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Friendship and Popularity in Mainstream Primary Schools

Dr Carole Yude is a research psychologist and the first part of this information sheet, written in 1996, is based on the findings of her doctoral research study. Carole worked with Robert Goodman, Professor of Brain and Behavioural Medicine, on his original study of children with hemiplegia, and her own study grew out of this.In the second part of the sheet Dr Yude revisits the subject to find out if anything has changed since.

Why choose to study children in mainstream primary schools?

Because children in years 5 & 6 are relatively settled and secure at this stage, and the majority start in reception or nursery class, and progress through the school with the same classmates. But more importantly the expectation is that teachers
would know more about the children in their class than teachers in secondary schools who spend less time with each class.

Why are we concerned about the school lives of children with hemiplegia?

Long before the very first study into the consequences of childhood hemiplegia was analysed, parents and teachers, and the children too, were revealing that life in mainstream schools was a struggle for many of the children. That first study showed that over half the children had significant emotional and behavioural problems. It seemed plausible then that difficulties at school with friendships and popularity might be related to these problems. But it was not clear whether it was the emotional and behavioural problems that were interfering with friendships or the lack of friends that was causing the problems.

Because parents and teachers can only provide a limited perspective of school life, we decided to ask the children themselves about their friendships and we also compared them to a group of classmates. We wanted to know if children with hemiplegia had more problems than their classmates and the sorts of problems they experienced. We also wanted to know if there were any differences in popularity and friendships between the two groups.

We asked both groups of children whom they liked to play with by rating all the children in their class (popularity) and to nominate the three children they liked to play with the most and the three children they liked to play with the least(friendship).

Who plays with whom in the playground?

Now we might have expected that children with hemiplegia would be less likely to take part in playground activities since these are generally physical activities requiring extra effort, speed or dexterity, and the major preoccupation in most schools, for most boys and some girls, is football. But it would seem that hemiplegia does not preclude a child from playing football at this level where specific skills, speed or dexterity are less important. However, it does seem to preclude children from playing for the team or the school, where these skills are more important.The children themselves told us that playground activities do not usually require an invitation to join in and the children who make up any group can vary from day to day or week to week. Friendships at this level might be more superficial and the larger groups are often made up of a core group, with several peripheral hangers-on. Most children with hemiplegia in mainstream primary schools told us that they usually have someone to play with, even if they do not always have a best friend, and it would seem that they are just as popular in the playground as their classmates.

The conclusion

The physical constraints of hemiplegia seem to be less important in deciding who plays with whom in the playground. Even so, some children were chosen less frequently as playmates, suggesting that the more subtle, less visible problems associated with hemiplegia such as low self- confidence,immaturity and vulnerability may be responsible. Yet these character traits were less important for their classmates - being aggressive or disruptive would appear to be more divisive.

About a third of the children with hemiplegia and a quarter of the comparison group also had problems with academic work - that is children with specific
learning difficulties or difficulties in keeping up with their classmates, each contributing to unpopularity in both groups. Sadness was another thing associated with difficulties arising from schoolwork and problems with friendships.

If there are few differences between the two groups, do they all have best friends?

Children with hemiplegia, compared to their classmates, were chosen less often as a best friend. And almost twice as many children with hemiplegia were either rejected or neglected by their classmates. (‘Rejected’ means that a child is
actively disliked and ‘neglected’ that a child is not particularly disliked but is more often ignored).

Rejected children, whether they had hemiplegia or not, had similar problems - immaturity, vulnerability, problems with school work, additional physical problems, being overweight and behaviour problems. Rejected children were more solitary and children with hemiplegia were likely to be more solitary than their classmates.

Neglected children appear to mix well with others but do not necessarily have close friends. They may have problems in getting on with one or more children in their class but they are rarely confrontational and as a general rule tend to avoid
conflict. They are frequently described as sensitive children who are anxious to please. Many are excessive worriers but rarely divulge their worries to parents or teachers.

As a general rule, neglected children worry and neglected children with hemiplegia worry more than their classmates.Some children were described as sad, in particular the children with hemiplegia, with sadness often related to feelings
about their hemiplegia and the constraints it imposed on them.

What conclusions can be drawn?

  • although physical characteristics do play some part in why children with hemiplegia are not chosen as a best friend, the visibility or severity of the hemiplegia was not a major factor.
  • being a child with hemiplegia does seem to influence friendship choice but it is the more subtle, less visible factors which seem to be responsible rather than the physical disability alone.

Early findings from another study seem to indicate that immaturity is associated with impaired social skills. For example,
problems with:

  • being tuned in to what others are thinking or feeling.
  • understanding the social rules of making successful friendships.
  • using and understanding the social cues we all use in a group or in conversation and so on.

There is more to making and keeping friends than simply asking someone to play:

  • being someone’s best friend is infinitely more demanding.It is more difficult for a child who might feel different.
  • children with hemiplegia have to learn to live with the constraints the hemiplegia imposes.
  • children with hemiplegia have to learn to accept the way that the rest of the world responds to their hemiplegia.
  • to be as popular as their classmates, children with hemiplegia need to try harder, be better behaved and nicer to their classmates.
  • But it is not all bad news!

    Despite the fact that children with hemiplegia have fewer friendships than their classmates, they are by no means friendless.
    Even though rejected children with hemiplegia are more solitary than their classmates, at least half the rejected children had one or two satisfactory friendships. However, only a third of neglected children with hemiplegia had satisfactory friendships in their class, compared to half of their ‘neglected’ classmates.

