ADHD & Social Skills

By | NESCA Notes 2022

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

When most of us hear the term “ADHD (attention deficit hyperactivity disorder),” we think of the little boy who can’t sit still at his desk or the girl gazing out the window lost in her own thoughts during class. While difficulties with hyperactivity and/or attention are core features of ADHD–embedded directly in the diagnostic label–there are often co-occurring features that are less obvious. Moreover, even the central aspects of ADHD can have far-reaching impacts beyond the classroom. One of the most frequently misunderstood and overlooked facets of ADHD is its potential impact on social functioning.

In clinical practice, parents of children with ADHD are often confused by the unexpected and indirect ways that attentional and executive functioning deficits can affect social functioning. They sometimes wonder if their children have an additional challenge, such as autism spectrum disorder. Most often, that’s not the case. Rather, it’s more likely that one or more of the following is at play:

  • Kids with ADHD can have difficulty selectively attending to relevant social cues
    • Imagine looking through a camera with a broken zoom lens. At first everything is in frame at once; it’s too much information. Then you try to zoom in, but when you do, sometimes the lens focuses on unimportant things (like the random details in the background), leaving out what’s most relevant (like the person you’re trying to capture in your photo). Children with ADHD have difficulty figuring out what details to focus on and struggle to effectively “zoom in” on those elements. In social settings, which are often unstructured, kids with ADHD are even more prone to “zoom in” on unimportant things and miss the more salient information. They can also become easily distracted and fail to register important information in the moment. To others, this can come across as lack of interest (for instance, the child who seems not to be listening or is distracted by sounds, sights, or other sensory information in the moment). It can also lead children with ADHD to overlook contextual cues about what’s expected in a given social setting, which can lead to inappropriate behavior.
  • Children with ADHD often struggle with nuance, making inferences, and reading between the lines
    • Social situations are much more complex than we often realize. Successfully navigating social interactions requires paying attention, not just to surface level information but to the often subtle, implied meaning embedded in things like figures of speech, tone of voice, and body language. For many with ADHD, it’s already a challenge to maintain focus at the surface level; the task of trying to simultaneously attend to and interpret subtext is too much. Individuals with ADHD may focus on what another person says (the content of their speech) but fail to notice the eye roll or sarcastic tone of voice that goes along with it.
  • Impulsivity can lead to social faux pas
    • Impulsivity is a central feature of ADHD in many cases. In social settings, difficulty inhibiting impulses can take many forms. For some, it may simply present as rapid-fire speech, leaving little room for others to respond in conversation. It can also look like interrupting, cutting others in line, or expressing ideas and opinions in a way that can be hurtful or seem rude. Especially in younger children, impulsive behavior can lead to difficulty sharing, physical aggression towards others, and trouble with turn taking. Children who have more difficulty slowing down and inhibiting impulses are more likely to inadvertently offend others or to engage in behavior that their peers may view as odd or inappropriate; in turn, this can lead to trouble developing and sustaining friendships and other positive relationships.
  • Hyperactivity makes participating appropriately in some social settings difficult
    • There are some social contexts in which an abundance of energy is a very good thing. For this reason, many ADHD kids can excel in activities like sports, into which they can channel their high energy. But other social situations demand a different set of skills. For kids with hyperactivity as part of their ADHD, sitting still and maintaining quiet can be a challenge. They may struggle with activities like going to the library, watching a movie in a theater, attending church or religious ceremonies, or sitting at the table in order to have family dinner.

The good news is that there are ways to manage these social challenges. If your child with ADHD has difficulty with any aspects of social functioning, it may help to seek out social skills training with a therapist or through a structured social skills training program. Interventions often include a combination of explicit instruction, modeling, role playing, and feedback. Parents can also help by implementing simple, consistent ground rules for behavior and providing gentle but clear reminders as needed. Additionally, parents can facilitate play dates with peers, during which the parents take an active role in helping children utilize social skills and engage with each other appropriately.

Finally, though ADHD can present challenges in the social domain, kids with ADHD often possess many strengths that can help actually them succeed socially. Children with ADHD can be highly engaging, curious, energetic, creative, and open-minded. When these strengths are reinforced, kids with ADHD can often utilize them to create fun, rewarding social interactions and to develop rich, dynamic relationships.


About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

To book a consultation with Dr. Rodriguez or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Good Ideas for Dogs are Good for People, Too

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

  • Play Every Day! — Play can promote calmness and reduce anxiety. This is true for adults and kids.
  • Play Is Learning — Reflect after play by creating and asking questions. Did you learn anything new? What surprised you? How did you feel before you played? How you feel now?
  • Walk, Walk, Walk! — Walking helps dogs stay engaged with the world and brains stimulated. Yup, works for humans, too.
  • Be Present While Walking — Go for walks with or without a dog. Feel the air blowing, smell the flowers, hear the birds singing, feel the rain on your face. Learn the bird calls, bring binoculars and look closely at the birds. Be present as you walk, laugh, sing, splash in puddles….
  • Game Play — Playing games can help satisfy natural instincts. Play old games, teach your children games you played as a child, learn new games. Any games will do – board, card, dice, movement, etc. Play skill games, games of chance or luck games, silly games, etc.
  • Feed Relationships Through Play and Exercise — Bond with each other (a child, a dog or both!) through playing or getting some exercise together. Be active together…teach new tricks, kick a ball around, play catch, take a yoga or Zumba class, watch GoNoodle as long as it’s together.
  • Be in gratitude that you are experiencing this time together to slow down and reconnect with each other. Laugh, play, sing and dance together. Love and care for each other. Enjoy each other.


