Monday, May 5, 2008

Sue Scheff: Building Social Skills for ADHD Children

By ADDitude Magazine

Role-playing strategies to help your child get along with others—even bullies

Making eye contact. Not interrupting. Taking turns. If your child with attention deficit disorder (ADD ADHD) needs help with these and other social skills, you may want to give “role-playing” a try. By testing out various personas, he can see how simple changes in what he says and does can help him get along better with friends and family members.

Role-playing works with almost any child who is old enough to talk. It’s especially good for teaching children how to deal with teasing — a problem familiar to many kids with ADHD.

Consider the case of Joe B., a nine-year-old I recently treated. Joe’s parents sought my help because he kept overreacting to playful (but sometimes hurtful) verbal banter that came his way during recess. On one such occasion, after Joe did something silly, a playmate laughed at him and called him a “turkey head.” Enraged, Joe shoved the boy and burst into tears. He looked like a crybaby.

Joe acknowledged shoving the other boy, but said to me, “He started it.” Joe felt it was the other boy who needed to change. I explained to Joe that he couldn’t always control what other people did, but that he always had a choice about how to react. “You’re the boss of yourself,” I told him.

Talking things over made Joe feel better, and I decided that role-playing might help Joe avoid future incidents. Here are the basic steps I used with Joe that you might try with your own child:

Define the problem. Talk things over until you understand the exact nature of the problem facing your child. Joe’s problem, of course, was that he felt angry and sad when kids called him names—and couldn’t stop himself from lashing out physically.
Acknowledge bad feelings. Let your child know that it’s normal to be upset by teasing. Joe’s parents and I made sure that he understood that—and that it was not OK for children to pick on him.
Discuss alternative ways to respond. Explain to your child that there are many ways to respond to teasing, some good and some not so good. Shoving the teaser was a bad choice. Joe and I explored better options, including walking away from the encounter and saying “I don’t care” over and over, until the teaser got bored. Ultimately, Joe decided he’d simply say, “Please stop it.” He said that gave him a sense of control over the situation.
Reenact the situation. Once you’ve armed your child with socially acceptable ways to respond, let him play the role of the child being teased while you play the teaser. Then switch roles, varying the “script” to explore the different ways in which the scenario could play out. You might videotape the role-playing sessions and review the tapes at a later time with your child to reinforce appropriate behavior.
Celebrate success. If your child comes home announcing that he has used the lessons learned in role-playing, congratulate him. Give him a high-five, and tell him how proud you are — even if he didn’t do everything you had practiced. This is not the time to nit-pick.
Role-playing didn’t help Joe right away. But one day, a few weeks after we began our sessions, Joe was beaming when he came into my office. Once again, a playmate had teased him, but this time Joe hadn’t struck back. “I told him I didn’t care what he thought,” Joe explained.

Over time, as we continued our sessions, Joe got even better at controlling his behavior on the playground. Other children accepted him as one of the gang, and that made him feel good about himself.