at risk, and in this case, children with ADHD, from turning to maladaptive coping strategies in the future. Mikami added, “This result highlights the continued need for novel treatment strategies to reduce peer impairment among children with ADHD.”

Mikami, A. Y., Griggs, M. S., Lerner, M. D., Emeh, C. C., Reuland, M. M., Jack, A., et al. (2012). A randomized trial of a classroom intervention to increase peers’ social inclusion of children with attention-deficit/hyperactivity disorder. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029654

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Does ADHD Have a Season?
How to Help the Special Needs Child Transition Back to School
Rewiring Your Brain: When Genomes Meet Connectomes

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  • allyson


    August 16th, 2012 at 6:33 PM

    just so many kids suffer from fact for some of them the effect of the disorder itself is not as much as the effect cause by the negative behavior and cold shouldering from peers.this is an important dimension for those with adhd and it is great that they are looking to work on this important dimension of the disorder.

  • Stella


    August 16th, 2012 at 11:54 PM

    Amazing how mere interaction and working with other people in a favorable environment can be beneficial to a variety of issues.Just demonstrates the power of human connection if you ask me.

    But what is happening now is the connection is either non existent or is fractured for most people.We need to work on this collectively as a community.

  • Caden


    August 17th, 2012 at 4:11 AM

    So glad that these students are finally having the types of friendships that they desperately need yet have had a hard time developing. Who wants to hang out with the kid who is always cutting up, can’t sit still, and in general has a terrible time in school? Even if I had wanted this to be my best friend my parents would have emphatically said no! So to introduce them to a program that helps them foster more meaningful friendships with their peers in school could be a real turning point for many ADHD students. It could help them to feel a more integral part of the classroom and keep them away from the fringes where the trouble usually lies.

  • TIA


    August 17th, 2012 at 10:32 AM

    Good, because I have seen a lot of kids with ADHD be treated in such a way that they begin to feel socially ostracized.

    The behavior may not be overt, but it is there and they feel it and recognize it, as do their classmates. And you know how others pick up on this- they see that and then think that this gives them the go ahead to do and say more to make this one child feel like he is alone.

    If you can only get these children to create friends, that at least gives them a buffer to ward off a lot of the negativity which will be directed toward them.

  • K.T


    August 17th, 2012 at 11:15 AM

    Is this really so hard to believe?Got an illness,we medicate.Got a problem with peer relationships?We help with socialization programs or practices.Simple is is not?!

  • Clint


    August 17th, 2012 at 2:33 PM

    It seems from what I am reading here that a program like MOSAIC. modified to meet the needs of other societal challenges, could be hugely successful in helping us to overcome our biases and prejudices in many other aspects of society as well. This is definitely a program that could be useful in helping kids confront stereotypes about race, ethnicity, sexuality, religion, whereever there may be some differences among us that tend to put up walls between us. Great stuff. Looking forward to see progress and change in so many of these areas where most of us need help.

  • Ella


    August 18th, 2012 at 8:04 AM

    Not only do we have to teach our children to be more tolerant of others who may look ar act differently than what w could characterize as the norm, but we must also teach adults to do the same.
    I have heard a lot of parents say that they will not allow their child to play with either this child or another because of their behavior and how they think that their child could be affected by being around that.
    Instead of doing that, why not use that as an opportunity to have your own child model appropriate behavior for the other so that maybe some of what is good about him will then rub off on the chld who has a harder time controlling his own impulses and behavior!
    This could be used as such a useful teaching tool both ways, with everyone gaining something positive from one another instead of shunning someone simply because they are a little different than you.

  • Jean Nystrom

    Jean Nystrom

    August 18th, 2012 at 9:44 AM

    I agree socialization programs do help to improve peer relationships. My daughter had ADHD. I use a program called play attention ( It is based on neurofeedback and edufeedback and was developed by a teacher. With parents consent, I allow her friends to play it with her. What I have found is that they don’t see ADHD as some kind of weird disease and are more accepting of my child. Now, when they come over they ask to play it. Using these types of tools instead of medication not only has help her but has improved her relationships with her friends as well. I cannot say enough about it.

  • alan


    August 18th, 2012 at 10:09 AM

    “MOSAIC also teaches peers how to be more accepting of ADHD kids.”

    ^^ I’m sorry but I do not think this is thee best approach. Why? Because this technique puts the onus of its success on not the victim bu those that are around the victim. The victim is not empowered but rather is at the mercy of those around him!

  • Richard H

    Richard H

    August 19th, 2012 at 5:16 AM

    I agree with Alan.

    let’s create programs that will help the ADHD patients devise their own special ways to manage their behavior instead of requiring everyone around them to change. That’s not how real life works and we know that. Those with ADHD need to learn that while their behavior should not exclude them from being a part of a group, that there will always be challenges that are associated with their behavioral issues and that they have to work on assimilating a little better and not depend on others to do all of the hard work for them.

  • cassidy


    August 19th, 2012 at 9:21 AM

    I know that we already ask a lot and expect a whole lot of our classroom teachers, but I kind of think that the classroom is where all of this has to begin. Well, there and at home. I will make the argument that the more parents do at home from a very young age to encourage tolerance and acceptance of others over exclusivity, then their children will be far more open minded and willing to accept behaviors and children with behavior problems more easily than those who have been taight to exclude others who aren’t like them. Along the same lines I think that teachers do have a responsibility too when it comes to helping children who have disruptive behavior issues to find other ways to channel all of that energy and to encourage them to look to their peers as models for guidance. Teaching them to actively seek help and to encourage those classmates to indeed be those models for them will teach them all to work together instead of creating an environment that instead fosters bullying and exclusion.

  • TED


    August 20th, 2012 at 4:39 AM

    Any socialization program needs to go both ways.

    AHDA kids need to learn to control their behaviors, and their peers need to learn how to be more open minded and accepting.

    Not saying that this will be easy for anyone, but it’s probably a decent start.

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