How can you boost the self-esteem of a 5 yr-old child diagnosed with ADD? Raisingkids.co.uk's guest expert Jill Curtis talks about the difficulties a child with ADD faces and advises which coping strategies to implement.

Raisingkids member's problem
My 5 yr-old daughter was diagnosed with ADD because her symptoms matched over 8 of those listed for the disorder. She was slow and day-dreamy rather than hyperactive. She was given Ritalin for approximately 12-18 months, which made a big difference to her communication ability - it was like her brain was 'on the ball' rather than sluggish. We didn't like the idea of her taking medication long term, so stopped this when she'd developed better reading skills. She nevertheless continued to have a short term memory problem and would tend to glaze over at an early saturation point in class when a teacher was lecturing.

My daughter's now almost 14, and has survived all levels of schooling without medication since she was 7. I believe she's doing well enough (straight 4's in her SATS in year 6), although with a high IQ, she's perhaps not doing as well as one would expect. She does have a low self-esteem, hangs back from the crowd and is rather oppositional when asked to do anything. We're very encouraging, endeavour to positively reinforce her sometimes negative thoughts about herself, and tell her every day that we love her, as well as trying our best to provide discipline. I'm writing to ask you whether you can offer any advice on the way forward with my daughter to enable us as parents (and how to help her teachers) to help her fulfill her full potential and to gain confidence and a higher self-esteem?

Jill Curtis's advice
I was most interested to read about your experience with Ritalin and your daughter. As you know arguments rage over the use of medication for some disorders, and it's helpful to know Ritalin helped your child. I've spoken to many parents about Ritalin. Some parents opt for this treatment quite early on, whilst others fiercely oppose any suggestion of medication for their child. Comments range from 'With Ritalin I got my son back again' to 'For us Ritalin was a last resort, and it didn't work' to an outraged 'We teach our kids to say NO to drugs, and then pump them full of medication.'

For your daughter short-term medication (12-18 months) has been beneficial. The fact that you did not expect the medication to solve all the difficulties and that you stopped when she had developed certain skills has meant your chance of good results was higher. Some desperate parents hope that medication will be the answer to a multitude of problems and are then become bitterly disappointed when there's no improvement and the child also has to cope with the side effects of the medication.

Many children who daydream, or cut off for one reason or other, find it hard to cope with gaps in their understanding. Quite often a child with mild ADD won't be diagnosed at all and their disability goes unrecognised for some time. They may just coast along, but it is more than likely they will soon find themselves in trouble at school for daydreaming, not seeming to concentrate, or for failing to complete tasks. A cycle soon develops - the child isn't engaged in the activity finding it their imaginary world preferable. Indeed many children with ADD symptoms are found to be very creative. If routine school work does not engage their attention, the daydreaming can begin. It may be too that in the past your daughter has been 'in trouble' at school for 'careless' mistakes, appearing not to listen, and for general lack of concentration. All this can erode a child's self-esteem. It can be hard for a child with a poor short-term memory to feel clued in all the time, and again this can attack their belief in themselves. This could account for your daughter hanging back from the crowd. You seem to be very loving and supportive parents.

Make sure that you help her with memory-aid strategies. Talk to her about the situation and work out together any schemes to help her keep up with work. Remember many people with mild ADD feel anxiety and low self-esteem because of the intolerant attitude of others. In this busy world we are all expected to jump to it, and anyone lagging behind, or who forgets things, is seen as annoying. Continue to reassure her that everyone is different, and make sure she doesn't become overloaded or overstimulated. Above all, talk to her and explain what you think is happening, and why.

• More Answers From Hidden Disabilities Specialist, Jill Curtis
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