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Is it a done deal, based on the consultation with the renowned expert, that the boy has ADHD? I am acquainted first hand with cases where meds were a condition to return to mesivta in the 10th grade. The boy took the meds & was aware of the effect it had on his body & personality. He didn’t feel like he was himself anymore. As far as self-esteem, having to take meds so “I can be like the other boys” does nothing for self-esteem. The solution in these cases was to find a mesivta that had more guidance for the younger boys (yes, 10th grade is younger boys), shorter independent prep time, a menahel/mashgiach who is astute in assigning pairing the right chavrusas. This does not mean a place with significantly lower learning. He will shteig just as well. And if this prevents him from becoming a gadol at 15, we’ll just have to wait until he’s 18.