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Peer Relationships: Effects on Children with ADHD

The Importance of Peer Relationships

Peer relationships are mutual social relationships between those of equal status and similar age group. These relationships include individual friendships, small and large peer groups. Peer relationships are crucial to the development of all children. They provide children with opportunities to learn skills relating to cooperation, negotiation and resolving conflict from their peers. Peer relationships are crucial to the development of all children. In fact, peer relationships are strong predictors of a child’s future. Issues in peer relationships can begin as early as preschool. Poor peer relationships can increase the risk of substance abuse, academic difficulties and psychological issues. Studies have shown that peer relationships can have a stronger influence than grades, IQ or test scores.

Peer Relationships Challenges for Children with ADHD

Children with ADHD have additional difficulties in forming and maintaining healthy peer relationships. Children with ADHD have a harder time making and keeping friends. The main symptoms of ADHD, inattention and hyperactivity/impulsivity can be some of the main culprits. Inattention issues can make it difficult for a child to remain focused during interactions, recognize social cues and monitor inappropriate social behaviour. In the same regard, children with hyperactivity/impulsivity symptoms may exhibit uncontrolled, aggressive and dominating social behaviour. The consequences of ADHD symptoms can negatively impact how they are viewed by peers. They are more likely to be disliked and rejected by others. Children with ADHD often have difficulties being aware of their own behaviour, and how it interferes with their social interactions. These consequences prove to be even more apparent when it comes to new groups and social settings.

Peer Victimization and Bullying

There is a higher occurrence of peer victimization among children with ADHD. Peer victimization is experiencing targeted negative action by one or more peers, repeatedly over time. These actions can be physical, verbal or relational. Examples of these behaviours include bullying, exclusion, and spreading rumours.

Children with ADHD are more likely to be both bullies (perpetrators) and victims of these behaviours. Girls are more likely to be victims, while boys are more likely to be bullies. Victims have an increased risk of anxiety, depression, lower self-esteem, and poor academic performance. Bullies display anti-social behaviour which increases the likelihood of criminal behaviour, and conduct disorder, and oppositional defiant disorder. For some children, they can be categorized as both bullies and victims and have overlapping traits and behaviours.

Treatment: Medication and Therapy

Treatment can help children who suffer from poor peer relationships. The most effective treatment combines medication with therapy. Medication helps reduce symptoms that lead to negative social behaviour. While therapy will provide behavioural intervention by teaching and reinforcing prosocial behaviour. This study showed that by introducing new prosocial behaviour peer functioning can be improved. The best treatment would address the poor peer relationship directly and teach new social skills to form and improve positive peer relationships.


  • Peer relationships are crucial to children development

  • Peer relationships are strong predictors of future behaviour and issues

  • Children with ADHD are most susceptible to limited or poor peer relationships

  • Children with ADHD are more likely to be victims, bullies or both

  • Treatment (medication and therapy) can manage negative social behaviour and can teach and reinforce prosocial behaviour

Peer relationships are hard to navigate for a child with ADHD. The core symptoms of ADHD can create unique challenges. If your child struggles with forming and maintaining friendships, consider consulting with a therapist. A skilled therapist can support your child by addressing problematic behaviour and developing better social skills.

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