Does My Son Need A Therapist?

Hi Ellen,

I am having some issues with my seven year old son. He is in 1st grade and is not getting great reports from his teacher. She says he is constantly trying to get her attention, usually only does the minimum work required, and acts like a “baby.” He is the second lowest performing student in the class, ahead of another boy who is ADHD. The main adjective she uses to describe him is “lazy.” She also thinks he uses humor or goofing off as a defense mechanism for his average reading and work skills. Further, on the playground he calls people “dumb” or “weird.” The other day, one little boy even hit him in the face out of anger.

His behavior continues when he gets home. Everything is a game, he does things only when he feels like it, and I do feel he acts younger than he should. He will follow rules but often it takes yelling at him to get him to respond. I have tried positive reinforcements, behavior charts, consequences, etc. He does ok for a while, but then depending on his mood, will fall back into his old ways.  He cannot watch TV, play video games or have playdates during the week because he can’t seem to handle those kinds of distractions on nights when he has homework. He has friends but does not get a lot of invitations to play. I’m not sure if it’s because of his behavior or because the other parents are too busy.

I have wondered if he has ADHD, but his teacher thinks not. She believes he is very bright but that he has some attitude issues. She feels that, when he cares about something, he does wonderful work and is completely engaged. When I ask my son to try his best, he says he doesn’t care about doing well and that he is dumb. Could he have self esteem issues at age 7?

I want to know how I can help my son to mature and to show more respect for himself and others. I know he is capable but doing well consistently, just doesn’t seem important to him. He has been getting reports similar to these since preschool. We are currently thinking about signing him up for karate (to address respect and discipline issues),  and were told by the teacher to take a more “drill sergeant” approach with him. I’m just not sure what to do. Do you have any suggestions?

Thank you!


P.S.- We have a 9 year old daughter who is doing very well socially and academically.

Dear Betsy,

First of all, I’m happy that you took the time to write in. It sounds like you and your son are having a very difficult time and that you have hit the wall. That’s actually good, because from what I can gather it’s time to take action in finding out what’s going on and then getting your son the help that he needs.

Whenever a child has been having serious issues for more than six months, it’s a good idea to have some kind of intervention or assessment done. By serious issues, which can be thought of as “red flags,”  I mean things like:

  • hurting himself or another child on purpose
  • hurting animals
  • having frequent problems at school — either academic or social, with classmates or adults
  • having frequent problems at home, including arguments, tantrums, or non-cooperative behavior
  • showing significant changes in sleep or eating habits
  • taunting or bullying behavior
  • persistent sadness, anger, anxiety or hostility
  • sexual acting out
  • persistent nightmares
  • persistent lying or stealing

Your son does have a few of these going on, and I do think an evaluation is in order. The sooner he can be assessed and a plan can be put into place to help him, the sooner he can start feeling better about himself. In answer to your question, yes, it is definitely possible for him to be having self-esteem issues at his age.

One of the most important reasons to address this ASAP is that without intervention, these kinds of behaviors tend to worsen over time. And before you know it, teachers will be talking about him, and kids will be avoiding him. He may well be marked as a “problem child” and then things are bound to go downhill even more. You definitely don’t want that!

But he’s still so young that if you get help now, the odds are very good that he will be able to turn things around and create a happier, more successful life for himself. It’s great that your daughter is doing well, but each child is different, and your son may need a very different approach.

So I would recommend that you take him to the pediatrician right away to rule out any health issues, including those involving vision and hearing. Sometimes kids act out and get very frustrated when they can’t see or hear properly. Let him or her know, before the visit, what your concerns are. Speak privately after the session about findings and recommendations.

Then talk with the school social worker or psychologist about having him evaluated through the school. If they are not equipped to do that, they should be able to refer you to someone who can. Part of his difficulties may have to do with a learning problem.

And finally, get a referral from your pediatrician or school counselor for either family therapy or individual child therapy.

Once you know what’s really going on with your little guy you can work with the right people to get him back on track. And as I said, the sooner the better.

In the meantime, keep letting your son know that you love him. Keep breathing and try not to worry. Good luck. I know this is hard but your instincts are right, and there is every reason to think that you can find a solution with some help. We’re wishing you and your whole family all the best!

P.S. I would hold off on the karate for now. Despite your good intentions, it may just add more behavior problems to the mix.

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Ellen W. Schrier, LCSW, is a family therapist and the mother of three adolescent/young adult kids.

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