Abstract It is well-established that youth with attention-deficit/hyperactivity disorder (ADHD) are often peer-rejected and rated by parents, teachers, and observers to have poor social skills, when compared to typically developing peers. Significantly less research, however, has been devoted to the experiences youth with ADHD have in their close friendships. The aim of this article is to draw attention to friendship as a distinct construct from peer rejection and social skills and to summarize what is known about youth with ADHD in their friendships. The potential for stable, high-quality friendships to buffer the negative outcomes typically conferred by peer rejection in this population is discussed. This article concludes with recommendations for interventions that specifically target improving the close friendships of youth with ADHD as a treatment strategy. Keywords: Attention-deficit/hyperactivity disorder, Friendship, Peer relationships

Summary It has been well established that children with ADHD experience substantial peer relationship problems leading to depression, criminality, school failure, and substance abuse. To date, difficulties with peer acceptance and social skills in ADHD populations have been studied to a greater extent than have difficulties with dyadic friendship. Nonetheless, all available evidence suggests that youth with ADHD experience trouble with making friends, keeping friends, the quality of the friendship, and selecting friends who are not involved in deviant activity. In light of findings suggesting the buffering effect of friendship on good adjustment among typically developing youth, there is reason to believe that if a child with ADHD can establish high-quality, stable friendships with nondeviant peers, this will protect against later psychopathology. The benefit of having even one good friendship may still occur even if the child with ADHD remains unpopular overall in the larger peer group. The peer rejection among children with ADHD has been refractory to most existing interventions, such as medication, behavior management, and social skills training. Given that peer rejection may be too difficult or too impractical to change, a targeted focus on improving dyadic friendship may be a feasible goal that is also more likely to lead to generalization of skills outside of the therapy context. This paper serves as a call to action to explore the development and validation of interventions targeted specifically to friendship. A successful friendship intervention might focus on the selection of appropriate friends, teach the particular behaviors known to be related to positive friendship formation in a single context of playdates, and have high involvement of parents in the treatment.