ADHD Weekly 2017-11-09

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Your child forgot to turn in his homework. Again. He struggled with organizing information into an assigned report. He works five times as hard for a passing grade as his schoolmates do. He talks too much, interrupting his peers, and is ostracized on the playground. He comes home feeling sad and withdrawn. What can you, his parent, do? 

Research has drawn a direct line between ADHD (particularly its inattentiveness) and low self-esteem. But further research has shown that parenting approach and style can directly affect a child’s self-esteem.

“Parental reflective functioning” is a term for the capacity to reflect upon (recognize, understand and accommodate) your child’s internal mental experience. For example, you can recognize the anxiety he may feel when he makes mistakes or has a hard time doing something, and proactively engage with him/her in ways to promote self-worth and confidence. This parenting style—a practiced and learned skill—is necessary to develop cognitive abilities in your child and enable emotional regulation and healthy social relationships.

On the other hand, because your child’s challenging behaviors can take a toll on you, practicing reflective functioning toward your own mental experience—recognizing when you are stressed and adapting your behaviors accordingly—is important in order to maintain a positive balance in your interactions with your child.

So how can you do this?

Practice a two-step process: Praising for things your child accomplishes, and recognizing/noting the challenges that made it hard for your child to do it.

• Frequent negative feedback can undermine your child’s self-esteem. Recognize your child’s successes, no matter how small. Make an effort to notice when your child is paying attention well or doing what he is supposed to be doing—as well as what skills and discipline he had to apply in order to do it. 
• Tell your child exactly what he did well—not just the general “good job!” but specifically “I love how you took the time to think about the assignment and organize your outline!” This can not only improve your child’s self-esteem, but also reinforce his understanding of what it takes to accomplish something, so he can engage the same skill again. This can also teach him to notice gradual improvements, rather than being too hard on himself. 
• Articulate what mental or emotional challenges he may have had to overcome in order to succeed in this instance. “I know you may have been distracted by other thoughts, but you worked real hard to overcome those in order to stay on task. Way to go!”
• ADHD often confers “mirror traits” that are of great value. Identify your child’s strengths. She may not be good at reading but she’s the next Picasso. He may not be good at writing reports but he intuitively generates creative new ideas, like the next Steve Jobs or Rube Goldberg. Recognize, praise, and leverage those strengths, so that your child will have a sense of pride and accomplishment. 
• Recognize that he may be feeling some residual anxiety after school and that he needs “wind down” time to do something he’s good at. Articulate that dynamic, so that he develops the skill to recognize his own feelings and how to deal with and overcome them. 
• Make sure your child has the opportunity to be successful while pursuing these activities, and that his strengths aren’t undermined by untreated ADHD. And don’t spoil the fun by withholding activities he loves as “reward” for doing the things he doesn’t love (like cleaning his room). 
• Help your child work through activities that are hard for him by breaking tasks down into small incremental components or steps. Recognize accomplishments at each step; that will build confidence, encourage him into the next step, and also teach the skill of breaking down tasks himself into manageable sub-tasks—an organizational skill. 

• Many children may resort to “horizontal storage” for their toys by covering every inch of the floor in their rooms. Sit with your child and step him through the cleanup one category at a time. “All the red trucks—where shall they go?” “Great! Now all the blue cars—where shall they go?” 
• And when it’s all done, “I love how you patiently organized your toys into categories—now you’ll know where everything belongs!”

• Set aside a daily special time for you and your child. A special time, whether it’s an outing, playing games or just time spent with your child in positive interaction, can help fortify your child against assaults to self-worth.  It also reinforces healthy attachment; research has shown that insecure attachment impedes development of a positive self-image and is associated with ADHD.
• Practice social skills with your child. Children with ADHD may be rejected by their peers because of hyperactive, impulsive or aggressive behaviors. Do role-playing with your child, through several social scenarios. Ask him to anticipate how someone, such as a friend, may feel if he were to do certain things or behave in a certain way. Ask your child to act that out. Then ask him to imagine a different way of behaving, which would not make the friend upset or annoyed. Agree on one-word “codes” or “signals” representing each preferred action. Then invite one of his classmates over for a supervised play date, and when necessary call out the relevant code words to signal your child to choose the more effective behavior he practiced. 
• Tell your child that you love and support him or her unconditionally. There will be days when you’re exhausted, angry, stressed, and it’s hard to feel loving. Recognize those times and grant yourself permission to breathe and reflect on how your child is feeling. This is when it is even more important that you acknowledge the difficulties your child constantly faces and express your love. Let your child know that you will get through both the smooth and rough times together. 

For more help:

• Parent training is advocated by experts as a vital component of multimodal treatment, which provides the greatest likelihood of improvement in children with ADHD.
• Parenting a Child with ADHD fact sheet

How do you help your child’s self-esteem?

Children with ADHD often suffer from poor self-esteem. Daily academic and social failures can take a toll on confidence. How can you help build your child’s self-esteem?