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Social Impairment

Created on August 5, 2017. Last updated on March 8th, 2020 at 09:07 pm

Social relationships are an important part of children’s mental and overall well-being (Patalay & Fitzsimons, 2016). Friendships are not just fun and games – they help children understand other points of view, develop kindness, and build communication skills (Rubin, Coplan, Chen, Buskirk, & Wojslawowicz, 2005). Research also shows that good social and emotional skills in childhood are related to higher education and employment, less drug use, and better overall mental health in adulthood (Jones, Greenberg, & Crowley, 2015).

Children who can manage their emotions and behavior in social situations are set up for social success (Webster-Stratton & Reid, 2004). Parents can help their children develop these skills by being supportive, establishing clear expectations, and providing lots of attention to positive behaviors. (Denham et al., 2000). Some of the important social skills include staying calm when frustrated, patiently waiting for a turn, making good eye contact, talking at an appropriate volume, and keeping personal space. Many children learn these skills over time by being with family, playing with other children, and being in school, with plenty of trial and error. Parents can also help their children learn appropriate social functioning by doing the behavior themselves (modeling) or by teaching children about social rules like making eye contact and using an “indoor voice” (Webster-Stratton & Reid, 2004).

When children grow older, their social relations and friendships grow, too. Friendships become more focused on trust and self-discovery (Rubin et al., 2005). Older children understand more complicated social signals, like body language and sarcasm (Glenwright, Tapley, Rano, & Pexman, 2017). As more connections happen online, teenagers also need to be able to interpret tone and other social cues from text (Valkenburg & Peter, 2009). Parents should recognize these changes and encourage social behaviors appropriate for a child’s age.

Almost all children will experience awkward social situations or some trouble with social functioning, especially in new settings; not every fleeting or short-lived difficulty a child has making friends is cause for worry. Typical social functioning can also look very different depending on the child’s age, personality, family background, situation, and culture. However, if a child has long-lasting and significant trouble interacting with peers and making friends, it may be cause for concern. Parents should consider consulting a professional if their child’s social impairment is long-lasting and severe.

Not all social challenges are caused by a psychiatric disorder, but major difficulties with social functioning could be related to conditions like Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), or Social Anxiety Disorder. Children with ASD may have difficulty with making good eye contact, sharing interests with peers, and understanding social signals (American Psychiatric Association, 2013). Children with ADHD often experience social challenges as a result of interruptions or hyperactive behavior that annoys other kids (McQuade & Hoza, 2015), or because of difficulties sustaining attention during social interactions. Kids with social anxiety disorder tend to avoid social interactions and worry about doing something that will cause embarrassment (American Psychiatric Association, 2013). Children who struggle with social interactions and friendships for a long time can develop more issues in the future (Katz, Conway, Hammen, Brennan, & Najman, 2011). That’s why it is important for parents to try to address these problems early.

Many different approaches can help children improve their social functioning. Structured activities like sports teams or themed clubs can help children learn social skills and make friends around the shared interest (Howie, Lukacs, Pastor, Reuben, & Mendola, 2010). For children with significant impairment or a psychiatric disorder, intervention may be necessary. Group or individual therapy are both effective, but group therapy may be particularly helpful for social impairment because it gives children the chance to interact with others while they practice social skills (Flannery-Schroeder, Choudhury, & Kendall, 2005). One challenge with group-based social skills programs is that children don’t always transfer the skills to new situations like the school playground (Bottema-Beutel, Park, & Kim, 2018). However, with attention and intervention, children with significant social impairment can grow to enjoy close, lasting friendships.

If you have questions about your child’s social difficulties, please seek the advice of a clinical child and adolescent psychologist. You can find a directory here.


American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Washington, DC: American Psychiatric Association.

Bottema-Beutel, K., Park, H., & Kim, S. Y. (2018). Commentary on social skills training curricula for individuals with ASD: Social interaction, authenticity, and stigma. Journal of Autism and Developmental Disorders, 48(3), 953-964.

Denham, S. A., Workman, E., Cole, P. M., Weissbrod, C., Kendziora, K. T., & Zahn-Waxler, C. (2000). Prediction of externalizing behavior problems from early to middle childhood: The role of parental socialization and emotion expression. Development and Psychopathology, 12(1), 23–45.

Flannery-Schroeder, E., Choudhury, M. S., & Kendall, P. C. (2005). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: 1-year follow-up. Cognitive Therapy and Research, 29(2), 253–259.

Glenwright, M., Tapley, B., Rano, J. K. S., & Pexman, P. M. (2017). Developing appreciation for sarcasm and sarcastic gossip: It depends on perspective. Journal of Speech, Language, and Hearing Research, 60(11), 3295- 3309.

Howie, L. D., Lukacs, S. L., Pastor, P. N., Reuben, C. A., & Mendola, P. (2010). Participation in activities outside of school hours in relation to problem behavior and social skills in middle childhood. The Journal of School Health, 80(3), 119-125.

Jones, D. E., Greenberg, M., & Crowley, M. (2015). Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. American Journal of Public Health, 105(11), 2283- 2290.

Katz, S. J., Conway, C. C., Hammen, C. L., Brennan, P. A., & Najman, J. M. (2011). Childhood social withdrawal, interpersonal impairment, and young adult depression: A mediational model. Journal of Abnormal Child Psychology, 39(8), 1227–1238.

McQuade, J. D., & Hoza, B. (2015). Peer relationships of children with ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment, 4th ed. (pp. 210–222). New York, NY: Guilford Press.

Patalay, P., & Fitzsimons, E. (2016). Correlates of mental illness and wellbeing in children: Are they the same? Results from the UK millennium cohort study. Journal of the American Academy of Child and Adolescent Psychiatry, 55(9), 771-783.

Rubin, K. H., Coplan, R., Chen, X., Buskirk, A. A., & Wojslawowicz, J. C. (2005). Peer relationships in childhood. In Developmental science: An advanced textbook, 5th ed. (pp. 469–512). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers.

Valkenburg, P. M., & Peter, J. (2009). Social consequences of the internet for adolescents: A decade of research. Current Directions in Psychological Science, 18(1), 1–5.

Webster-Stratton, C., & Reid, J.M. (2004). Strengthening social and emotional competence in young children: The foundation for early school readiness and success: Incredible years classroom social skills and problem-solving curriculum. Infants and Young Children, 17(2), 96-113.


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