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«by Ellen Marie Strickland A Research Paper Submitted in Partial Fulfillment of the Requirements for the Master of Science in Education Degree With a ...»

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Ellen Marie Strickland

A Research Paper

Submitted in Partial Fulfillment of the

Requirements for the

Master of Science in Education Degree

With a Major in

School Counseling

Approved: 2 Semester Credits


Rod Crist, Investigation Advisor

The Graduate School

University of Wisconsin-Stout August, 2002 ii The Graduate School University of Wisconsin-Stout Menomonie, WI 54751


Strickland, Ellen M.

(Writer) (Last Name) (First) (Initial) The Effects of Attention Deficit Hyperactivity Disorder on the Social Skills of School- (Title) Age Children School Counseling Rod Crist 08/2002 31 (Graduate Major) (Research Advisor) (Month/Year) (No.of Pages) American Psychological Association (APA) (Name of Style Manual Used in this Study) Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent emotional and behavioral disorder that can affect the scholastic and social functioning of school-age children. ADHD is characterized by developmentally inappropriate inattention, impulsiveness and motor activity. Children with attention problems create a special population with diverse needs within an educational setting. Although there are a myriad of problems associated with children identified as having ADHD, social skill deficits are one concern of many parents and school personnel. Topics addressed in the literature review include the definition and common interventions regarding ADHD, as well as the definition of social skills and social skill assessment and intervention programs. Also addressed is how ADHD is linked to social skill deficits in school-age children.

iii Table of Contents Chapter One: Introduction………………………………………………………………..4 Statement of the Problem Definition of Terms Assumptions Limitations Chapter Two: Literature Review……………………………….……………………….10 Attention Deficit Hyperactivity Disorder Causes of ADHD Diagnosis and Assessment of ADHD Interventions for ADHD Social Skills Types of Social Skills Identifying Social Skill Deficits Interventions Designed to Improve Social Skills Roadblocks Associated with Acquiring Social Skills Effects of ADHD on Social Skills Chapter Three: Summary Critical Analysis, and Recommendations……………………27 Summary Critical Analysis Recommendations

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Disorders of attention and activity are amongst the most prevalent of emotional and behavioral disorders affecting children and adolescents. They are also currently considered the most controversial disorders in our society. Children with attention problems create a special population of students with a wide array of needs. The most commonly diagnosed childhood disorder among students is Attention Deficit Hyperactivity Disorder, also known as ADHD (Kronenberger & Meyer, 1996).

ADHD is marked by developmentally inappropriate inattention, impulsiveness and motor hyperactivity (Rosenhan & Seligman, 1995). In general, ADHD is defined by the presence of socially disruptive behaviors, either attentional or hyperactive, before the age of seven, which persist for at least six months (Sue, Sue, & Sue, 1997).

Characteristics of children who suffer from ADHD primarily include inattention, impulsivity, and deficits in rule-governed behavior, not the restlessness or squirminess that has often been the focus of adults’ concern. Those identified as having ADHD may show difficulty in focusing and sustaining attention, controlling impulsivity, and showing appropriate motivation (Kauffman, 2001).

Students with ADHD have attention problems that span several settings. ADHD is extremely apparent in a school setting and may have a grave impact on a child's educational experience. Traditional schools expect students to be patient, listen attentively, complete assignments, cooperate with peers, and pay close attention to the task at hand. These activities are difficult for children who have ADHD because they

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inability to “think before you act,” take turns, wait in line, and excessive fidgetiness and restlessness. School children who have ADHD may have a hard time remembering to do tasks, constantly run late, and turn in homework that is unfinished or past its due date.

Students with ADHD may appear to be emotionally immature, quick-tempered, and easily frustrated (Kauffman, 2000). All of the above characteristics may make it difficult for children to function successfully in a school setting both academically and socially.

Recently, it has been discovered that students with ADHD may suffer from developmentally inappropriate social behaviors, which likely affects the development of friendships and relationships with peers. Many studies have found evidence that suggests that children with ADHD manifest social skills deficits with peers because of the behaviors that often accompany ADHD (disruptiveness and poor impulse control). Poor development of social skills can have very serious negative side effects, which include long-term effects that may carry over into adulthood. Children who demonstrate problems with social and peer relationships at an early age often continue to have socialization problems later in life (Dumas, 1998). In order for students with ADHD to positively participate in classroom and social settings, their academic and social deficits need to be addressed and accommodated.

Social skills deficits are not only experienced by students with ADHD, although it is predicted that fifty percent of students with ADHD experience relationship problems (Dumas, 1998). Low social functioning can be experienced by students with exceptional needs as well as regular education students. Poor social skill development in children can lead to adverse effects in the future. For example, poor social skills have been linked

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conduct and law enforcement contacts (Landau & Milich, cited in Landau & Moore, 1991). Lack of adequate social skills can negatively effect the development of peer relationships, which can lead to having few friends. A study done by Weiss & Hechman (cited in Landau & Moore, 1991) indicated that students who have been identified as having ADHD are more likely to experience feelings of sadness and loneliness when compared to their non-ADHD peers. It also seems that students with ADHD are less involved in their communities as well as in school activities.

A person’s social status greatly determines if an individual is accepted or rejected by their peers and determines if a person is acceptable to a group. Students who are labeled as hyperactive have a high incidence of being rejected by their same age peers.

