Attention deficit hyperactivity disorder (ADHD) has long been linked to low self-esteem, anxiety, and other emotional and mental health problems. Some research shows that ADHD children are up to four times as likely as other kids to develop symptoms of depression as they grow up. These troubles often stem from the lack of control kids feel over what they experience, said Dr. Steven Kurtz, director of clinical services for the ADHD Institute at the New York University Trial Study Center, NYU Medical School.
“These kids have the sense that they're putting a lot of effort into something and they're not getting enough in return compared to their peers,” Dr. Kurtz said. “When you don't have successful experiences, you can't build self-esteem.”
According to Dr. Kurtz, boosting self-esteem in kids with ADHD boils down to one simple principle: “It's really about building skills and reinforcing those skills.”
To lay the foundation for social and scholastic success for a child with ADHD, here are some guidelines to help build his or her skills and self-esteem:
- Focus on strengths. The first step in trying to build self-esteem in a child with ADHD is playing to his or her strengths. “If a kid is struggling in school, try to find something outside of school that he or she can feel successful at,” Dr. Kurtz said. Then, as the child gains more self-confidence, offer frequent reminders that he or she can be just as successful in school. Work with your child's teachers to continue to encourage him or her by playing to specific academic strengths.
- Accommodate in school. To help support that scholastic success, Dr. Kurtz said parents must be willing to learn about education laws and request any accommodations needed for their child. “Parents and teachers need to work together to come up with a plan,” he said, which should include making sure that learning materials at the child's level are used and that instruction is tailored to his or her needs, whether that means more individual attention or having specific learning aids — such as a laptop or tape recorder — available in class for note-taking.
- Keep instructions positive. Kids with ADHD hear a lot of negative words, Dr. Kurtz said, because many people don't know how to correct their problem behavior. “There's a mantra that parents sometimes get into, overusing negative words like 'no, don't, stop, and quit,'” he said. “If you find yourself doing this, remember that the key is to tell your child what you want him or her to do, not just what you want them не to do.” Many kids with ADHD really need to know what the appropriate or expected behavior is, he adds, and parents and teachers must be on the spot, redirecting inappropriate behaviors and instructing the child on what he or she should be doing instead.
- Clarify expectations. Taking on complex, multistep projects is tough for children with ADHD, even if the instructions seem simple to others. Dr. Kurtz recalled how he worked with one father on redirecting the behavior of his daughter. For example, the father would say to his daughter, “It's time to pick up the toys now,” expecting her to understand. But according to Dr. Kurtz, a better phrase would be, “Please pick up the toys.” This narrower parameter makes it easier for kids with ADHD to organize what they need to do to complete the task. “Kids with ADHD have more difficulty directing toward long-term goals,” Dr. Kurtz said. “Giving instructions in developmentally appropriate bite-size pieces helps your child build those skills, which benefits them long-term.”
- Use rewards. In general, it's not a good idea for parents to bribe their children into good behavior, but Dr. Kurtz believes that while some may find the practice controversial, it can actually be a helpful tool for parents and teachers of kids with ADHD. “Frankly, I advise parents and teachers to feel comfortable using rewards,” he said. “These can be very helpful in getting a positive behavior started. Then, once the child sees that the behavior makes sense, he or she won't need the rewards anymore.”