Self-esteem in elementary school children with and without attention deficit disorder or attention deficit hyperactivity disorder

The self-esteem of children with Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) has been hypothesized to be low. These children receive frequent negative feedback from the important people in their lives for their hyperactive, impulsive and often intrusive behaviors and for frequent academic failures, which can result in low self-esteem. The research in this area however, reveals conflicting results. The purpose of this research study was to answer the question, Is there a difference in self-esteem between elementary school children diagnosed with ADD/ADHD and their peers? A comparative descriptive study design was used to compare the self-esteem scores on the Coopersmith Self-Esteem Inventory (SEI) of81 third- and fourth-grade students with (n = 7) and without (n = 74) a diagnosis of ADD or ADHD. Teacher ratings for each subject\u27s self-esteem using the Behavioral Academic Self-Esteem Rating Scale (BASE) and parent ratings of their child\u27s self-esteem as high, average or low were also compared. Using the demographic information provided by participants parents, there were no significant differences between groups by gender, ethnicity, parents\u27 marital status, parent\u27s level of education, parental employment, or number of children in the home, Jl. \u3e .05. Parent ranking of the self-esteem of the children with ADD/ADHD was significantly lower than their peers, Jl_ = .013. Although no significant differences were found between groups on the SEI or the BASE total scores or subscales,12 \u3e .05, the ADD/ADHD group did consistently rate themselves lower than their average classmate on the SEI. These findings are clinically significant in that studies of adolescents with a childhood diagnosis of ADD or ADHD consistently reveal low self-esteem by that age. These findings are similar to previous research with this age group. It is proposed that these children tend to answer defensively or offer inflated self-evaluations as a selfprotective mechanism. Advanced Practiced Nurses are often part of a collaborative team in the Family Practice, Pediatric, or Psychiatric office setting or in a school health setting which provide opportunities to identify indications of low self-esteem and to offer early appropriate interventions for the child, parents, teachers and significant others in the child\u27s life, which may help to minimize the life long negative consequences associated with low self-esteem. Limitations of the study, and recommendations for future research are discussed