    Since only classroom relationships were being studied, friendships and popularity outside the classroom or school were not considered. A seemingly ‘friendless’ child may have a good friend in another class or elsewhere. And many seemingly unpopular children derive all the support they need from just one best friend, whether that friendship is at school or outside school.


    Children with hemiplegia, in comparison to their classmates, in this study, were more likely to be teased or bullied. Despite a vast number of possible explanations, only the neurological measures obtained in the original study (for the children with hemiplegia) predicted this higher rate of teasing and bullying. These neurological measures included information about the severity or visibility of the hemiplegia, for example how much the arm and leg was affected, whether the child had seizures and language problems.

    It is possible that children with hemiplegia (and perhaps some of their classmates) are teased or bullied for many of the same reasons that lead to their unpopularity as playmates or as best friends.

    The early findings of another study of children with hemiplegia associating immaturity with poor interpersonal social skills, difficulties in empathising with others and being tuned in to what others are thinking might well define these
    children as ‘easy targets’. It is plausible that it is this increased vulnerability which sets them up as victims.

    Clearly being victimised or being unpopular has an effect on the child, leading to anxiety, loneliness, poor self-esteem and, in a worst case scenario, depression. Since it looks as if we can predict those children most likely to be at risk from the earlier study, we might be able to use this information to intervene and head off possible problems in the future.

    Carole Yude 1996

    Part 2 Has anything changed? A review of current research.

    It is more than a decade since the original research on which the first part of this information sheet was based. Therefore,
    a good time to review other studies to see what, if anything, has changed. Although none of the studies were specifically about children with hemiplegia, all included them as a separate group. The literature is vast and this is but a snapshot of just three relevant studies and three intervention strategies.

    These are the questions which seemed to be important.

    • Are other researchers still finding the same self reports from children as we did?
    • Are children with hemiplegia still experiencing the same difficulties with friendships?
    • Did our study, and more recent studies, lead to any useful interventions?

    The three studies below are a cross section of research in this field - one in the UK, one in Canada and one cross European study

    • A UK study in 2005 [i]), which was almost identical to ours in its method, compared children with various disabilities, including a group with hemiplegia, with their classmates. Their study, however, did not report from the perspective of the children with hemiplegia as ours did, their focus being the perspective of their classmates. They found both boys and girls to be somewhat negative towards children with a physical rather than a learning difficulty and girls to be rather more negative than boys. They conclude that it is unclear whether the girls are just indifferent to this group of children or whether they are actively victimising their physically disabled classmates.
    • A study in Canada in 2006 [ii]) looked at the social adjustment of a group of physically disabled children, including some with hemiplegia. They found that girls had fewer reciprocal friendships, irrespective of their type of physical disability, and that they described themselves as more isolated and victimised by their classmates.
    • The European study (2008 (iii]) reported much the same as our longitudinal study and found that a significant proportion of children with physical disabilities (including the group with hemiplegia) in mainstream schools still have psychological problems.

    Are children with hemiplegia still experiencing the same difficulties with friendships?

    From the three studies detailed above, it would seem that children with hemiplegia, identified as a separate group in each of the studies, are still experiencing difficulties with friendships.

    So has anything changed in the way that schools are addressing their difficulties?

    Over the past decade a great deal of research has addressed the problems of children with Autistic Spectrum Disorder(ASD). Whilst our group of children do not meet the criteria for this diagnosis, they do share some of the same characteristics which can impair the making and keeping of friends. For example, understanding the rules of social interaction, using theright body language, and so on.

    A UK study in 2008 [iv] suggests two possible interventions.

    Firstly, Circle of Friends, which works by building relationships around the most vulnerable children in the class. This in turn may lead to more support and perhaps to the establishment of more lasting friendships.

    Secondly, social or guided stories as a way to teach children to understand the complexity of their social world.
    Social stories are described as:

    • descriptive - defines the event or situation and the people involved.
    • perspective - how people are feeling
    • directive - what is expected in this situation

    Another practical approach which seems to be useful is Social Skills Training (2003 UK [v]) here children are taught
    how to:

    • use social problem solving skills
    • use relaxation skills
    • think positively
    • modify their non-verbal behaviour
    • use some verbal strategies

    At the end of this eight week course children were reported to have increased self esteem and better coping strategies, both vital to acceptance by their classmates.

    However all these interventions need to be set within a whole school perspective.

    • Circle of Friends can lead to increased self esteem and possibly more friendships
    • Social or guided stories can help children with impaired social skills to understand the complexity of social interactions

    In conclusion, children with hemiplegia are still experiencing many of the same difficulties in mainstream schools we
    reported a decade ago. But it would seem that more effort is going into ways of intervening in schools to address these problems.

    Carole Yude 2009


    i) Kelly G; Laws E. (2005) The Attitudes of Friendship Intentions of Children in UK Mainstream Schools towards Peers with Physical or IQ difficulties. International Journal of Disability, Development and Education. p.79-99

    ii) Nadeau L; Tessier R. (2006) Social adjustment of Children with Cerebral Palsy in Mainstream Classes. Dev Medicine and Child Neurology. (48) p331-336

    iii) Parkes. J. et al (2008) Psychological Problems of Children with Cerebral Palsy: A Cross Sectional Study.Journal of Child Psychology and Psychiatry (49, 4) p405-413

    iv) Humphrey N. (2008). Including Children with ASD in Mainstream Schools. Support for Learning 23 (1)

    v) Fox C. Boulton M. (2003) Evaluating the Effectiveness of a Social Skills Training Programme for victims of Bullying. Educational Research. P 231-247

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