When children feel good about themselves, everything goes a little easier for them and their parents. But poor self-esteem is a big problem for ADHD children — and an even bigger problem for the 50 percent or so of ADHD children who also have learning difficulties.

To feel good about themselves, children need two things: the sense that they’re successful, both socially and academically, and unconditional love from their parents. If either ingredient is missing, a child will have a hard time developing a sense of self-esteem.

A child might reveal his unhappiness by saying, “I hate my life” or “No one likes me” or “I’m just dumb.”

Does your child say or do things that suggest that he feels he isn’t “good enough” or is unworthy of love? Do her words or behavior suggest that she feels like a failure at school? That her peers aren’t especially fond of her, or that she is otherwise unsuccessful socially?

Negative reactions?

Think back over the past few weeks. Were there times when you or your spouse felt so frustrated by your child’s behavior that you yelled at him or said things that you later regretted? Were there times when you or your spouse tried to avoid your child?

If so, sit down with your spouse and discuss why the two of you are having trouble being calm and affectionate. If it is because of your child’s hyperactivity, inattention, or impulsive behaviors, is his ADHD being properly treated?

If it is her poor performance at school and battles around homework, might she have undiagnosed learning difficulties? If your child’s ADHD behaviors are triggering negative reactions from you, other family members, or other children, it’s essential that you consider the impact this has on his self-esteem.

Billy’s story

Not long ago, I worked with an eight-year-old named Billy. Clearly, he needed to be on ADHD medication, but his parents were wary about putting him on medication throughout the day. At their insistence, I put Billy on a drug regimen that would cover him only at school.

When we met again two weeks later, Billy’s parents told me that he was doing much better at school. But I discovered that there were big problems at home. Billy’s parents were yelling at him on a regular basis — to stop interrupting, to quit jumping on the furniture, to sit still at mealtimes, and so on. When I asked Billy’s parents to consider the effect their yelling might be having on Billy’s self-esteem, they quickly agreed to add medication coverage for evenings and weekends.

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