How Mental Health Diagnoses in Children and Adolescents Affect Peer Relationships and Strategies for Intervention Colleen Butcher, M.Ed. Brooke Chapla, M.S., M.A.
Development of Social Competency For the purposes of this presentation, we are defining social competency as: ● Social behaviors ● Social cognition ● The ability to synthesize the two to achieve a social goal In other words, the knowledge , skills , attitudes, and beliefs that make it possible for a student to form and maintain satisfying personal relationships with other people – peers and adults
Social Behaviors and Social Cognitions Social Behaviors Social Cognitions • Social Cognition is understanding: Social behaviors represent a match between the social setting and • what is happening, the behavior choice • why it is happening, and • what thoughts , feelings and Choosing appropriate behaviors can intentions are motivating other extend the interaction people to behave the way they do Appropriate social behaviors • Children can identify alternative promote cooperation and mutual responses and strategically choose enjoyment over conflict one likely to promote an effective social interaction Socially competent children shift and change their behaviors in • Children can understand and reflect different settings and with the feelings of others, creating a different ages sense of shared experience (i.e., empathy)
Social Competency and Friendship Child Ch ildren wit ith frie friends typically ly: Ch Child ildren wit ithout frie friends typically ly: • Want very much to be friends and have Have significant difficulty making and keeping friends: friends • Have fewer than 3 friends • Are not invited to socialize by others • Manage conflict without over- • Are turned down when asking others dominating or over-conceding • Are often without a peer at recess/lunch or • Understand how to respond to social times for social interaction (e.g., hallways) situations and how to fix social accidents • In observations, are alone more than half the time • Connect empathically with others What parents and teachers notice • Recognize and follow social conventions • These students worry a lot about having friends (which differ from adult conventions) • They aren’t able to resolve conflicts , and • disagreements stop their play Peers expect they will enjoy spending What is the time with them • They aren’t always sensitive to other kids’ basic recipe for points of view • Peers don’t always expect to enjoy spending friendship? time with them Have fun doing things together.
What do children typically need to develop social competency? Children need to opportunities to practice social competencies with feedback from both peers and adults • Children need to experience multiple , positive peer interactions to foster social-efficacy beliefs • Children need opportunities to practice social behaviors in a variety of settings with a variety of peers • Children need opportunities to learn to manage conflict and problem-solve differences without constant adult mediation • Children need self-regulation skills to inhibit their impulses and manage their emotional responses across settings • Children need the capacity to take the perspective of others
Many children encounter difficulties in the development of social competency Social Opportunities: Conflict, Aggression, and Bullying: • Children with few leisure skills or • When conflict regularly escalates who lack common interests with to aggression children may other children may find their struggle to learn adaptive opportunities for interaction strategies for conflict resolution limited • Children in rural or isolated areas • Bullying is a specific and repeated often have a limited pool of peers form of aggression that can with whom to interact, and produce multiple negative possibility lack neighborhood outcomes and limit a child’s friends to play with regularly beliefs that she or he will be successful and find pleasure in • Children who are prone to worry social situations may avoid social interactions or experience less pleasure with peers
What are the impacts of childhood mental health diagnoses on the development of social competence ?
Typical Mental Health Diagnoses Identified in Childhood and Adolescence • Autism Spectrum Disorder • Trauma • Disorders of Impulse Control • Intellectual Disability • ADHD • Giftedness • Oppositional Defiant Disorder • Conduct Disorder • Communication Disorders • Anxiety • Learning Disabilities • Depression
Autism Spectrum Disorder Typical features: • Deficits in social communication and social interaction • Restricted, repetitive patterns of behaviors, interests, or activities Impact on social behaviors: • Difficulty adapting behaviors to setting • Difficulty coordinating verbal and nonverbal behavior • Effects on initiations and responses, play skills Impact on social cognition: • May have limited ability to read social scenarios • Difficulty with perspective taking and theory of mind Impact on peer evaluation
Disorders of Impulse Control Impact on social behaviors: ADHD • Tend to be more talkative, impulsive, • Typical Features greater emotional expressiveness (facial • Inattention (failure to attend to expressions, tone) details, difficulty maintaining • More limited reciprocity in interactions attention, difficulty organizing) • Use fewer positive statements and/or • Hyperactivity/Impulsivity (frequent Impact on social cognition: fidgeting/movement, “On the go”, • More limited knowledge of social skills excessive talking or blurting, • Process social/emotional cues in more interrupting) limited and error-prone fashion ODD/CD Impact on peer evaluation: Inhibiting/self-regulating • • More likely to be neglected or rejected • May receive less social support Often antagonistic to adults • and peers Can be callous and • unemotional
Anxiety Typical features: Impact on social behaviors: • Excessive fear (anticipation of a • May avoid interactions • May engage in behaviors that are future threat) negatively perceived (e.g., crying, • Behavioral disturbances (muscle tantrums) tension, vigilance, cautious or Impact on social cognition: avoidant behaviors) • May have fears of being evaluated by Social Anxiety: others • Fear or anxiety about or Impact on peer evaluation: avoiding social interactions that • Often have fewer friends involve the possibility of being social evaluated • Selective Mutism
Depression Impact on social behaviors: Typical features: • May withdraw socially • Sad, empty, or irritable mood • Difficulty negotiating peer • Somatic and cognitive changes conflicts • diminished interest or pleasure in Impact on social cognition: activities • May excessively seek reassurance • weight changes • sleep changes • May respond ineffectively to peer • Fatigue stressors • diminished ability to concentrate or Impact on peer evaluation: make decisions • Elicit negative affect and aversive • feelings of worthlessness responses from unfamiliar peers • May lose friends over time
Trauma Typical Features: Impact on social behaviors: • May exhibit more hostility or • Exposure to a traumatic depression or stressful event Impact on social cognition: • May have difficulty identifying • Psychological distress emotions • May have difficulty recognizing • Anxiety- or fear-based risky situations symptoms • Depressive symptoms Impact on peer evaluation: • Angry/aggressive symptoms • May appear overly responsive to • Dissociative symptoms stimuli (e.g., affective states, sounds, touch, etc.)
Intellectual Disability Impact on social cognition: Typical Features: • Risk of gullibility or victimization • Deficits in general mental • Difficulty with social problem abilities solving • Impairment in adaptive • May have difficulty regulating functioning emotions Impact on social behaviors: • May misinterpret social cues • May have limited language Impact on peer evaluation: abilities • May be judged as immature • May be more concrete or literal in communication
Giftedness Impact on social cognition: Typical Features: • May have a tendency toward being • Superior intellectual functioning • Sometimes differences in adaptive functioning judgmental and critical • May be more socially successful than typical • May interpret lack of understanding peers or interest as rejection Impact on social behaviors: Impact on peer evaluation: • May want to discuss topics or ideas that are not • May perceive negative evaluation meaningful for peers • Peers may express anti-intellectual • May prefer to work or play alone stigma • May be tempted to conform to social scene
Communication Disorders Typical Features: • Deficits in: • Speech-articulation, fluency, voice, and resonance quality • Language-form, function, and use of symbols (words, sign language) • Communication-verbal or nonverbal behavior that influences others Impact on social behaviors: • May demonstrate more limited play behaviors to engage with peers • May have difficulty responding to interactions (e.g., frequent “no”s ) • May have difficulty initiating Impact on social cognition: • May have difficulty negotiating and resolving social problems Impact on peer evaluation: • May have difficulty adapting to peer interactions
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