A study published in the October 1997 issue of the Journal of Consulting and Clinical Psychology (pages 758-767) highlighted the importance of a child's peer relations in their long term successful adaptation. In this study, the authors followed boys who had been diagnosed with ADHD over a 4 year period. At the beginning of the study, careful assessments were made of the boys' emotional state, aggressive behavior, and conduct disorder symptoms. The authors also paid close attention to the quality of the boys' peer relations -e.g. how well accepted were they by their peers; did they have a close friend. Boys who fared poorly on these assessments of social functioning were considered to have a "social disability". (It is important to note that this peer relations variable was evaluated independently from children's behavioral and emotional functioning. Thus, some boys who were doing well socially were showing emotional and/or behavioral problems while others did not show these latter difficulties but were struggling in their relations with peers.)

Two questions were of primary interest. First, the authors wanted to know if social disability at the beginning of the study was a significant predictor of severe long term outcomes 4 years later when the boys were adolescents (e.g. substance abuse). Second, they wanted to determine whether being "socially disabled" (i.e. having important difficulty in one's relations with peers) made a unique contribution to boys' long term outcomes. That is, do social problems play an important role in children's adjustment as adolescents even when other difficulties such as emotional and behavioral problems are taken into consideration.

The results obtained were quite interesting. At the 4 year follow up period, boys with ADHD who had been identified as socially disabled had higher rates of mood, anxiety, behavioral, and substance use disorders than ADHD boys who were not socially disabled and boys without ADHD. In addition, statistical analyses indicated that having a social disability at the beginning of the study significantly increased the risk of developing later conduct disorder and substance use disorders even after earlier emotional and behavioral functioning was taken into consideration. In other words, difficulty with social relationships appeared to be making a unique contribution to many boys’ adjustment as adolescents.

How can this information be useful to you? The very important conclusion that emerges from this study is just how critical children's peer relations are to their long term development. It is clear that children who have difficulty making friends and getting along with peers - regardless of whether or not they also have ADHD - are at increased risk for a variety of negative developmental outcomes.

Sometimes, it is easy for parents to focus primarily on children's grades and their behavior at home and with other adults, and to lose sight of how their child is succeeding or not succeeding in the peer arena. Paying attention to how your child is faring socially, and trying to get him or her help in this area if they are struggling, however, can be one of the most important and helpful things that parents can do.

There are several ways that parents can be helpful to their child in this regard. First, you may have to take an active role in trying to arrange play activities for your child (this applies more for younger children, of course, than for adolescents). This can be quite helpful in assisting your child in developing a good friendship. If you know that your child has difficulty with social skills - e.g. sharing, compromise, turn taking, etc., you may need to actively supervise the play times to try and make sure that things go okay and to help get things back on track when they start going downhill. Reviewing with your child the kinds of things that will help him or her to be a better friend - both before and after the play session - can also be helpful in getting your child to try and focus on these important issues.

You should also be aware that their is a specialized type of treatment called "social skills" training that is specifically geared towards helping children learn the kinds of skills they will need to do well socially. In many communities, these groups are offered on a private basis by child psychologists.

The point to emphasize is how important it is to pay close attention to how your child is doing with friends and with peers. Helping your child to make and keep even a single good friend can make a significant difference to your child's development.