Social perception in children and adolescents with ADHD: The role of higher-order cognitive skills.
Kids with ADHD stumble on social-perception tasks only when audio and video cues come together—check attention and theory-of-mind first.
01Research in Context
What this study did
Cardillo et al. (2023) watched kids with ADHD and typical kids do social-perception tasks.
Some tasks used only faces, some used only voices, and some used both face and voice together.
The team also gave quick tests of attention and theory-of-mind to see what might explain any slips.
What they found
Kids with ADHD scored lower than peers only when the task mixed audio and video at the same time.
On single-mode tasks—just faces or just voices—the two groups looked the same.
Poor scores on the combined task tracked with weaker attention and lower theory-of-mind scores, not the ADHD label itself.
How this fits with other research
Clarke et al. (1998) first showed that kids with ADHD mis-read facial fear; Ramona updates that story by showing the real trouble starts when cues pile up in two senses at once.
Lin et al. (2021) found attention gaps in one sense at a time; Ramona’s audio-video deficit lines up with that modular view and links it to social settings.
Amorim et al. (2025) widened the lens to autism and OCD and found that IQ and social-communication scores matter more than diagnosis; Ramona’s ADHD-only data fit that same rule—attention and ToM scores, not the diagnosis, predicted the drop.
Why it matters
Before you write a social-skills goal, test combined audio-video attention and theory-of-mind. If those pieces are weak, start with brief dual-modality drills and build from there.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Run a 5-trial probe using short clips with both face and voice; score errors and note if attention drifts or if the child can’t say what the speaker thinks or feels.
02At a glance
03Original abstract
Despite children with ADHD frequently experiencing difficulties in social perception, the mechanisms underlying this impairment have been poorly explored. In this study, we examined social perception in children with ADHD, comparing them with typically-developing (TD) children on semi-naturalistic tasks, and considering the effect of nonverbal signal recognition. Our aim was to ascertain whether the two groups' social perception related to different types of stimulus (video, audio or combined/multimodal). The role of three higher-order cognitive skills (theory of mind, attention and pragmatic language) was also investigated. Thirty-six children with ADHD, and 36 TD controls were tested. Social perception was significantly associated with participants' ability to recognize nonverbal signals, and with the stimulus presentation modality. Children with ADHD only performed less well than TD children with combined stimuli. As concerns the higher-order cognitive skills, theory of mind had a significant role in both groups, but only with the video and combined stimuli, while attention explained most of the variance in social perception for all types of stimulus. Better pragmatic language skills were only associated with a better social perception in TD children, whatever the type of stimulus presented. Semi-naturalistic tasks should be included when assessing social perception in ADHD, and both theory of mind and attention should be the object of efforts to enhance social perception in the ADHD population.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104440