Q My 10-year-old daughter has ADHD and ODD, which we've worked hard to manage at home. Her real struggle is with other kids, mostly girls. She cannot keep friends. At all. And this is beginning to have a real effect on her sense of self-worth. What can we do? I feel a sense of urgency here since I know statistically she is at higher risk for substance abuse, self harm and suicide attempts.
First of all, you are right to be concerned about friendships, self-esteem, and body image at this age, because now is the time when a lot of these issues first start to surface, and they can grow as kids enter middle school and then high school. And you are right about the increased risk for substance abuse and related risky behavior. There is research to show that organized sports can help prevent substance abuse and also build self-esteem, confidence, and peer relationships.
Now, I know that not every kid is good at sports or enjoys sports, so any structured extracurricular activity that allows her to interact with peers and succeed reasonably well—where she can feel confident and enjoy herself — is protective. That said, sports might be great for your daughter because the physical activity can help with attention and focus. I’d also add theater, choir, and science clubs to the list — anything that takes up time.
Once kids get into middle school and high school, the hour or two after school is the highest risk time for dangerous behaviors like substance abuse, because it’s the largest chunk of time when kids are unmonitored. By starting to develop good habits and skills in an extracurricular activity now, your daughter will be prepared for the higher risks of adolescence. To encourage her to keep going and have a lasting involvement in the activity of her choice, I would use rewards to incentivize attendance and clearly defined good behavior — something as simple as introducing herself to other children, etc.
Of course, you have described your daughter as having trouble with other girls her age. It can be helpful if you identify a few children in the group that your daughter might get along better with, and have playdates outside of the activity. They should be short and structured — like a movie — minimizing the amount of time for problems to develop. I would also suggest a book, A Smart Girl’s Guide to Friendship Troubles. Giving her some agency in how she shapes her behaviors and interactions with other people is very important. I like this book because in addition to its message and practical tips, it includes worksheets and scenarios your daughter can use to practice real world interactions.