I have an 11-year-old son who is finding life quite difficult. He has always suffered from very low self-esteem and confidence, even as a toddler. He has always had a strong need for control and experienced extreme separation anxiety. It even happened while toilet training, when he would “hold on” for as long as possible.

At school, he would give up on things very easily and say “I can’t do it”, or say that something he’d done is “rubbish”.

He also finds friendships difficult. He seems keen to have friends but at the same time, is reluctant to see friends outside of school or join clubs. He is not keen on team sport because he says he was laughed at during PE lessons at school . At home, he chats away but is shy with others to the point of sometimes coming across as rude. He has even begun talking about how he doesn’t like the way he looks.

My main concern is his lack of self-esteem – no matter how many times I tell him how wonderful he is, it doesn’t make a difference. As parents we have always praised him for trying (rather than for the end result) and are not critical at all. We also don’t put pressure on him to succeed. He is a lovely, thoughtful and kind boy, so I am simply looking for any advice on how I can help boost his confidence.

Generally speaking, a child’s self esteem develops from being recognised, listened to and accepted for who they are. This can be eroded for all sorts of reasons, one of which is being laughed at at school.

You didn’t give me much context so I don’t know if he has siblings, or if anything has ever happened at home or in his upbringing which may have affected him.

Instead, I contacted consultant child and adolescent psychotherapist Cathy Troupp whose first thought was that “whenever a child has mental health issues or problems with relationships, one should always consider possible factors other than parenting”. Troupp lists some of these as “developmental issues, or even autism spectrum conditions or even ADHD”. She also says you shouldn’t turn yourselves inside out looking for answers.

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It’s important to point out that your son cannot be diagnosed from a letter, so this is just an avenue to explore based on what you’ve told us. If you felt this chimed with you Troupp says your first port of call is a trip to the GP to ask for a referral to Child and Adolescent Mental Health Services (Camhs), which could screen and refer to specialist autism assessment services if that’s appropriate. Waiting lists are long, so if you think this is a possibility it might be worth getting on the list sooner than later.

Equally, your son may be what we call “neurotypical” (meaning he may not have any of the developmental issues that Troupp outlines). If this is the case, I asked Troupp what you could do to help him, so we started by looking at expectations. Troupp suggests “reframing your view of your son. Don’t expect him to fit in with social norms, and instead think [as best you can] about what works for him?”

She adds: “If he finds it more comfortable to be alone, for example, then maybe limit the amount of social interactions, and just see that as OK and meeting his own unique needs?”

Troupp also suggested “doing something like drama? Somewhere where children are well led, there is some structure but they are also free to express themselves.” If he doesn’t like certain sports does he have to do them?

Finally, says Troupp: “if he doesn’t believe you when you say he’s wonderful, then maybe it’s because he doesn’t [its] feel [its] wonderful so start talking to him in a more grown up way. Ask him “what do you find difficult?” and “What do you think you’re good at?”

It’s common for parents to try to problem solve, but children can hear that as dismissal. Most of all be patient, both with him and yourself.

Every week Annalisa Barbieri addresses a personal problem sent in by a reader. If you would like advice from Annalisa on a family matter, please send your problem to [email protected]. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.