Compassion, Part 3: Are kids with ADHD less compassionate?

As parents, we want our kids to be compassionate - to be concerned about the suffering of others. On this week's episode of the Family Anatomy Podcast, we talked about some possible ways that parents can encourage the development of empathy and compassion in their kids. Empathy is important in relationships, and it has been linked to prosocial behaviour and reductions in aggression - both of which are likely to have a positive impact on peer relationships! However, there is a large group of children who tend to experience social behaviour problems that interfere with their friendships - research has consistently shown that kids with Attention Deficit/Hyperactivity Disorder (ADHD) are more likely to have trouble in these areas. However, it isn't clear why. Some have proposed that the impulsive behaviour of kids with ADHD gets them into trouble at school, leading to peer rejection. Others have suggested that distractibility interferes with social interactions. Researchers at University of Toronto and Dalhousie University investigated whether ADHD is linked to reduced empathy or difficulties in social perspective-taking that might affect kids' relationships with their classmates. The study, published in a recent issue of the Journal of Abnormal Child Psychology, included nearly 100 8 to 12 year-old students, about half of whom had been diagnosed with ADHD. Parents also provided information. Although the kids with ADHD rated themselves as being equally empathic as those without the disorder, parents' ratings were lower for the kids with the diagnosis. There's a lot of research suggesting that people with ADHD tend to underestimate their problems, so this finding may not be surprising. Upon further examination, though, it turns out that ADHD was not actually the reason for the lower empathy scores - in fact, kids with conduct problems (e.g., aggression, bullying, lying, cheating, etc.) were actually the ones who received lower ratings. And conduct problems happen to be more common among kids with ADHD. So attention problems aren't necessarily linked with lower empathy, unless conduct problems are present.

If empathy isn't lower for distractible, impulsive children, why do they have more social problems than other kids? It may come back to another prerequisite for compassion - perspective-taking, or being able to put oneself in another's shoes. The researchers examined the impact of IQ and language abilities as well as ADHD on social perspective-taking. They found that slower learners and those with language difficulties had more trouble with perspective-taking. Kids with ADHD had particular difficulty, though. They had trouble considering multiple perspectives when solving social problems; this was concerning for the researchers, since previous studies have found that understanding the thoughts and feelings of others facilitates sympathy, sharing, comforting, and helping - if these behaviours sound familiar, it's because they're also elements of compassion! Children with difficulties in perspective-taking have trouble forming and maintaining friendships, and are rated as being less popular than their peers. It seems plausible that the limited ability of kids with ADHD in perspective-taking could contribute to their peer difficulties.

What are the implications? Parents of kids who have conduct problems might be wise to seek help sooner rather than later, since these behaviours might interfere with their relationships. More generally, kids with attention problems might require explicit teaching to learn to recognize the thoughts and feelings of others. In fact, previous research has shown that impulsive, disruptive kids who learned to take into account the thoughts and feelings of others have greater improvements in behaviour than those who participate in a traditional social skills training program.

You can find the Journal of Abnormal Child Psychology study here.

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