What role does peer interaction play in emotional development for children with ADHD? 

Friendships and social belonging play a crucial part in how children with ADHD develop emotionally. According to NICE guidance on ADHD (NG87, reaffirmed 2025), structured peer interaction and social-emotional learning are essential to help children build empathy, regulate frustration, and reduce anxiety linked to rejection or isolation. 

Why peer relationships matter 

A 2024 PubMed longitudinal study from the Children’s Attention Project found that children with ADHD who experienced positive peer interactions showed lower irritability and better emotional control over time. Conversely, peer conflict and rejection predicted heightened emotional reactivity 18 months later. The Royal College of Psychiatrists (2024) notes that supportive friendships help develop patience, empathy, and problem-solving, protective factors that buffer against emotional distress. 

The effects of rejection and bullying 

Children with ADHD are more vulnerable to social exclusion due to impulsivity or intense reactions. A 2023 BMJ Open review found that emotional dysregulation and rejection sensitivity make children more prone to bullying and peer dislike, creating a feedback loop that reinforces anxiety and frustration. Meta-analyses from 2024–2025 confirm that sustained peer rejection is one of the strongest predictors of later mood difficulties in ADHD youth. 

Supporting emotional growth through inclusion 

Inclusive classrooms and structured play improve both confidence and empathy. Evidence from BMJ Paediatrics Open (2025) and Public Health England SEND guidance (2024) supports whole-school approaches that include: 

• Peer mentoring or “buddy” systems to reduce isolation. 

• Emotion coaching sessions to help children recognise and manage frustration. 

• Role-play and empathy-building activities to encourage cooperation and social perspective-taking. 

Structured behavioural and CBT-based interventions also show benefit. A 2023 PubMed meta-analysis found that CBT and social skills groups significantly improved emotional regulation and peer cooperation among primary-age pupils with ADHD. 

The role of families and teachers 

Both the NHS and DfE SEND frameworks highlight collaboration between parents and schools as critical to sustaining emotional progress. Teachers and caregivers can model calm communication, support cooperative play, and use structured feedback to help children repair conflicts rather than internalise rejection. 

Services like Theara Change are developing ADHD-informed emotional coaching tools that complement school-based approaches, helping children apply these skills beyond the classroom. 

Key Takeaway 

Peer relationships shape far more than friendship; they build the emotional foundation children with ADHD need to thrive. When schools and families prioritise inclusion, empathy, and early social support, children learn not just to manage emotions, but to connect with others confidently and compassionately.