In the ADD child, low self-esteem is manifested not just by the self-putdowns he may utter, such as “I’m dumb.” Above all, it is apparent in the perfectionism and in the dejection and discouragement he experiences when he fails at a task or loses in a game. Nor can he accept not being in the right. The fragile and self-rejecting ego is unable to endure any reminders of its fallibility. Many people with attention deficit disorder retain that fragility into adulthood.