This negatively affects the hyperactive student’s status as acceptable and makes it difficult for a student with ADHD to maintain healthy friendships (Landau & Milich, cited in Landau & Moore, 1991). A study conducted by Milich, Landau, Kilby, & Whitten suggested that children with hyperactivity are more unpopular and socially rejected than peers who are aggressive in nature (as cited in Landau & Moore, 1991).

Social skills training can be integrated into learning disabled and regular education curriculum to help students learn the skills necessary to develop and maintain relationships in and out of a school setting. School-based interventions can be planned and implemented to help students with ADHD form positive relationships with peers and teachers (Evans, Axelrod, & Sapia, 2000).

In order for students with ADHD to function appropriately in a classroom and at school in general they must be accepted and included by their peers and teachers. The

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other children in the classroom. Teacher perceptions often influence how students respond to others, whether teachers are aware of this or not. It has been suggested that students who suffer from learning disabilities, including ADHD, are the recipients of more negative attention, less praise, and more disciplinary action by their teachers when compared to their non-disabled peers (Hepler, 1994).

The previous literature has suggested that, along with other difficulties, students with ADHD suffer from social skill impairments. Attitudes and attention from a student’s peers, whether negative or positive, can have a huge impact on a student’s educational experience. It is pertinent that professionals within the field of education better understand the social deficits and needs of children with ADHD. Therefore, the impact of social skill deficits of by students who have been identified as having ADHD needs further exploration. By understanding a student’s social needs we can ensure that students identified as having ADHD have the best possible opportunities to develop social skills that are socially desirable by others. In turn, this allows a better chance to be

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Statement of the Problem The purpose of this study is to further explore, through the published literature, the social effects that ADHD has on a student’s social skill development and how a student’s lack of social competence effects relationships with their peers. By exploring the subject of ADHD and its social manifestations, educational professionals will be better able to understand students who are lacking adequate social skills. This knowledge will assist in the implementation if interventions designed to assist students in the development of social skills,which will lead to success within the classroom, as well as with their peer groups.

Definition of Terms For the purpose of clarity, the following terms are defined.

Conduct Disorder (CD)- a disorder characterized by a repetitive and persistent pattern of behavior in which a young person violates the basic rights of others or major age-appropriate societal norms or rules (Hetherington & Parke, 1999).

Self-esteem – a good opinion of oneself, self-confident (Abate, 1997).

Social Competence – how social skills are linked to socially valid outcomes.

Social Skills – discrete molecular behaviors that, if present increase the probability that the child will be considered socially competent.

Social Skills Rating System (SSRS) – a clinically useful instrument that incorporates a broad multi-rater format that addresses social behavior (Dumas, 1998).

Social Status – peer nominations of acceptance or rejection, the personal appeal

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Assumptions There are several assumptions which are apparent in this research. This includes the assumption that ADHD is a real, diagnosable disorder, and that the lack of appropriate social skills is detrimental to the development of healthy relationships.

Limitations There are several limitations associated with this research. These limitations include the fact that commonly prescribed ADHD medications may decrease the appearance of social skill deficits and that diagnosis for ADHD often varies. Another limitation is that peer socialization and interaction may vary between males and females, and females may not display as many outward behaviors associated with ADHD as

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Attention Deficit Hyperactivity Disorder The term Attention Deficit Hyperactivity Disorder (ADHD) is relatively new within the medical and educational community. Over the past several decades, disorders of attention and activity have been described in a variety of terms, including hyperactive and hyperkinetic. Severe and chronic problems in regulating attention and activity are now commonly known as Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). Although the terms ADD and ADHD are both used and found in the published literature, the term ADHD is the official term found in the Diagnostic and Statistical Manual of Mental Disorders 4th edition. (American Psychiatric Association, 1994) (Kauffman, 2000).

The DSM-IV (American Psychiatric Association, 1994) is published by the American Psychiatric Association and is used to classify and diagnose mental disorders in individuals. ADHD is defined by the DSM-IV (American Psychiatric Association,1994) as a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. Some hyperactive, impulsive, and inattentive symptoms must be present before the age of seven in order for individuals to be diagnosed as having ADHD.

In addition, symptoms must be present in at least two settings (school, home, work, etc.) in order for a diagnosis to be valid (American Psychiatric Association, 1994; Barlow &

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The DSM-IV (American Psychiatric Association,1994) classifies ADHD into two separate subtypes: Predominately Inattentive Type and Predominately HyperactiveImpulsive Type. There is Combined Type as well, which is a combination of the above two subtypes. The DSM-IV (American Psychiatric Association,1994) specifies that the frequency and intensity of the symptoms must be “maladaptive and inconsistent” with developmental level. Some symptoms described in the DSM-IV (American Psychiatric Association,1994) include: failure to give close attention to details, difficulty sustaining attention in tasks or play activities, does not listen when spoken to, and is easily distracted and forgetful (American Psychiatric Association, 1994; House, 1999).

In general, definitions of ADHD assume many things. It is a developmental disorder of attention and activity and is evident relatively early in life (some symptoms before age seven). ADHD persists throughout adulthood, involves both academic and social skills, and is frequently accompanied by other disorders. Such disorders include Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD), which usually have overlapping symptoms (Sue, Sue, & Sue, 1997). Approximately three to five percent of the school-age population suffers from ADHD, with boys outnumbering girls 4 to 1.

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