About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.


To book a consultation with Ms. Lucci or one of our many expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.


Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.


Why Sexuality Education For People With Developmental Disabilities Is So Important

By | NESCA Notes 2019

By: Dina DiGregorio Karlon, M.A.
Transition Specialist, NESCA

Sexuality is something that connects all humans throughout the lifespan. We, as parents, want to see our children as forever young and protect them. For many parents it is extremely difficult to consider our children as sexual beings. Add the complexity of having a child with a developmental disability, and it appears even more challenging; yet ironically, it is even more important. Here are some reasons why:

People with developmental disabilities are not children. While many people believe that children with disabilities are childlike and dependent on others, their humanity and independence should be respected. They have desires and needs similar to others. They deserve to have access to information which will help the make good choices and have healthy relationships.

Sexual education should be taught according to one’s biological age, not cognitive age. Most children with disabilities experience physical changes (i.e., puberty) at the same time as their neurotypical peers. Therefore, sexuality education should be given to them at similar times as peers, but the delivery needs to be the different – one which allows them to access the information.

Sexual education is a protective factor. Educating people with disabilities about sexuality is a protective factor for them, because it provides the knowledge they need to protect themselves against sexual crimes, unprotected sex, unwanted pregnancies and unhealthy relationships. Information is power.

Understanding sexuality will not encourage your children to have sex. Giving individuals with developmental disabilities sexuality education will not put the idea to embark on sexual explorations in their heads. Giving them access to sexuality education gives them information and ultimately the power to make educated choices about their bodies.

People with disabilities are significantly more likely to be a victim of a sexual or violent crime than their non-disabled peers. Understanding consent and sexual advocacy empowers people to protect themselves from being the predator or the prey by learning about concepts, such as, “my body, my choice” and “no means no.”

Much of the general population learns about sexuality and relationships from friends. This means that some of the information they receive about sexuality is not always accurate. People with disabilities may not have as many friendships as their peers without disabilities. Those with developmental disabilities tend to be more isolated, so they do not have the opportunity to learn from friends. Often, they learn about sexuality information from parents and television. Another concern is the ease with which the internet provides sexual information. Access to pornography and posting pictures can be confusing to a person with a disability who doesn’t understand the legal, privacy and employment implications, putting them at even greater risk. So, as parents, it’s very important to give accurate information or seek out professionals who can work with your child.

Sexuality education does not teach sexual values. Parents are the ones who should be teaching their children with and without disabilities about their values around sex. Sexuality education focuses on teaching accurate information in a format that students can access and understand. It is then incumbent upon those students to develop their own values.

Because of the nature of some disabilities, picking up on social cues is challenging. So much of relationships is understanding verbal and non-verbal social cues, so many people with disabilities can struggle with identifying healthy relationships. It makes it easier for others to take advantage of them, instead of enjoying a relationship with both partners on equal footing. Therefore, it is important to teach social skills as part of sexuality education.

There are common universal values:

  1. It is important to respect others by treating them well and listening to them.
  2. It is important to get consent from a partner before being sexual with them.
  3. Relationships should be equal and positive without violence or abuse.

When discussing sex with your children, it’s okay not to have all the answers and to ask for a pause, take a break or a deep breath, and return later with more information. There are always plenty of opportunities for teachable moments. We know that people with disabilities can take in a great deal of information, and sexuality education is critical information to have healthy, sexual relationships. So, while we hate to see our children grow up, we all want the same things – to see them be happy and belong in an appropriate and respectful, safe way.

NESCA has personnel trained to provide sexuality education training to parents and to teens and young adults with disabilities. Training can be done one-on-one or in a group. If you are interested in learning more, contact Dina DiGregorio Karlon at (603)818-8526 to set up a consultation.



Elevatus Training: GULP! Talking with Your Kids About Sexuality Newsletter, Volume 4, Number 1, May 2003


About the Author: 

Dina DiGregorio Karlon, M.A., is a seasoned counselor who has worked as both a school counselor and vocational rehabilitation counselor, guiding and coaching students and adults through transitions toward independence in both college and the working world. With NESCA, she offers transition assessment services in Londonderry, New Hampshire as well as transition planning consultation and coaching to students and families throughout New England.


To book Transition Services at NESCA or an evaluation with one of our expert neuropsychologists, complete NESCA’s online intake form. To book Transition Services in N.H., ask for Dina Karlon. 


Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.