How to Build Self Esteem in ADHD Kids Two


In this second article on “Building self-esteem in kids, whether ADHD or not”, we will continue looking at ways to build self-esteem and confidence in all children, teens, and just maybe in adults, too.

Just like most children with learning problems, kids with attention deficit hyperactivity disorder often have poor confidence, a shaky self-image and poor self-esteem. This combination of social-communication shortcomings usually leads to disaster sooner or later as these kids and teens fail to develop and retain the skills necessary to survive in an academic environment, needed to get and retain a job; and fail to acquire the social-interpersonal skills used in building a successful life. “If you can’t clearly and effectively tell someone what you’re thinking or what you want them to do; then you can’t expect them to understand you.”

For these very reasons, ADHD experts and child behavior experts place a great deal of emphasis on building confidence levels and a positive self-image-self-esteem in all children and teens (and sometimes adults) in their care. This is often done by teaching the ADHD-behavior problem child the skills needed to build positive self-worth, positive self-image, and good confidence leading to improved self-esteem.

Ways to build positive self-image and confidence include:

  • Teaching the ADHD child better communication skills and the patience needed to exercise those new found skills when dealing with others
  • Providing experiences which allow the child or teen to build confidence and self-esteem in front of his peers and dedicated coaches
  • Overlooking those little annoying things that behavior problem children so famously tend to show when stressed or when they just can’t figure out what else to do
  • Using each positive and negative behavior display as a non-punishment learning experience
  • Helping the child find his or her place of value in your family or in the classroom.

As an example, I’d like to tell you about a 10 year-old boy named Nathan who I first saw in my office 8 years ago.

At the time, Nathan was what his mom called “the devil without a tail”. No one liked Nathan…not his parents, his sister, his grandparents, his teachers, his classmates, the next door neighbor…well, I’m sure you get the idea. Nathan’s behavior was so terrible, no one wanted to be around him. He was so disruptive, that he turned everyone off. He interrupted regardless of who was speaking, became angry when ignored, punched holes in walls, broke windows, threw rocks at neighborhood kids, screamed obscenities, and threatened literally everyone who didn’t give in to his demands.

At first glance, I was willing to bet that Nathan was bipolar or had a mild psychosis. But, after finishing his evaluation, it became clear he was suffering ADHD with oppositional defiant disorder. What clinched the diagnosis?

  • His physical exam, blood testing and reality testing were all normal-he knew what he was doing and why he was doing it. No one had bothered to ask him in the past so he didn’t share it. He actually understood his behavior was uncontrollable. He just couldn’t understand why he behaved the way he did. He said it was like “My brain just said do it, before I thought about it!” That’s what we call impulsivity-a core symptom of ADHD.
  • His impulsive-disruptive behavior only appeared to occur during time of distress. He was picked on a lot at school because he was taller than everyone else, very skinny and had two very large left feet. He couldn’t run without stumbling, so no one invited him to play sports. It was obvious that Nathan was a victim of bullying and ostracized by classmates and teachers.
  • His attention span was so short on some days that he couldn’t focus long enough to read comic books or watch an entire cartoon show on Saturday morning. But, on other days, he could sit and draw or read for hours with no problems. So, his grades weren’t bad, but weren’t great and everyone in the class called him stupid, brain-dead, and dumb for brains.
  • Nathan was suffering from terrible self-esteem-confidence problems. Everyone around contributed to his punishment…he was literally in a no-win situation.  You know the old saying…kick a dog when he’s down? A child can’t build confidence and a positive self-esteem when he feels inferior, when he feels punished all the time, when he feels unloved.

In order to discover all of these things, I had to speak with and get feedback from everyone … parents, sister, grandparents, teachers and his “best friend”. Many doctors skip this absolutely necessary step when evaluating a child for ADHD and I think it’s one of the biggest reasons so many children suffer misdiagnosis of ADHD.

Now that we knew Nathan’s diagnosis with reasonable certainty, what do you think we did to fix his lack of confidence, self-esteem and ADHD?

  • We found a life-skills coach for Nathan.  His new coach concentrated on teaching him out to sort out his feelings when things happened before reacting to those things. How to handle bullying and being unable to match the athletic abilities of his classmates. How to communicate what he thought by first thinking about what he wanted to say and do before he actually committed to the behavior and terrible words.
  • We started him on Focalin-a stimulant-an ADHD drug- in hopes it would help his brain executive thinking centers slow down long enough to focus on controlling his behavior.
  • We referred him to a physical therapist for gait testing to find out why he stumbled when running. Guess what? He was suffering from a slight in-toe-ing and with orthopedic intervention was running well enough to play sports without embarrassment.
  • We discussed all of this with the Boy Scout Master at his church and convinced him to help. He allowed Nathan to join the troop and tutored him though all of the merit badges he needed to gain confidence and a positive self-image in front of his peers. This would not have worked if either of his parents had tried to do so or if they were directly involved with the Boy Scout troupe. Having a parent be your coach is like having a jailer who is supposed to teach you how to be a good prisoner. It just does not work…it places too much pressure on the ADHD child or teen and is a recipe for failure.

I’m happy to tell you that all of these ADHD interventions worked. Nathan’ grades went up, the bullying stopped; he played varsity football in his final high school years, worked a part-time job at a local grocery, bought a car, got his driver’s license, got a scholarship to a local community college, and now has a steady girl-friend.  The thing he was most proud of? He earned an Eagle Scout Award. This is the award most consistently earned by US presidents, CEOs of major corporations, career military personnel, lawyers, doctors and other highly motivated people. This is a really big deal!

Nathan is a prime example of what  goes wrong when a child is suffering from lack of confidence and poor self-esteem; whether he or she has ADHD or not. Building good self-image, confidence and self-esteem should be one of the first things considered when a child starts showing any type of behavior disorder before drugs or other interventions.

We’ll go further into depth discussing life-styles coaches, self-image evaluations and ADHD medications in the next three or four articles. See you there!

Frank Barnhill, MD

Just in case you missed the first article in this series…

How to Build Self Esteem in ADHD Kids One


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