Peer Relationship Problems and Disruptive Behavior Disorders

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Abstract
About half of all children with attention deficit–hyperactivity disorder (ADHD) have significant problems with their peer relationships. These social difficulties appear to be related to a high rate of intrusive behavior, deficits in conversation and reciprocity, social–cognitive biases, and poor emotional regulation. Social skills interventions have been advocated to teach children and adolescents how to interact more successfully with their peers. To date, few studies have systematically evaluated social skills interventions for children with ADHD. However, studies with children and adolescents who are disruptive have pointed to serious limitations in the generalization of treatment effects to the natural environment and questionable changes in peer relationships as a result of these treatments. These limitations and potentially useful adjunctive and alternative treatment strategies are discussed, including careful attention to setting events, the strategic use of peers, and the impact of medications on peer interactions.