Social Understanding and Friendships in Children with Attention Deficit/Hyperactivity Disorder or Dyslexia

Social understanding relies upon children's experience of the world and their communicative interaction with others. Opportunities to engage in cooperative social interaction, such as friendships, can foster the development of social understanding. Children with attention deficit/hyperactivity disorder (ADHD) and dyslexia often have friendships of poorer quality. The present study examined relationships and differences in social understanding and friendship quality in children with ADHD or dyslexia, in comparison to neurotypically developing children (NTD). Participants were 192 primary-school students (Mage = 9.77, SD = 1.21) from Attica, Greece. Social understanding was measured with second-order and advanced theory of mind (ToM) tasks, and the Bryant's Index of Empathy for Children and Adolescents, while friendships were examined with the Friendship Quality Questionnaire. Children with ADHD scored significantly lower across all positive characteristics of friendship quality, empathy and advanced ToM than those with dyslexia, who in turn scored significantly lower than NTD children. Moreover, children with ADHD performed significantly worse in the second-order ToM tasks compared to children with NTD or dyslexia, while NTD children scored significantly lower in the friendship conflict betrayal subscale compared to both ADHD and dyslexia groups. Multiple regression analyses controlling for learning disability status, gender, and age showed that ToM and perceived empathy predict friendship quality characteristics in all groups of children. Our findings contribute to a better understanding of children's friendship relationships and give insight to parents and professionals involved in children's education, provision, and mental health care.