Medical Matters

Ritalin: Not the First-or Only-Choice for Active Children with Academic and Social Problems

Dr. Jo Reed Program Specialist at The Training & Technical Assistance Center Virginia Institute for Developmental Disabilities Virginia Commonwealth University November 1996

Recent statistics say that nearly 3 million children in the U.S. use Ritalin to cope with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD). This number has raised concerns among the public that Ritalin is being over-prescribed, and teachers and parents are being blamed for Ritalin's prevalence in classrooms. Critics claim that parents and/or educators use Ritalin as a quick fix to calm active children and render their behavior more manageable.

Ritalin can play an important role in helping children, parents, and schools manage ADD/ADHD. The use of this medication, coupled with appropriate behavioral support and classroom/instructional accommodations can help students with ADD/ADHD find meaning and fulfillment in every day activities such as completing tasks, making friends, and participating in conversation. The quality of the students' lives and the lives of their loved ones and teachers may be enhanced.

The potential for such positive outcomes, however, must not tempt parents or teachers to view Ritalin as a wonder drug to be administered to any child who encounters social or academic difficulties. The decision to use Ritalin or any other medication can be made only after careful consideration of information about the student and his or her environment. This decision can only be made by parents and a physician, and in some cases, in consultation with the student.

Given the intensity of some students' behaviors, it is easy to understand why teachers may choose to recommend that parents see their family physician and have Ritalin considered for their child. Educators must never, however, assume they can make a diagnosis of ADD or ADHD, nor may they ever directly recommend that a medication such as Ritalin be prescribed for a student. Furthermore, Ritalin must never be viewed as the first intervention for students who exhibit symptoms that might indicate the presence of ADD or ADHD.

While educators are not in a position to diagnose ADD/ADHD or recommend that a student take Ritalin, teachers can suggest that a student participate in a multidisciplinary evaluation to determine the presence or absence of ADD/ADHD. Teachers may offer diagnosticians valuable information through behavior checklists, frequency data, and anecdotal observations that can help to confirm a diagnosis or assist in making decisions regarding medical management of behavior and/or learning problems.

Responsibility for assuming that educators do not feel that Ritalin is their best- or only- strategy for improving the climate in their classrooms is shared by educational institutions. Colleges and universities must assure that new teachers graduate with knowledge of effective instructional strategies for promoting positive behavior in all children. School divisions must assure that all teachers have plentiful opportunities to develop higher levels of expertise in these areas. These strategies should always be employed in partnership with parents to determine if students can be successful in school before the diagnostics process that may lead to a diagnosis of ADD or ADHD and a prescription for Ritalin.