Building Social Skills in Children with Anxiety or ADHD
Supporting Connection, Confidence & Communication
Children and teens who live with anxiety and/or Attention Deficit/Hyperactivity Disorder (ADHD) often face unique challenges when it comes to social skills. Making friends, reading social cues, managing emotions in peer interactions, or maintaining relationships can be tough. For parents and caregivers, recognizing these challenges and intervening early can make a meaningful difference. At Long Island Behavioral Health, we help families build the skills and confidence that support real, meaningful connections.
Why Social Skills Matter
Strong social skills are more than “just being friendly.” They influence self-esteem, school engagement, emotional well-being, and long-term success. For children with anxiety or ADHD, social difficulties can contribute to isolation, peer rejection, academic strain, and emotional
Why Anxiety + ADHD Can Lead to Social Skill Challenges
Several overlapping mechanisms help explain why children with anxiety and/or ADHD often struggle socially:
Attention, impulse control, and social awareness: Children with ADHD may struggle to monitor their behavior, overlook social cues, interrupt peers, speak out of turn, or miss non-verbal signals.
Anxiety amplifies avoidance and fear of social situations: When social interactions feel risky or overwhelming (e.g., because of prior negative experiences or peer rejection), children may withdraw or hesitate to engage, reducing opportunities to practice social skills.
Reduced social motivation and peer engagement: A recent study found adolescents with ADHD had significantly lower social motivation compared with typical peers, and higher anxiety predicted lowered motivation.
Fewer successful social experiences → fewer opportunities to build skills: Without repeated positive peer interactions, children may lag in social-emotional development, leading to a cycle of fewer friends → less practice → more difficulty.
Co-occurring emotional challenges complicate things: When children have ADHD + anxiety (or other internalizing/externalizing comorbidities), social deficits tend to be more severe and persistent.
Practical Strategies to Build Social Skills
Here are actionable strategies parents, caregivers, and professionals can use to support children with anxiety or ADHD in developing stronger social skills:
For Parents & Caregivers
Model social behavior: Show friendly greetings, ask your child how others might feel, talk about expectations ("When someone raises their hand to speak, we wait our turn").
Role-play and rehearsal: Practice common social situations (inviting a friend, joining a game, replying when someone is upset, sharing). Use simple scripts, and then gradually shift to improv.
Break it down into manageable goals: Focus on one or two skills at a time (e.g., greeting a peer, asking a question, taking turns). Celebrate successes and set realistic, specific targets.
Use structured small-group opportunities: One-on-one playdates or small groups with 1-2 peers are often more effective than large, unstructured gatherings for children with ADHD or anxiety.
Frequent, immediate feedback: When your child misreads a cue or acts impulsively, gently pause and help them reflect: “I noticed when Sam said he was sad, you started to joke — what do you think he might have been feeling?”
Integrate movement and outdoor/active peer time: Sometimes social skill development is stronger when children are engaged in shared physical or game-based activities, rather than static conversations.
Encourage self-awareness and emotional labeling: Help your child become aware of their feelings (“I feel nervous when I don’t know what to say”) and link them to behavior (“When I’m nervous, I might talk too fast, so I can pause and take a deep breath”).
For Children and Teens (age-appropriate)
Teach “mini scripts”: For example, “Hi, I’m [Name]. Do you want to play [game]?” or “It looks like you’re upset. Do you want to talk?”
Visualize social scenarios: Imagine how you would join a conversation, what you’d say, how you’d let someone else speak, and how you’d respond.
Check-in prompts: Use a simple self-check: “Did I listen? Did I wait for my turn? Did I ask a question about them?”
Use peer-led activities or clubs: When children share interests (sports, games, art, music), social interactions often feel more natural.
Gradual exposure to bigger groups: Start with smaller, comfortable settings and expand into larger social opportunities as confidence grows.
Mindfulness or pause routines: Before joining a group, pause for 10–20 seconds, take three deep breaths, and remind yourself of one social goal (“I’ll ask a question and wait for the answer”).
Why a Specialized Approach Matters
Generic social skills groups or school-based interventions may fall short for children with both anxiety and ADHD, especially given the interplay of attention, motivation, internalizing fears, and social cognition. Research shows that social-skills interventions must tailor to these nuances:
The link between anxiety and social skills in ADHD means interventions need to address both the internal state (anxiety) and the external behavior (social interaction).
Social motivation may decline in adolescence among youth with ADHD, meaning they may be less likely to engage in traditional peer-group opportunities without targeted support.
When social-emotional challenges co-occur with ADHD, children are more likely to miss school or have more health-care visits, showing the broader impact of social functioning.
Hence, a thoughtful, customized plan that integrates clinical insight, peer practice, parent involvement, and real-world application is key.
At Long Island Behavioral Health, we specialize in working with children and adolescents who face social, emotional, and behavioral challenges, including anxiety and ADHD, by offering:
Individual assessment and goal-setting: We assess your child’s social-emotional profile—what skills they have, where the gaps are, and how anxiety and/or ADHD influences their social functioning.
Parent coaching and collaboration: We work with you to reinforce skills at home, create consistent routines, model social behavior, and help dovetail therapy into everyday interactions.
Integration of anxiety-management and executive-function support: Because anxiety and ADHD often overlap, our approach addresses worry, attention/memory challenges, impulse control, and social confidence together.
Ongoing monitoring and feedback loops: We track progress, adjust goals, measure real-life social outcomes (friendships, peer acceptance, school engagement), and provide practical next steps.
Building strong social skills in children with anxiety and/or ADHD requires a thoughtful, individualized approach that combines skill practice, emotional regulation, and real-world application. At Long Island Behavioral Health, we partner with families to assess each child’s strengths and challenges, coach parents on supporting social growth at home, and provide targeted interventions that address both internal experiences and social behavior. Through this comprehensive, evidence-informed approach, children and teens can gain the confidence, connection, and communication skills they need to thrive socially, academically, and emotionally.